Medical doctors and frontline workers have had to work under extraordinary circumstances during the COVID-19 outbreak. Here’s one story.
Pooja Patel’s COVID-19 story is stunningly unique. As a medical doctor who spends two weeks every month taking care of COVID patients, Patel’s life is unimaginably hard. But when she’s off duty from the hospital, Patel has another challenging tour of duty as co-owner of Zaika, a modern Indian restaurant in midtown Manhattan struggling to stay afloat in the aftermath of the lock-down. COVID-19 has hit everyone hard, but Patel has had a double whammy.
A typical workday for Patel the hospitalist actually starts the day before, when she drives two hours from her parents’ home in New Jersey to a hospital in Reading, Pennsylvania. The morning of her duty, she dons an N95 mask, goggles that leave deep imprints on her skin, a face shield, and a bouffant cap. On most days, she knows that she’ll be dealing with a COVID positive patient. “You’re right there, you’re face to face, and when you examine them, they end up coughing. Even with one cough, you can feel the fear,” said the doctor.
“But I can never leave them. I will do everything I can.”
The end of the long day involves cleaning every single thing she touched. During the peak of the epidemic, Patel saw many patients pass away without anyone beside their beds. No visitors are allowed for coronavirus patients, so it was she who served as the link between the dying and their families – a superhuman ask from a doctor – but she did it, on repeat. She watched some of them get progressively worse and berated herself for not being able to do anything at that point. Hospitalized patients with COVID have higher mortality rates than those who did not end up in hospital.
While the life of the ER doctor is tough, so too is the life of a hospitalist like Patel who provides “comfort care” to patients, knowing all too well that some of them will not make it. But unlike in hospice care, COVID-19 wards require strict isolation, leaving frontline healthcare workers like Patel having to play the role of an extended family member who connects COVID-infected patients with their families over the phone, on Facetime, one last time. In some cases, healthcare workers have had to read the last rites to some patients.
“What we see with COVID patients is that they don’t look that sick,” Patel said. “Happy hypoxia” means they smile, despite having very low levels of oxygen, but then they crash suddenly. “Some of them have seizures and their mental states can change dramatically,” Patel added. The only respite for them is to be able to talk to their families. For most, the hospital allows a 5-minute last-visit by single-family members, well-protected with protective gear, one-at-a-time. But 78-year-old Dan Larken’s [name changed] case was different.
Larken was hospitalized with COVID along with his wife, who was also infected with the virus, in the next room. For most COVID patients, as conditions get worse, patients’ lungs are overcome by COVID-19 infection and they are unable to breathe on their own, their oxygen levels drop to dangerous levels. Using ventilators would be the last attempt to save a patient whose lungs are giving up, and in order to ventilate them, they must first be “intubated” – a process which involves using a high dose of muscle relaxants to sedate them so that a doctor can insert an endotracheal tube down the throat.
But Larken would have none of that. He decided not to go into intubation, changing his status to hospice care instead. He just wanted to be with his wife, knowing that he might not make it anyway. So Patel and her colleagues arranged for the two to have breakfast together, in the hospital. Larken passed away not long after that, and for Patel, the couple left a lasting impact on her psyche. It was one of the most painful episodes of her life as a doctor.
By now, everybody knows that the coronavirus has no treatment; but none so much as the patients themselves, and the doctors working on the frontlines of the pandemic.
“Every day has been a challenge; you’re trying to learn every single day about what’s new. We just want to save as many people [as we can],” said Patel.
As for her own life, in the initial days of the pandemic, Patel would not go home at all to keep her parents safe. She parked herself permanently in a nearby hotel and would shuttle between the hospital and her hotel room after every 12 hour a day shift. She still follows this routine for two weeks every month.
Meanwhile, Patel’s entrepreneurial venture was spiraling as well. She co-founded Zaika, an Indian restaurant, in Manhattan. She caught the entrepreneur bug from her father, says Patel who attended medical school in India and spent 7 years working as a doctor; working alone in the US for most of that time and bringing over her parents later. “My dad was an entrepreneur too – I’m a Patel,” she said. And so, she took the entrepreneurial leap.
The idea behind Zaika was to create a space and connect with people through food. Patel helped with marketing and invested much of her savings in the business, armed with only the hope that it would fly. And for a while, it was wonderful. She developed a network within the community.
“It was so wonderful for me, I built such amazing friendships through Zaika,” she said. Business helped her focus on something outside of medicine. The restaurant was breaking even and would typically generate high revenue during the summer months. Plus, Zaika would often be packed during big UN events, which is just a stone’s throw away. So Patel was optimistic about this March as well, but that’s when COVID hit, sending the restaurant industry into a tailspin.
“All of a sudden everything is taken away from you,” Patel said, pensively. “I lost all of it.”
Zaika did not apply for New York’s Paycheck Protection Program (PPP) because she didn’t believe it would be worth it for them to open the restaurant, even if only temporarily for pickup. Patel and the team pay high rents to maintain a restaurant in this part of the city. And so, she listened to many seminars and kept herself up to date with COVID developments at the hospital, while also noting what members of the New York State Restaurants Association (NYSRA) were saying about the future of the restaurant industry.
“We owners don’t even get unemployment,” Patel explained. “Then there’s the new reality of whether or not people will be mentally ready to sit in a restaurant setting. So the only thing to do is to close Zaika.”
For Patel, being a woman of South Asian descent has been a blessing on many fronts. But she often feels the downside of a “cut-throat desi mentality” in the restaurant industry, which does more harm than good. “Everyone’s pulling each other’s legs down, instead of helping,” she said.
But Patel is hopeful that what binds people together is a stronger force. There are so many examples of South Asians coming together during the pandemic, handing out PPEs to medical workers, donating free meals, she says. She is also vociferous about her views on the need for racial justice and recently took a knee along with other colleagues at the lawns of her hospital. “While coats for Black lives,” she said.
Despite all that’s going on with her life and in the country, Patel takes care of her own mental health and her parents’. “I realized I didn’t want to start living my life only once I got married; so I did so much for myself that would make me happy, like buying a home, car, traveling and venturing into entrepreneurship,” Patel said, referring to Zaika. “I slowly started to discover myself and realized the power of being by oneself.” The days she spends alone in the hotel to work at the hospital are long, but she’s so tired at the end of the day that she has no time to think about anything beyond her work.
After much contemplation, we asked Patel again what she thought was the final word on her restaurant’s future. She talked with a heavy sigh, reflecting the hopelessness of the mother of a very sick child, or the partner of a COVID patient, knowing very well that they might not make it.
Read other stories of women on the front lines of COVID