FROM OUR FELLOWS
The COVID Pandemic was disruptive to our normal training, but fellows found it to be a very meaningful experience. We had daily morning ZOOM panel discussions and lectures and daily ZOOM informational sessions with Dr. Fuster. Dr. Goldman stayed in touch with each fellow. We provide a few fellow’s impression of their experience.
"I find myself to be very fortunate to have been at Mount Sinai during the time of COVID. The institution and particularly the cardiology fellowship program have been extremely supportive, unlike anything my peers at other institutions have experienced. From Day 1, our leadership and administration were ready and had a plan in place that allowed for accessible care to patients. GME was involved and made sure fellows/housestaff had the support they needed, including allowing for increased Uber usage to make it to COVID shifts in time and hazard pay (which was not requested/demanded). There was never a dearth of PPE. Our nursing staff was incredible to work with in our ICU, and I became closer with our critical care attendings as I learned more about managing the complications of the viral illness. Our cardiology attendings really stepped up, particularly Dr. Croft, who was doing echoes on COVID positive patients for fellows on call. I think, most importantly, whether a fellow was working in the COVID ICU or planning for the birth of a child, our program leadership sincerely cared for our health and protection. Dr. Goldman, Dr. Stern, and Dr. Sharma made sure fellows were being tested, remaining healthy, had access to adequate PPE, and were certainly not being overworked. What COVID taught me is that I'm incredibly fortunate to be at such a program and institution that truly cares about the wellbeing of its housestaff."
Far from hampering my training at Mount Sinai, the COVID-19 pandemic created new opportunities to develop my cardiology skills. For example, working in the COVID-ICUs improved my competence in point-of-care echocardiography, venous and arterial access, and in critical care cardiology overall. Furthermore, working in New York City, the virus epicenter in the United States, has given me invaluable insights into crisis response, effective leadership, scientific inquiry, and the human spirit. The lessons learned during this pandemic have undoubtedly made me a better physician.
Having spent a lot of time in the COVID ICU, it has been a whirlwind of admiration and respect for my colleagues. Seeing how people stepped up to answer the call for help across various specialties has been heartwarming. For the first time, we were no longer consultants but members of the same cohesive primary team.
“Cardiology fellows at Mount Sinai were called to act as ICU fellows and residents during peak COVID volumes. Fellows had the opportunity to master vent management and end-of-life care, as well as engage in new multidisciplinary research initiatives. Our program leadership provided daily updates, incorporated fellows' feedback, and provided ample protection for fellows on the front lines. As the pandemic wanes in New York City, we find ourselves admiring our peers for their compassion and resilience during an unprecedented time of need.”
Benjamin Bier: Is This What I Signed Up For?
Over the last month, almost every medical worker in the world has, at the very least, thought, “Is this what I signed up for?” When I applied to Cardiology fellowship, I was one of the few residents interested in Cardiac Critical Care. My current program, at Mount Sinai Hospital, offered a unique opportunity to integrate a critical care training year into a 4-year Cardiac Critical Care program. I have wanted to run a Cardiac Intensive Care Unit (CICU) since I was a fourth-year medical student, and this program design provided me an unparalleled opportunity to pursue that dream.
Eighteen months into my fellowship, COVID-19 was discovered. We watched in weariness and anxiety as a slow tidal wave enveloped the world. We, the fellows in New York City, waited with bated breath, for the wave to make landfall… and it did.
It felt as though the cardiology services were short-circuited. Overwhelmed by an unstoppable force of infected patients arriving in our emergency room. We sat, alone, waiting for our call to aid in the fight against the seemingly unending flow of patients streaming into the ICU. For me, the anticipatory anxiety of waiting was the worst part: not knowing how it would feel to be in the center of the rip current… and then it arrived. My co-fellows and I were called into the now COVID filled Intensive Care Units (prior CICU) to serve as critical care fellows.
The element of cardiac critical care that has always appealed to me was the unrivaled reliance on teamwork. There is no place in the hospital, in which every single person is as vital to the functional operation, as in the Cardiac Intensive Care Unit. The nurses, patient care attendees, the unit clerks, the cleaning teams, the residents, fellows, and attendings all play critical and essential roles for the unit to function and produce optimal patient outcomes. It turns out, this holds true no matter what disease process we are confronted with.
My first COVID shift was surreal. 26 patients filled an ICU initially meant for 20 patients. The IV polls lined the corridors, to ease the constant burden of having to enter patient rooms. The floor was eerily quiet. Instead of the constant telemetry alarms for VT, Afib, or multiple PVCs, the alarms were few and far between. Instead of dozens of family members lining the family rooms, all were deserted. Patients were left in a soundless unit, alone.
For the first time in weeks, I was focused. I was determined to take care of the patients in front of me. I wasn’t worried about numbers, statistics, or what the politicians were saying on TV that day. The only things that mattered were the patients in front of me and keeping my team safe. I couldn’t treat everyone in the hospital, but I took comfort in knowing that down the hall, another team was doing the same.
The other night, my program director called me and asked if my experiences have changed my career goals. I responded that, if anything, my time in the COVID unit has given me confirmation of my future endeavors. None of us in medicine signed up for being responsible for holding back a tidal wave, however we all did sign up for caring for patients. As a team, we have, and will, continue to treat patients as they come into the hospital, for whatever ailment that plagues them. A single stone cannot hold back a wave, but when combined to build a barrier, even the largest tides can be held in check. Although unexpected, this is undoubtedly what I signed up for.