As a physician in one of the hot zones for the spread of COVID-19, I am haunted by daily encounters with patients and their families who have to make impossible choices.
One day it was a man who does not have legal residency receiving a positive COVID-19 diagnosis and hearing me order him to stay home. He looked at me like I was giving him a death sentence: “What am I supposed to do about work? Without work I can’t afford food, I can’t afford to stay where I’m staying, I don’t have any family here and I don’t have any family who can help me. I do not know how I will survive without work.”
In addition to not qualifying for unemployment or many social services, he shared fears of seeking out other community resources, such as food banks or the local hotel program, because of his immigration status. This patient’s survival extends beyond his COVID-19 infection; every day is centered on survival.
The next day, I saw a patient in acute respiratory distress, struggling to breathe with COVID-19. I went outside the clinic to speak with his daughter. I told her that he was very ill, that he would likely require a ventilator to help him to breathe, that this was the time to say goodbye.
The daughter, tears streaming down her face, turned to me and asked, “Could I have given him the disease? Is this my fault?” She and her siblings were essential workers in a factory without access to protective gear. The front desk staff and I watched, tears now welling in our eyes, as the daughter quickly embraced her father as he was wheeled to the ambulance, not knowing if she would see him again.
I wish I could say these dire circumstances surprised my fellow physicians and care providers. But these are the fault lines within communities like Chelsea, Massachusetts, the disproportionate suffering all too familiar to our medical staff at Chelsea Urgent Care. (cont)