As an emergency room doctor, my days are filled with crisis, trauma and very few breaks. At home, my dining room looks like a hazmat zone.
The University of Chicago Medical Center is located on the city’s South Side, where there have been a lot of COVID-19 cases — in early May, we were ranked third in terms of cases by U.S. county — and a disproportionate number of deaths. The new virus accentuates health care disparities. It doesn’t necessarily create them, but it brings them into the light. For the coronavirus, a lot of that has to do with patients with preexisting conditions or poorly controlled conditions. As we’re seeing from the statistics, a lot of those patients are from underserved populations.
The vast majority of deaths from COVID-19 in Chicago — more than 70% — are African Americans, and a lot of those deaths are concentrated in just five neighborhoods on the South Side. We’re looking at that data very closely. Across the country, there’s a much higher mortality rate among African Americans than other groups because of disparities in access to health care.
My lens is through the emergency department, so I’m seeing the COVID-19 patients who have to come to the ER for difficulty breathing or low oxygen levels. They’re very short of breath and can be very ill. It starts with a 911 call. Emergency medical service (EMS) will respond. If the patient has coronavirus-like symptoms, the paramedics will take the needed precautions to safely transport them to a hospital. The hospital will triage the patient based on their symptoms. If they look like they might have the coronavirus, they will be taken to a part of the hospital reserved for COVID-19 patients. These are isolation rooms, where negative air pressure is maintained. There’s an anteroom where we don and doff personal protective equipment (PPE).
As part of my fellowship, I do a certain number of shifts in the emergency department, then a certain amount of time doing EMS activities. I’m also a flight physician with the University of Chicago Aeromedical Network. Sometimes I’m with the Chicago Fire Department on the ground. I’m on call for the SWAT team, so I go to those calls if there is a SWAT callout. Every week looks a little different.
The scrubs I wear at the hospital can get covered in viral particles. If we do an aerosolizing procedure, the particles can spread like a fine spray or even stay suspended in the air for hours. An example would be intubation, which involves placing a breathing tube into someone’s trachea. It gets everywhere — your hair, your glasses, your shoes, even your eyelashes. In China, the doctors wear full-body suits. We don’t have those available, so we use hairnets, eye protection, respirators and gowns. I get pressure ulcers on my nose from wearing the respirator all day. Some days, there aren’t any breaks because patients keep coming for eight hours, 12 hours, however long the shift is. Taking breaks is hard anyway because safely taking off and putting on equipment is time-consuming.
My fiancée, Maria Maldonado ’12, is a third-year trauma internal medicine resident at the University of Chicago. She was one of the first people to volunteer to work in the COVID-19 intensive care unit here, so she’s also around the sickest of patients. She stays in full protective gear all day. But we trust that we have the right PPE and processes in place, and we try to relax at home when we have a chance. Going out to buy groceries and then cooking dinner is our main pastime now. It’s a great way to destress and talk about our day, our challenges and all the things we want to do after things settle down.
We have an extensive decontamination process at home. Some might find it comical. We wear one set of scrubs at the hospital and one set of transit scrubs for the drive home. When we get home, we throw our equipment in a basket and our scrubs in a laundry hamper to be washed. We leave our shoes outside of the house. All our equipment gets wiped down. We jump in the shower and scrub, scrub, scrub. Our dining room certainly looks a lot different these days — it’s more of a hazmat decontamination zone now. We’ve adapted. There are cold zones and hot zones. Outside is a hot zone, the decontamination area is a warm zone and the cold zone is the rest of the house — hopefully.
Rice EMS is really what led me to emergency medicine. I took the basic class my sophomore year, and some of the people in that class are still my best friends today. It’s one of the most unique things about the university — it’s like there’s an extra college called Rice EMS. A lot of us end up in health care, whether that’s emergency response, disaster preparedness, public health or emergency medicine. Those skills translate very well into the professional world. When I interviewed for residencies, all anybody wanted to know about was Rice EMS.
The community support in Chicago has been extraordinary. Lots of people are donating food and drinks to the ER. Some people are donating homemade cloth masks; we use those masks going to and from work. Lately, though, we’ve been seeing more protests. Some people are clamoring to end the lockdown. I think the most important thing is to listen to public health authorities. They’ll be the best guides for when and how to reopen. — as told to Michael Hardy ’06
Hashim Q. Zaidi M.D. will soon wrap up his appointment as an EMS Fellow at the University of Chicago Medical Center. He and his partner Maria Maldonado M.D. ’12 will return to Houston this summer to work in the Texas Medical Center, and Zaidi will be part of the medical direction team at Rice EMS.
Michael Hardy ’06 is a writer-at-large for Texas Monthly. His stories have been published in The New York Times, Wired, The New Republic, The American Scholar and elsewhere. He lives in Houston.