Tag: covid 19

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How Grey’s Anatomy is portraying the COVID-19 pandemic

For those of you that know me well, you know I’m an avid Grey’s Anatomy fan. Not for the medicine – that is usually quite inaccurate. But for the fun drama, and the very deep life lessons. But the first episode of this season (Season 17) was extremely compelling and incredibly accurate. It gives you an inside look to how truly devastating this pandemic is.

 

At one point, the main protagonist, starts listing off the names of patients that died that day. She says of one of her colleagues: “He was fine yesterday. Became hypoxic an hour ago… it’s the fourth patient I lost today. And they are all dying alone.”

 

This is almost the exact dialogue that I had with acolleague in the hospital last week. This is real. And kudos to Grey’s anatomy for portraying it so accurately. At one point, she breaks down because her patients decompensate so quickly and she has no control over it. It is hard to watch, but it is what is actually happening in the hospital at this very moment.

 

I once called a daughter to tell her that her 66-yo father had died of COVID-19. She began to cry uncontrollably. But she kept repeating: “This is all my fault,” because she had contracted COVID while attending a backyard bbq and had passed it on to him (while asymptomatic) before she became outwardly ill. She thought it would be ok since it was outdoors, but she ended up getting it anyway. She gave it to her father, and a month later, he was gone. He died alone in the hospital.

 

I don’t know what the worst thing about this pandemic is – there are too many terrible things to count. But if I had to choose one, it would be that people are dying alone. No one should have to live through this, and we are. So, that’s why doctors and scientists don’t understand the cavalier attitude when people say that we have to open gyms or that they are entitled to go to restaurants. It’s not a right at all. You know what’s a right? Being able to say goodbye to your father in person as he dies.  But instead, he has to die alone.

 

So, if we can contribute in any way, however little, it is to be part of the solution, not the problem. It is our responsibility to do so. If you knew that your actions could keep someone from dying alone at the hospital, I believe you’d make the sacrifice. I hope you believe that too. I hope you live that. Because your actions truly do make a difference here.

 

And with that, I will leave you with this dialogue, which again, is painfully accurate to real life: Meredith: “Marvin Lindstrom just died.” Schmitt: “No, please no.” “I tried calling his wife. Are you with her?” “She wanted to say goodbye to him.” “I wanted that too, Schmitt.” “They were married 62 years.” “I held his hand while he died.”

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Which mask is the right mask to wear?

Do you wear a face covering when out in public spaces? Thank you. But to add another layer of complexity, the type of face covering you wear matters. A recent study from Duke University (my alma mater!) demonstrated that bandanas and neck gaiters may actually be causing more harm than good. The problem is the porous nature of the fabric. The study demonstrates that if you sneeze or talk under a gaiter or bandana, the larger droplets may actually disperse into smaller droplets, which are lower in weight and mass. These lighter and smaller aerosolized droplets are more apt to linger in the air (which is the main avenue by which COVID is transmitted).

Based on the study results, the most protective masks (protecting others from you!) are N95 and surgical masks. But everyone in the world wearing N95 or disposable surgical mask is not sustainable. So, default to a cotton mask; they are still quite effective (reducing your expelled droplets by 10-40%) due to the multi-layers and tightly knit cotton. A good rule of thumb? If you can see through it when put it up against a light or you can blow through it easily, you are not protecting anybody. And continue to socially distance to further reduce your rate of transmission.

Remember, this pandemic has been so hard to contain because of asymptomatic carriers. And masks keep these carriers from unknowingly spreading the virus when they cough, sneeze or just talk.

I know this virus is complicated. But the guidelines are not. Wear a mask. Wash your hands. Socially distance. I’ll share something I said to my own mother the other day: “Just because it’s not convenient for us, does not mean we should ignore the science.” I’m not telling you what mask to wear. I trust and believe you are trying your best. But I want to share the science as it evolves, so you can make an informed decision. This study demonstrates that the right face covering works. And if we want this pandemic to subside, the-right-mask-wearing is the way to do it.

Thanks for listening and spread the word (not droplets). 😉

Love, Dr. Yang

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Do masks restrict your breathing?

Warning! Math coming your way!
I wanted to dispel a common claim that masks disturb breathing.

A coronavirus particle is 120 nanometers (nm) in diameter. Oxygen is 0.120 nm and Carbon Dioxide is 0.232 nm. To interpret these numbers very clearly, oxygen is 1000 times SMALLER than the coronavirus particle and carbon dioxide is 517 times SMALLER than the coronavirus. Meaning that in the same little hole that one coronavirus might be able squeeze through, 1000 oxygen molecules can get in and 517 carbon dioxide molecules can get out.

The pore size in N95 masks is generally 100 to 300 nm. Meaning the average single pore will allow 1667 oxygen molecules in and 862 carbon dioxide molecules out.  Other masks like surgical or cloth masks have even higher pore sizes. Therefore, it is not mathematically sound to say that that a mask restricts oxygen or carbon dioxide flow. In fact, it is impossible. It doesn’t mean that the wearer does not feel restricted (psychological effect), however, the math and physics are not consistent with that feeling.

So why wear a mask? The good news is, you don’t have to worry about the 120nm coronavirus particle itself because the virus collects together in larger droplets from your respiratory tract. The average size of the droplets is 1000 nm. And a mask is quite effective at blocking the droplets you are exhaling, coughing, or sneezing. So, the mask prevents the droplets from your mouth and nose from going anywhere past the mask, thereby leaving no SARS-CoV-2 particles in the air for someone else to inhale.

So woo hoo! By mask wearing, you can breathe freely AND keep you respiratory droplets to yourself. It’s like magic! Except it’s really just math.

We have the ability to end the pandemic in 4-6 weeks if everyone would wear a mask 100% of the time in public! AND we could all get back to our lives of going to the restaurants we love, traveling, going to the beach etc. so the economy would recover much sooner IF WE ALL JUST WORE MASKS!

Wear a mask, save a life. Maybe also your own. And please share the math!

Love, Dr. Yang

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How Empathy Can Save the World

 

“The world is a dangerous place to live; not because of the people who are evil, but because of the people who don’t do anything about it.” – Albert Einstein

 

Growing up, I’d say I had an average amount of empathy. I was a sensitive child, but as far as empathy, my ability to relate to and feel the emotions of others, was pretty average. It was not until I went into medicine, that this ability to sense other’s emotions really blossomed. I believe this happened for two reasons. First, as I stepped into the role of a medical student, then resident, then attending physician, my patients opened up their lives to me. Their deepest insecurities, concerns and triumphs were shared with me during our times together. Their trust in me has touched and opened my heart in ways I never could have imagined. It truly is a privilege to be part of another human’s life with so much trust and faith. The second reason is by observing my mentors. During my 8 years of training (10 if you include pre-med where I did a lot of observation!), I observed, precepted with, learned from, and assisted hundreds of attending physicians. I have to say honestly that each and everyone one of them had the biggest heart for their patients. I have never met a group of humans that has cared so much for others, often in sacrifice of their own needs and comfort. I have seen surgeons perform laborious surgeries going into the double digit hours, hospitalists go for days at a time without leaving the hospital or eating a proper meal, primary care physicians sobbing when one of their long time patients passes, pediatricians literally giving the jackets off their backs or the ties around their necks to their young patients. Sure, there are a few bad eggs out there, there will be in any group of people. But I can count out only on one hand the physicians that I did not have the utmost respect for… and in those instances, they were usually just having a rough day. It is from these mentors that I have learned that understanding and feeling someone else’s circumstances and emotions is what we are built for. And the more empathy that you have, the more connected as a human you will be…. And the more complete life you will live.

 

My first year as an attending has been an interesting one. Not just complicated by the first pandemic of a century, but also in starting a new job in a new hospital with way more responsibility, and staring down the mountain of debt that I have accumulated that is now coming due. And through the challenges and stresses, my colleagues have shown nothing but the highest degree of support and empathy, for myself and the patients we serve. I have never once been let down by colleagues when calling for an sub-specialty consult, requesting a surgery or procedure for my patients, or just for advice. I am so lucky to be in this profession with these people. I learn from them day after day, not only how to be in better service of our patients, but also how to be a better human, a more giving, selfless and compassionate person. As I’ve lived my life and observed human interactions, I have seen how petty and selfish we can be as humans. It’s innate, and we must learn to forgive. But, day after day, I see my colleagues working in the best interest of others, without pause – it has become instinctual… or maybe it always was. They think long and hard (so much longer than most) about other’s perspectives. They feel sorry when they are unable to help more based on circumstantial constrictions out of their control. Truly sorry. And often truly heartbroken.

 

I have been continually impressed with my colleagues and how they have risen to this occasion – volunteering for COVID specific units and traveling to hospitals in NYC, Seattle and New Orleans where the pandemic is worst to volunteer. In fact, I applied to volunteer in NYC during a 5 day period that I had off from the hospital… I waited and waited, only to find out they had enough volunteers already. I was both disappointed that I wouldn’t be able to contribute, but so proud that so many of my colleagues stood forward and rose to the occasion. Who else does this? Sacrifices themselves and purposely puts themselves in harms danger, without seeking compensation or recognition, to help their fellow human being? I know so few, or at least thought I did. But indeed there are hundreds, if not thousands, of health care workers that are doing just that. That is the medical profession. This is why we did this. Sacrificed a decade of income, comfortable lives, retirement savings, only to work tirelessly in the trenches with inhumane hours, little to no sleep, crippling debt accumulation, just to ensure the health of others. It is incredible, and I am humbled day after day by their example. It makes me want to be a better doctor, and it has undeniably inspired me to be a better and more empathetic human, volunteer, and citizen of the world. It is humanity embodied. And I am so grateful to be a part of this group, I am grateful to learn from their intelligence, hard work and empathy daily. It, undoubtedly, has made me a better doctor, friend, and human. I am so grateful to call physicians my colleagues. Those that are able to see the dangers in life, and do something about it.