My COVID-19
Authors: Sondra S. Crosby
Journal: Annals of Internal Medicine (2020)

On Being a Doctor11 August 2020My COVID-19FREESondra S. Crosby, MD, PharmDSondra S. Crosby, MD, PharmDBoston University School of Public Health and Boston University School of Medicine, Boston, Massachusetts (S.S.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-5126 Audio Reading - “My COVID-19” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “My COVID-19” by Sondra S. Crosby, MD, PharmD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I returned home to Boston from a weeklong trip on March 13. When I arrived at the airport and turned on my cell phone, the messages coming through were jolting: Clinics had shut down, patient encounters were converting to telephone visits, my hospital was preparing for a surge of patients with COVID-19, my son had been sent home from his university dorm, and all classes at my university were being taught remotely by video. The pandemic had hit home, and the crisis was happening at full throttle.I returned to a surreal environment in general internal medicine, working several sessions in the newly created “influenza-like illness” clinic screening for COVID-19 after learning to don and doff full PPE. I then moved to attending on the inpatient medicine service. The hospital was unrecognizable. Greeters handed out masks and took temperatures. Most of the familiar medical wards had turned into COVID-19 ones; patients without COVID-19 were housed in postanesthesia care unit bays or observation units, tightly packed and separated by curtains. Some spilled into the pediatric and OB/GYN wards, wherever there was an empty bed. Staff were stretched thin, with everyone unrecognizably masked and shielded and trying their best to practice social distancing. Consults to specialty services were mostly performed over the phone, and the joy of spending time sitting at the bedside getting to know my patients had vanished. Our hospital was the center of the coronavirus storm. At its peak, 7 out of 10 admissions were for COVID-19. I wore scrubs to work as an attending for the first time, changing at the end of the day. I took off my sneakers before entering the house and threw them in the trash at the end of service. I had no social contact.On my second-to-last day in the hospital, I felt a sudden, unexplainable fatigue—nothing else. I finished work, asked the resident to page me with updates, and left early. The next morning, I awoke with a fever, sweats, headache, and mild cough. Not surprisingly, I tested positive for COVID-19. At the testing site, I became confused when someone asked for my address and insurance. Upon my return home, I isolated myself from my family in my bedroom. That was the last time I left my bedroom for 4 weeks.I became so ill. I had drenching sweats, shortness of breath, nausea, vomiting, diarrhea, and incontinence. I experienced confusion—or, more aptly, bouts of delirium. I could not remember how to open my phone. I had hallucinations of lizards crawling on my wall, so I kept my eyes closed. I knew I was dehydrated, with peeling lips and a bone-dry cotton mouth. My husband kept glasses of Gatorade by the bed and brought Tylenol at regular intervals; I did not eat for 5 days. I kept in the prone position as much as possible, something I remembered from the wards. I realize now that my judgment was impaired and that, during this worst time, I should have sought medical attention instead of reassuring my husband that I was okay.The most distressing symptom for me was the horrible odor emanating from my skin, sweat, breath, and urine. It was nauseating and horrid, and I will never forget it. It reminded me of rotting reptile flesh.After the worst phase, I was so weak I could not ambulate or shower without help. I was sleeping 18 hours a day, and my head was in a fog the other hours. I had lost 10 pounds.Once, I fell out of bed, contusing my hip and head. I was terrified of being alone but even more terrified of infecting my family, so I enforced isolation as much as possible.I had dreams and visions of my inpatient service: scores of dead COVID-19 patients being taken down the utility elevator to the morgue and the seemingly nonstop overhead pages of “rapid response team and code blue.” My mind replayed colleagues describing the agonizing and isolating deaths of so many patients.My recovery has been steady but slow. Now, more than 2 months after becoming infected, I am still fatigued and have dyspnea with exertion and musculoskeletal pain. My husband bought a recliner chair to put beside the bed where I have spent countless days. I am in the process of further testing and physical therapy.My brain is not working at 100%, and I still find myself with lapses. I initially couldn't remember passwords to my computer and had them reset. I recently panicked when a pharmacist asked for my DEA number—it was as if it had been completely wiped from my brain. COVID-19 is a mean and humbling illness. We do not yet know the long-term effects.I did not require a ventilator and was not one of the 8000 deaths in Massachusetts. One patient who I had seen for more than 15 years was not so lucky: a woman my age with no underlying risk factors for serious COVID-19. Once I recovered enough to work on my computer from bed, I read her discharge summary, which was waiting in my inbox. Over and over again, I reviewed every grim detail of her more than 40-day nightmare in the ICU, which ended abruptly in an isolated death.The toll of COVID-19 on mental health compounded by quarantine, isolation, and uncertainty cannot be overstated, and the global impact is yet unknown. I have felt fear, anxiety, helplessness, hopelessness, and low mood. I feel guilt. How did I become infected? My mind has repeatedly rehearsed the daily routine of masking, shielding, gloving, and handwashing. I constantly wonder who I may have infected.I don't know when or if I will recover my pre–COVID-19 state of health, but I remain optimistic. Life, including work, has slowed down for me. Like so many others, I am forging a path forward as a human and a healer who has been profoundly impacted by a pandemic in a world that will never be the same, keeping my eyes on the horizon. Comments 0 Comments Sign In to Submit A Comment Author, Article, and Disclosure InformationAuthors: Sondra S. Crosby, MD, PharmDAffiliations: Boston University School of Public Health and Boston University School of Medicine, Boston, Massachusetts (S.S.C.)Corresponding Author: Sondra Crosby, MD, PharmD, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118; e-mail, scrosby@bu.edu.This article was published at Annals.org on 11 August 2020. PreviousarticleNextarticle Advertisement Audio Reading - “My COVID-19” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “My COVID-19” by Sondra S. Crosby, MD, PharmD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Cited by« COVID long » : une opportunité pour approcher la complexité des syndromes fonctionnels post-infectieux January 2021Volume 174, Issue 1 Page: 120-121 Keywords Brain Computers COVID-19 Dyspnea Inpatients Sweat Urine Ventilators Vision Vomiting ePublished: 11 August 2020 Issue Published: January 2021 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...