ER Doctor Saw COVID-19 Devastate New York. Now, He's Doing It Again In California

Jul 23, 2020

Dr. Louis Tran, an emergency physician, spend much of May in New York City ICUs treating patients with COVID-19. Now, he's back at home in San Bernardino County in California, fighting the same virus on a different coast.

This week, California surpassed New York and became the state with the highest number of COVID-19 cases in the country. But the deaths are far lower, in part because the majority of new cases are young people, who are not at an increased risk of severe illness and are less likely to die from the virus, according to the Centers for Disease Control and Prevention. Gov. Gavin Newsom reimposed restrictions on some indoor businesses, including restaurants, wineries, movie theaters, family entertainment centers, zoos, museums and bars on July 13.

"It's difficult when you're just being bombarded on a daily basis," Tran says. "COVID-19 is a different animal and there's a lot of us who are wondering how it's going to look when we really get hit."

He says some of his colleagues are experiencing what he would describe as symptoms similar to PTSD.

"I've had professional colleagues tell me that they're not sure that they could handle a second wave if it would hit again," he says. "They are so overwhelmed."

On Morning Edition, Tran describes what it's like for his colleagues at Arrowhead Regional Medical Center and how doctors are handling working during the pandemic.

Here are excerpts of the conversation.

On the impact the pace of work is having on him

Just because we're physicians does not make us not human. ... Obviously we're fearful of not caring for our patients but we also are concerned for our families and friends. I haven't seen my mother in months. The only time I saw her was one time when she injured her knee and I came over to examine her from a distance. But other than that I haven't seen my mother personally in months. We FaceTime. I haven't seen my friends who are older or who have significant comorbidities in a while. And I do miss them. I miss the community of people that we all need. ... It is definitely putting a stress on all of us. Our staff is short. We are asked to cover more shifts. Just the emotional and physical demands of the job itself — forget about the impact of the disease on your psyche. That itself is already putting a toll on a lot of us.

On long doctors can operate at this pace

How long can we deal with this? The short answer is as long it needed to be. The bottom line is that if there's a need, we'll be there. Someone has to be there. That's the calling of emergency medicine and we answer the call 24/7. Someone always has to be there. But it can be a little taxing on the body and soul. But we all agree that we will always be there.

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RACHEL MARTIN, HOST:

All need days off - right? - especially now when work and home are so intertwined. And we are all under so much stress. But not everyone can do that.

LOUIS TRAN: Well, today's my day off. But unfortunately, the hospital needs me to come in because we are short on staff. I have a dental appointment. So I told them I will come in after my dental appointments.

MARTIN: This is Dr. Louis Tran. He's an emergency physician at Arrowhead Regional Medical Center in San Bernardino County, Calif. That state now has the highest number of COVID-19 cases in the country. But months ago, the crisis was in New York City. And Dr. Tran was one of many doctors from around the country who went to help out in New York's ICUs. Now he's going through it again back home.

TRAN: It's difficult when you're just being bombarded on a daily basis. COVID-19 is a different animal. And there's a lot of us who are wondering how it's going to look when we really get hit. We're seeing patients trickling in. But if we get hit with the same numbers New York did, I'm not sure if we could handle it any better or any differently.

MARTIN: There's not a lot of time for self-reflection in an ER or an ICU. But have you been able to have more personal conversations with colleagues about how they're coping? And are you able - because you have been through this before in an even more intense environment, are you able to give guidance?

TRAN: I definitely encounter professional colleagues who are experiencing, as best I could describe it, something similar to PTSD. I've had professional colleagues tell me that they're not sure that they could handle a second wave if and when it hit again. They were so overwhelmed.

But like I said, back then, they didn't have much chance to think over it. Now that they have a chance to think about it - you know, when it's just kind of rolling around your head, your imagination kind of take over. And it becomes a little bit more difficult when you're just hit with it fast and hard and you don't have a chance to think. Your training takes over. Your reflexes take over. Your intuition take over and, in a sense, at times, better that way.

MARTIN: So even though there might be a reprieve, you're saying it's in that space - even though they might need it just for their own mind, soul and body - it allows for self-doubt or emotional stress to creep in. Whereas, when you're just in the thick of it, you can block it out.

TRAN: Yeah. I mean, just because we're physician does not make us not human. You know, we have our foils. We have our deficiencies as well and so forth. Obviously, we are fearful of not caring for our patients. But we also concern for our family and friends. I haven't seen my mother in months. The only time I saw her was one time when she fell down into her knee. And I came over to examine her from a distance. But other than that, I haven't seen my mother personally in months. We FaceTime.

I haven't seen my friends who are older or have more significant comorbidities in a while. And I do miss them. I do miss the community of people that we all need. Fortunately, for me, I do have my community at the hospital and at work. And that is very helpful. But it is definitely putting a stress on all of us. Our staff are short. We are asked to cover more shifts. Just the emotional and physical demands of the job itself - forget about the impact of the disease on your psyche. That, itself, is already putting a toll on a lot of us.

MARTIN: In light of all of that, how long can you operate at this pace? I mean, I hear in your voice you're committed. You do the work. You go in. You do what needs to be done. But back in the spring, we thought this was going to be a few months. And then it was going to be over. And now, I mean, we just don't know. How much longer can you and your colleagues just keep going?

TRAN: How long can we deal with this? Well, the short answer is that we - as long as it needed to be. The bottom line is if there's a need, we'll be there. I mean, there is - who else (laughter)? Someone has to be there. That's the - you know, that's the calling of emergency medicine. We answer the call 24/7. Someone always has to be there. But, you know, it can be a little taxing on the body and soul. But we all agree that we will always be there.

MARTIN: Dr. Louis Tran, an emergency physician at Arrowhead Regional Medical Center in San Bernardino County in California. Thank you so much for talking with us. We really appreciate it.

TRAN: It's my great pleasure. Thank you so much for having me. Transcript provided by NPR, Copyright NPR.