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Commentary
We're Pediatricians In A Pandemic. We Shouldn't Be Taking Care Of Your Grandparents
Don’t make us take care of your grandparents.
We are pediatricians. We take care of sick kids. We can treat an asthma attack or croup. We know when a newborn needs a spinal tap for a fever or an ultrasound for vomiting. We dream about insulin-dosing for Type 1 diabetes.
We work with amazing nurses who can convince any 4-year-old to take their medication, who immediately recognize when a toddler’s mental status is worsening.
We don’t take care of adults. We are not trained to. You shouldn’t want us to.
Last spring, we were asked to do something extraordinary. We were asked, along with our colleagues in radiology, psychiatry, obstetrics and every other specialty to take care of sick and dying adults. We relied heavily on our internal medicine peers and they coached us every step of the way. We did it and it was hard. It was an emergency that we didn’t see coming and everyone pitched in. You did, too, when you stayed at home and went months without seeing friends and family. Some of you lost your jobs. Many of you lost loved ones. Communities of color, again, bore the heaviest burden. We were grateful for your sacrifices -- they helped us save lives.
Far too many teenagers reached their breaking points and tried to end their lives.
As spring gave way to summer and the last adults left our Pediatric Intensive Care Unit, we filled those beds with children suffering from a new, confusing disease — so new, its name merely described what it looked like, a multisystem inflammatory syndrome in children, or MIS-C. These kids seem to have a delayed immune response to the coronavirus and developed inflammation throughout their bodies.
They had high fevers, swollen, red rashes and abdominal pain as their bodies reacted against an enemy that was long gone. Their hearts stopped pumping efficiently and began to stretch out as their blood pressures became dangerously low. Most of them had been infected with COVID-19 without knowing it some weeks before. We took care of them and happily, most did quite well. It was hard to see them lying in hospital beds and not wonder if they might have been spared the IVs and the injections and the imaging studies if we had done a better job keeping their communities safe.
As summer turned to fall, our pediatric floors turned into way stations for teenagers unable to cope any longer with virtual school and social isolation. We begged our case managers to do the impossible: to find beds in psychiatric and rehabilitation facilities to get these young people the help they needed. We followed the labs on the patients struggling with eating disorders as they regained their strength. We pursued increasingly unlikely medical causes for the patients who suddenly found themselves unable to walk as part of stress-induced functional neurologic diseases.
Far too many teenagers reached their breaking points and tried to end their lives. We administered antidotes to drug overdoses when we could. When none were available, we provided supportive treatments, buying time to overcome the self-inflicted kidney damage, liver failure and hallucinations. It wasn’t hard to imagine that things might have turned out differently had these teenagers been able to go to school, see their friends, work with their school counselors and therapists.
The pandemic changed the illnesses we treat, but at least we were back to treating our patients.
Please, wear a mask so we don’t have to wear one in another dying adult’s room.
Now COVID-19 cases are on the rise again. This time, we see it coming and we know how to stop it. A vaccine is on the way, but it’s not here yet. Please, don’t make us take care of your grandparents again. We’ll do it, because it’s the right thing to do, to help in a crisis — but we’re your last resort, your second string. As pediatric trainees, every adult patient we treat distracts us from learning how to take the best care of your children. This time, the crisis is of our own making. Let’s stop it together.
Please, wear a mask so we don’t have to wear them in another dying adult’s room.
Please, stop socializing indoors with people outside your household.
Demand that the governor close restaurants and bars and gyms.
Demand that our state and federal representatives pass emergency financial relief so that we don’t cause twin, self-inflicted wounds.
We turned the tide once. We can do it again, but time is running out. Let us save our stickers for the kids.
Sam Cohen, Anna Handorf, Vidhya Kumar, Sarah Servattalab, Jeffrey Sumner and Emily Ziady are senior pediatric residents at MassGeneral Hospital for Children.