Redeployed: Columbia Physicians Describe Their COVID-19 Reassignments

August 10, 2020

By Allegra Califano

Both inside CUIMC’s hospitals and globally, COVID-19 has caused major disruptions. When the COVID-19 pandemic first started, Columbia staff was notified that they may be redeployed to medical services. These temporary changes for Columbia’s employees’ occupations were not guaranteed to be directly within their current day-to-day skillset, but rather could have included a training to reacquaint the staff with tasks they had learned in the past and may be doing for the foreseeable future. Now that redeployment has ended, numerous Columbia physicians have shared their experiences with the public.

Columbia providers from many different departments have shared their experiences in popular and academic press. One such article was written by Dr. Nana Sarpong and his coworkers, orthopedic surgeons at CUIMC, who wrote of their experience handling a makeshift-ICU in the Journal of Bone and Joint Surgery. In March, the surgeons, nurse practitioners, physician assistants, support staff and other capable affiliates of the Orthopaedic department were redeployed to the COVID-19 frontlines due to countless original frontline workers falling ill. Many of these healthcare workers have not had exposure to the ICU or the Emergency Room procedures since their training. Although they expected to take on a chaotic war zone with a barrage of coughing, they instead were faced with an eerie silence from intubated patients. They handled the challenges of the makeshift ER-ICU with what an orthopedic surgery resident called the three As: “Availability, affability, and ability.”

Dr. Christopher Magoon, a psychiatry resident at Columbia, and Dr. Ragy Girgis, an Associate Professor of Clinical Psychiatry in the Department of Psychiatry at Columbia University, and Director of the Center of Prevention and Evaluation (COPE) at the New York State Psychiatric Institute, both offerent their redeployment perspectives and insights into the chaos that was COVID-19. 

Dr. Magoon was redeployed to the ICU at NewYork-Presbyterian. The hospitals were flooding with COVID-19 patients that needed intensive care, and frontline doctors were falling ill due to the limitations. All departments of the hospital were redeploying their staff to help in the makeshift ICUs. Even Dr. Magoon found similarities in his day-to-day with COVID-19 patients taking from his experience in internal medicine rotations. “I rounded on patients, discussed the treatment plan with the attending physician, called families for updates and responded to emergencies.” One of the main differences he noted was that all his patients essentially had the same illness: “hypoxemic respiratory failure due to COVID pneumonia.” While treatment options and guidelines were always changing, all the frontline healthcare workers had to constantly be on their toes. “[I am] grateful…for my co-residents and program leadership. They have been nothing short of amazing: responsive, supportive and proactive.”

During his redeployment, Dr. Magoon’s wife was pregnant, due at the end of May. In her own ways, she too was redeployed outside of the city and quarantining while Dr. Magoon battled the frontlines, and even overcame a 10-day bout of COVID-19 himself. (Read a more in depth recount of his experiences in STAT News) Magoon’s experiences highlight how hospital systems have had to rethink what it means to practice medicine and treat patients in psychiatry.

It is important to note that not all of our doctors at Columbia were sent directly to the frontlinesof the ICU. Some redeployment logistics includedmaking room in hospital in-patient units to accommodate for the influx of COVID patients, which required qualified personelle to monitor those discharged patients closely. Dr. Girgis, who specializes in clinical research, was redeployed to do exactly this. As the Director of COPE, he works with children and young adults who exhibit certain early symptoms of psychosis. While some doctors were redeployed to do jobs that were dissimilar from their usual day-to-day, Dr. Girgis’s redeployment made him very qualified for his redeployment position. Dr. Girgis pointed out, “[I] I gained an even greater appreciation for the health care workers who are truly on the frontlines dealing with the horrors of the pandemic.”

Dr. Girgis’s work was mainly accomplished through telehealth, which is becoming the new normal for outpatient healthcare treatment. While his work remained consistent with his current work-from-home full-time position as a Director, his redeployment gave him the opportunity to work with a different subset of clinically high-risk patients. He was designated to help chronic and seriously ill patients. Dr. Girgis participated in and reviewed patients’ status in daily clinical meetings, and he completed follow-up appointments with already-established patients and did intake evaluations for new patients. His experience was positive, despite the underlying and daunting COVID pandemic spreading throughout the city. “I enjoyed my work and I enjoyed seeing the patients,” Dr. Girgis said, “I was reminded about why I went into psychiatry to begin with. I was also reminded about how there is still a large minority of patients who are treatment refractory. This was important and reaffirmed my commitment to trying to find better ways to treat, and possibly even prevent, schizophrenia.”

COVID-19 has also changed the way that medicine is and will be practiced. With many administrative procedures going electronic and with the utilization of telehealth and telemedicine, COVID-19 has influenced the way research and therapy will be conducted for patients. Dr. Girgis made an important point stating that, “for now, the main change is that we are going to have to rely a great deal more on using telehealth for all of what we do in research, clinical work and otherwise.” It is reassuring, however, to know that our doctors are capable, willing, and able to be put up to any task they are asked of, and to perform them to the best of their abilities, despite originally working in orthopedics, psychosis research, or having just started as a psychiatry resident.

 

Allegra Califano, BA is a COPE Clinic Research Assistant and a contributor to Columbia Psychiatry News.

 

 

Topics

Mental Health, Psychiatry

Tags

Redeployment, COVID-19