A few thoughts on outpatient oncology care here in #NYC.
10 days ago, we melanoma med onc @sloan_kettering agreed to cut back in person clinic from 1-2x / week to once / 1-2 weeks. My clinic frequency was quartered. I was excited to leave the apt (I'm allergic to combs).
My commute to work is entirely by foot, and I'm privileged to be able to do so. Ordinarily I walk by hundreds of people in 15 min.
Today, I counted about 30 people. We are successfully distancing! Yay!
The in person visits that remain are the most complicated ones, where infusion and scan review are done on same day. Our (very smart) new visitor policy doesn't allow family members to attend, with rare exceptions.
Skeletal, 50% staff on site in clinic.
So today was...eerie.
No fellows to teach, no RNs entering rooms. Gloves, masks obscuring facial expressions, blunting gestures.
Once inside the room, we spend a bit of time connecting FaceTime on their ancient iPhone so we can loop in their concerned daughter or son. Or futz with the speakerphone.
It's slow and difficult. Bad news hits harder, echoing around the clinic room that's emptier than usual. The buoyancy normally afforded by good news is gone, either weighed down by uncertainty over the virus or dissipated by giving it over the phone ("no need to come in!).
Making decisions for salvage, palliative intent therapy is hard in the best of times. Doing it during social distancing is torturous. We are doing the best we can but I can't be doing it as well as normal, right? BC that would mean my personal touch isn't crucial. Lose-lose.
BUT then I train myself to see the other side of it.
We are striving, and dare I say mostly succeeding, to keep patient care excellent while we all protect ourselves. It's inspiring to see how patients and staff all have adjusted to the uncertainty, clumsy technology, PPE.
And I'm proud that our small team (@DrBetofMDPhD @MPostow @wolchokj and others not here) and our admin, RNs, NPs have nimbly adjusted our entire lives to serve our patients.
I'm proud that others all over the city, country, globe are doing the same.
Even the loneliness of a peaceful walk through Midtown reminds me...
I MISS BUMPING INTO RUDE PEOPLE on my walk to work. I miss you, NYC.
We will do our best to keep our patients well, however possible, until we can get our real, crowded, noisy city back. It's a privilege.
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