Health

The Doctor’s Symptoms Weren’t Typical. Was She Sick Enough to Stay Home?


After the phone call, the young woman was overwhelmed with relief. Later that morning, the head of her residency program called. How would she feel about letting her colleagues know about her diagnosis? This way they might feel better about calling in sick if they had symptoms that didn’t seem that bad. Remembering how important the story about the E.R. doctor had been in her own decision, she immediately agreed. She’d already called the people she interacted with on her last morning at work.

In an email, she described her symptoms and the anxiety she had about calling in sick. “It can be tough to stay home, especially at a time like this, but it’s the best thing that we can do to keep our patients, families and each other safe,” she wrote. Once she hit send, she felt a sense of satisfaction, she told me. But that night, although she believed she was done with this virus, she found that it wasn’t done with her.

On March 21, a week after her first symptoms, the young resident was reading a book when suddenly she felt as if her chest was squeezed tight, as if there was a band restricting the expansion of her ribs and lungs. She’d never felt anything like it before, and it scared her. She stood and felt lightheaded. “I don’t feel good,” she said to her husband. “I can’t breathe.” The suddenness with which this came on argued against its being a pneumonia. Could this be a panic attack? She tried taking deep breaths and relaxing. It didn’t help. She needed to go to the E.R., she told him. She put on a face mask, and the couple headed to the hospital where they worked. The woman fought against a rising sense of panic. Every stoplight seemed torture. There were reports of this virus causing sudden death. Was she dying? Would it just keep getting harder to breathe?

In the emergency room, her heart was beating faster than normal, and she was breathing rapidly, but her oxygen level was fine. “Don’t leave me alone,” she pleaded with her husband and the nurse who took her to a negative-pressure room.

Over the course of the next couple of hours, blood tests were done, and an EKG and X-ray were performed. Her doctors wanted to make sure she didn’t have something on top of her known viral infection. One blood test looked for an increase in white blood cells in her circulation — a sign of a possible bacterial infection. It was normal. The other tests were equally unrevealing. The EKG showed no evidence of heart damage. The chest X-ray showed no sign of a pneumonia. The weight on the young woman’s chest didn’t get better, but it got no worse. Early reports of Covid-19 cases in China showed that some patients who already had serious symptoms suddenly got worse a week or more into their illness, a so-called second-week crash. It’s still not clear exactly what might be causing this late exacerbation. After promising the doctors she’d come back if she felt any worse, the young doctor and her husband went home.

I spoke with the patient on March 26, and she told me she was feeling better. She gets a little out of breath when she climbs the four flights of stairs to her apartment, but even that is improving.

Right now, she’s focused on going back to work — she recently tested negative. Although no one knows for certain if getting the infection provides long-term immunity, current thinking is that she is probably immune to the virus for now. She is eager to return to the fight and, given the proper equipment, is ready to take her place at the very front lines of this war.



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