This is the first in our occasional series called Portraits in Healthcare to capture the changes happening in healthcare due to COVID-19 as experienced by providers.
Cecile Hollinshead has been a physician assistant in the emergency department for nearly 15 years at Michigan Medicine. As an amateur photographer, she recently got the idea to take pictures of her colleagues behind their surgical masks as a way to show how COVID-19 is changing the practice of medicine. This is her story as told to FierceHealthcare edited for length and clarity.
We are all wearing head covers and goggles for 12 hours. It's not our norm.
Trying to recognize everybody, you have to look into their eyes. Actually, I realized we actually make more eye contact now that we have to look at each other's eyes. You can try to relay a message through your eyes. I thought this could be a powerful message. That's why I did this project.
A few people said, "Sure, I'll participate." And they weren't sure what it was going to come out to. And when I released the first few photos, people were raving about it. Some of the people who told me "No" initially actually came back and said, "I want my picture." To this point, I have 200 photos that I've taken.
(Courtesy photo)
I think it's for all my co-workers that they have something to hold onto and saying, "This was then." Or hopefully: "This was the only time that we're going to be wearing masks and headcovers in the emergency room." But it could be the norm. You never know. That's why I did what I did ...
Initially, my thought was "I didn't sign up for this." The fact we're on the front line means we're at higher risk of acquiring COVID if we don't protect ourselves, if we don't have the proper PPE, and also, without the proper triaging. So I pretty much depend on my colleagues, the nurses and the techs, to make sure the patients coming through the ER are triaged appropriately. So there's definitely more anxiety involved with it. But I feel privileged being at Michigan because they are on top of things. I have to say, in the beginning and even the peak of this—hopefully, we're on the downturn of this—we were having daily meetings online you could call into and listen in about what was going on, what the testing was, the PPE requirements. They opened an ICU at Michigan just for COVID. So they really were preparing and anticipating the worst. That lessens the anxiety about going into work thinking "Oh God. What am I going to do?"
I think our location or our population is not as bad as Detroit. I don't think we're seeing the volumes, but the acuity we're seeing. People are being transferred to us because they don't have enough room or for the critical aspects of it ...
I know at one point we had an appendicitis case that waited eight hours to go to the operating room because they want to make sure the patient is not COVID-positive. I had a patient with acute cholecystitis. That's a slam dunk. They usually take them into the OR in an hour or so. But now they have to wait until the COVID testing to do it.
It's hard to not think about it or change your care when you know that you're taking care of a COVID-positive patient. Now at [Michigan Medicine], we have a phone in each room and we try to get each person's history behind closed doors through the phone. Before I'd just do a heart and lung exam for every patient. But, if I do a lung exam, that increases the risk of aerosolizing. That increases the risk.
Medicine is changing. The way we care for patients is changing.
Are you a provider with a story about COVID-19 you'd like to share for our Portraits in Healthcare series, we'd love to hear it. Please email [email protected]. Please include a photo that can be used with your story and a telephone number where you can be reached if your story is selected.