New York Lung Doctors Rush To Spread Their Expertise To Other Physicians

Apr 10, 2020
Originally published on April 10, 2020 8:25 pm
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MARY LOUISE KELLY, HOST:

COVID-19 is changing the way that lung doctors work. In New York City, hospital pulmonologists are supervising doctors from other specialties, trying to spread out their expertise and treat more patients at once. NPR's Rebecca Hersher reports.

(SOUNDBITE OF DIAL TONE)

ROBERT FORONJY: Hello. It's Dr. Foronjy.

REBECCA HERSHER, BYLINE: Dr. Robert Foronjy is a pulmonologist at University Hospital Brooklyn. And when I called him earlier this week, he was eager to talk, but he was juggling a lot.

FORONJY: Can you hold on one second? Hold for one second.

HERSHER: Foronjy's normal job is to take care of critically ill people with respiratory diseases in the intensive care unit. Usually, there are fewer than 10, but two weeks ago New York state made his hospital COVID-only. Foronjy and his colleagues rushed to triple the number of ICU beds with ventilators, but...

FORONJY: An ICU - what is it? It's people.

HERSHER: Intensive care units require a lot of staff - one nurse for every two patients plus doctors and respiratory therapists and pharmacists to make sure drugs are being administered properly.

FORONJY: So these teams take a lot of resources, and now overnight, you have to double, triple, quadruple these teams. And it's not easy.

HERSHER: There simply are not enough doctors who specialize in severe respiratory illness to treat everyone personally. So all over New York City, hospital pulmonologists are spreading out their expertise by training doctors and medical residents and then supervising them. Dr. Cara Agerstrand is a pulmonologist and critical care doctor at New York Presbyterian Columbia. She says she's supervising multiple groups of doctors and nurses at once.

CARA AGERSTRAND: So I am actually overseeing more patients than I would normally care for. It has an extra level of safety and sort of scrutiny.

HERSHER: She says she's been impressed by how quickly doctors who usually would be fixing broken bones or doing checkups have taken on their new roles. Treating serious breathing problems is hard. People with COVID-19 can get really sick really quickly, for one thing.

AGERSTRAND: Humility is perhaps a very good word for it. I think people have come in with very open mind and very much a willingness to just do what needs to be done.

HERSHER: Still, many New York City ICUs are barely managing to treat everyone who comes in. At University Hospital Brooklyn, Foronjy says it's been hard to find enough nurses.

FORONJY: Nobody spends more time at the bedside than the nurses, so that means the nurses get sick.

HERSHER: This week one nurse at his hospital was so sick with COVID-19, she was on a ventilator. The U.S. military has started sending nurses and respiratory therapists into hospital ICUs in the city to help staff them. And even at hospitals that have managed to keep up with the surge of patients, a lot of people are dying. University Hospital Brooklyn serves a population with a higher than average percentage of diabetes and heart disease, which Foronjy thinks may be contributing to the high number of deaths. This week 10 patients were dying every day.

FORONJY: It's really a high number. It's high in terms of the emotional toll it takes on the staff. I'll be honest. My alarm clock will be set for 6, and I'll wake up 4 o'clock in the morning, you know, with a vivid dream (laughter). So no matter how tough a front we put on, it's affecting everyone from a psychological level.

HERSHER: But there's nothing to do but keep working. Rebecca Hersher, NPR News.

(SOUNDBITE OF ROYKSOPP'S "TRISTESSE GLOBALE") Transcript provided by NPR, Copyright NPR.