Therese Zink M.D.

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A sigh of relief?

I am hoping you are breathing a little easier. The late night comedians talked about feeling 247# lighter. I won’t go that far, but I do see a glimmer of hope.

I want to share with you a section from my upcoming Covid Chronicles: How Essential Workers Cope. I hope to offer this as an ebook in the next month or so and a paperback shortly after that. If you wanted to be informed when it is available, email me.

I have interviewed different essential workers to understand their journeys with Covid, and how they kept going. This is a section from one of my favorites.

Dr. Jackie embodies the essence of a true primary care physician, she is dedicated to her patients and her community. She practices in the rural south, about an hour from the town where she grew up, and the residency where she trained. The region which is largely black was hit hard by Covid, and the state’s Covid response became a political football. “We don’t have all the resources or staff we need to manage the pandemic,” Jackie says, “but we do our best.”

“Unfortunately, with Covid,” Jackie complains, “All the attention is on the hospitals and emergency departments. Granted they are working very hard, but primary care is kind of forgotten. Not only am I dealing with how to help my patients prevent Covid, but I also have to keep managing their diabetes, hypertension, kidney disease, obesity, and all the chronic problems that I’ve managed over the years. Those illnesses put them at greater risk for Covid, so we can’t ignore them just because we are worried about getting Covid. And don’t forget the emotional relationships I have with patients. I’ve heard stories about their kids and grandkids. I often take care of the whole family. I’m attached. And when they’re sick, I worry. When they die, it’s a loss. I have to stop for a few moments at least.”

A level of fear comes from knowing that day in and day out Jackie is being exposed to Covid. She worries for herself, although she is young and healthy. She hasn’t seen her family, parents and siblings or her elderly grandmother because she doesn’t want to risk exposing them. She didn’t go home for Thanksgiving, and at the time of our conversation, she wasn’t sure about Christmas. Although she had received her first vaccine a week before Christmas.

Explaining how to stay safe is a challenge. Jackie talks about the need to be creative. “Patients live in small houses, with extended family.” She tells patients to wear masks inside, scrub down the only bathroom the best they can. She is proud of the way black churches have educated their congregations about staying safe. “Their efforts have been overlooked.” Her congregation has gone virtual, but has a big church and figured out how to rope off every third seat, re-do the entrance and the exit and the communion service so some members can worship together on Sundays. “The pastor says we are reaching a larger group now than we were pre-Covid.” Jackie thinks black churches have a role for helping publicize the value of the vaccine as well.

When she got her vaccine she took a picture of “the shot” going in her arm and sent it to her mom and cousins. “Sure, the history of blacks as guinea pigs is real. So is sterilization of black women and John Hopkins using Henrietta Lachs’s cells, both done without permission. But the worry and distrust has also been perpetuated by the black community. There comes a time for common sense. That time is now. I can say, ‘I look like you and I took the vaccine. You should too.’”

Her mother was worried though. “She told me I should have waited. She reads all the conspiracies shared on Facebook.” It frustrates Jackie that people are so susceptible to the “Fake News.” Jackie believes she has a role as a scientist and a black woman to confront the misunderstandings and old worries. “Times are changing,” she says.

Dr. Jackie described a few of the silver linings that arrived despite the many tragedies that Covid delivered. One of those was a patient we’ll call Ms. V. 

“Ms. V is a role model for who I want to be if I should live until 93.” She took good care of herself, always well groomed, and smelled good. Her hair fixed just so, her makeup nicely applied, her clothes clean and pressed. She drove herself to clinic and survived two different types of cancer. Annually she took trips with friends, even at 93.

She called the clinic one morning and reported a cough and losing her sense of smell and taste, so Jackie directed her to the Covid tent and the nurse swabbed her. When she turned positive. Jackie came down to talk with her. Garbed in her mask, she stood by the car where this time Ms. V rode as a passenger, she didn’t feel up to driving. “We went over the CDC guidelines and warning signs—fever, shortness of breath, chest pain, and when to come to Emergency.” A week later she was admitted to the hospital. Although, Jackie does not care for patients in the hospital, she put on PPE and visited Ms. V in her hospital room. “That’s part of primary care,” Jackie says, “I care about my patients.”

Ms. V was thrilled with the young, black female hospitalist who was caring for her. “You remind me of each other. You should get to know each other.”

Jackie took Ms. V’s hand. “I promise I will. And I’ll pray for you.”

“God will take care of me,” Ms. V whispered with a smile.

Ms. V recovered from the pneumonia. The hospitalist wanted her to stay a few more days for additional respiratory therapy. “But Ms. V needed to get home so she could vote,” Jackie told me. “Voting was important to her. More important than a few more days in the hospital to ensure she was fully recovered.”

She voted on November 3rd and was admitted to the hospital a few days later, but passed from Covid "She lived a long and full life and said it was God’s will. She didn’t want to be intubated.”

After Ms. V’s death, Jackie finally connected with the hospitalist and they reminisced about Ms. V, and what an inspiration she was to both of them. “Maybe we can be there for each other. It was her gift to us both.”

I hope Ms. V lived to know the outcome.

--Photo by Markus Spiske on Unsplash