Deadline Detroit | Book excerpt: Young Detroit doctor shares scenes and emotions from the Covid ‘warfare’ at Henry Ford

The first year of Selina Mahmood’s neurological stint at the Henry Ford Health System was frightening, historical, and unusually educational.

The daily experiences were so vivid that Covid escalated quickly that the trained doctor kept a diary and turned it into a book called “A Pandemic In The Residence: Essays From A Detroit Hospital”.

It is part of the diary of an eventful March to December last year and part of the essays with philosophical reflections and literary references. Quotes and name checks include Yeats, Joan Didion, Noam Chomsky, and Vladimir Nabokov.

Dr. Selina Mahmood: “I was scared. … I wavered.” (Photo: Facebook)

Dr. Mahmood recalls the terrifying reality of a turning point last spring:

It is the evening of March 24th and my neurology co-interns and I have been notified that we are being “reinstated,” that is, being pulled out of our current rotations to create a new Covid floor. I’m not going to lie, I was scared. I won’t lie, I wavered. … Damn it, it really feels like we’re going to war. …

The hospital has basically become a Covid center. There is concern that Detroit and Chicago will be the next New York to get the worst of it in the US

The neurologist (brain and spinal cord specialist) was born in Detroit, grew up in Bloomfield Hills, and graduated from the University of Michigan in 2012 with a degree in history, which she remembers as “a past life”. She completed her medical degree in 2016 at a college in Lahore, Pakistan.

The 176-page paperback, published May 18 by Belt Publishing of Cleveland, is touted as “Your Personal and Meticulous Document of an Unprecedented Year in Medicine.” The publisher adds:

In the tradition of writers like Oliver Sacks and Paul Kalanithi, Dr. Mahmood unravel the science of neurology and weave it into poetry, exploring theories of mind, Pakistani-American identity, immigration, family, the history of medicine and of course, the challenges of becoming a doctor amid a global health crisis.

The main campus on East Grand Boulevard (Photo: Henry Ford Health System)

The young doctor remembers how “the bolts are emptied if we try to understand everything” in mid-March 2020. She describes a sudden blizzard of new hospital routines and learns that “it is difficult to maneuver in protective equipment”.

Our administration is preparing for the worst and creating more intensive care units. Whole floors are dedicated to Covid patients. … It was about ten overnight [emergency] Codes distributed on the various Covid floors. … The hospital’s first COVID-19 death has occurred. …

Every time I feel like I’m overly dramatic, something triggers a reality check. Doctors and health workers have spoken with their partners about code status – that is, whether they want CPR and intubation.

In an exclusive excerpt from her last chapter, Dr. Mahmood, how to wear “goggles” [makes me] Always feel like “Amelia Earhart” and, after vaccination, feel that “the end is not the end”.

“Covid cases are starting to rise again”

It’s finally warm outside. We got through our internship year – the interns who experienced the pandemic. I’m sure this will be a good story towards the end of our lives when we’re wrinkled and plugged into dialysis machines that baseball caps allude to the earlier part of this century. A new intern … will be surprised to find someone who has lived through something only read about as we look at the rare person who made it through the Spanish flu.

(Cover design: David Wilson)

July marks my transition to my second year of training. The [pandemic] The epicenter has moved from the Midwest and Northeast to Florida, Arizona, and California. …

The two competitors for mRNA vaccines are Moderna / NIH and Pfizer / BioNTech. The vector viral vaccines are Johnson & Johnson and the University of Oxford / AstraZeneca.

On July 14, Reuters reported that the first phase of the study for Moderna, which was the first in large-scale human studies, is both safe and effective. … The US signs a contract with Pfizer to supply vaccines by January. …

Things have returned to normal in the hospital, except for all the masks and virtual ones [instruction]. During life

With health workers maintaining a degree of normalcy, most of human existence has changed – my family and friends had to work and study from home for months at this point.

Why does this feel so abnormal and what was normal in the beginning? It’s strange that it means so much to be able to go out of the house. On the other hand, all roads lead to movement. …

“Distorted sense of time and existence”

It’s August and I have my first two weeks of night swimming when we work night shifts from 7:00 p.m. to 7:00 a.m. The exhaustion sets in on the third night, the lack of natural light contributes to a distorted sense of time and existence. …

Pfizer is expanding the number of people participating in the Phase 3 trials of its vaccine. According to the New York Times (Sept. 28), the number of coronavirus deaths worldwide has passed the one million mark.

I’m back in the night for the first presidential debate on September 29th. My senior [physician] and I’m laughing at one of the most ridiculous American presidential debates in history. One of the patients on the floor is admitted for a transient ischemic attack (colloquially known as a minor stroke) after his stress level shot through the roof during the debate. …

“I feel like Amelia Earhart”

AstraZeneca and Johnson & Johnson restart their suspended vaccine clinical trials [in October]. Thirty-four editors of the New England Journal of Medicine are publishing an editorial entitled “Dying in a Leadership Vacuum,” which is trending in a matter of hours, on October 8th. She criticizes the Trump administration for “taking a crisis and turning it into a tragedy”.

The Covid cases are starting to rise again. A new Emergency Ordinance will be issued which will restrict social gatherings.

The intensive care units are preparing again and the plastic partitions come back up. Steroids work well before patients are vented, but once patients are vented we have limited treatment options that actually work. In addition to the masks, we have to wear goggles and I always feel like Amelia Earhart.

I’m canceling my plan to attend my best friend’s wedding, which I never imagined.

It’s November and we’ve had our first snow. I meet the new interns, faces that I have never seen behind surgical masks and who still empathize unadulterated with their patients. As a second year I’m exhausted and superficial.

A new intern sits by her patient’s bed, the patient’s hand in hers, as she tries to calm him down from an apparent panic attack. … I am surprised to remember it was only a year ago when I followed a patient’s readmission to the hospice floor and put my hand over his deathly heart.

“The absurdity of reality”

Dig in your heels, clap back. I have to purposely slow down instead of rushing from one counseling session to the next. Time can come and go, but moments remain.

It’s mid-December and the vaccine has been approved and shipped and our hospital has started vaccinating. …

Events and months and now years roll out like coins. … The years in my life have turned into a bloody tally and I feel trapped between the absurdity of reality and the desire to feel protected and closer.

Some days I’m forever enough to make it all last. Most days I’m not enough to make it through that final explosion, but most days most don’t believe in life or death or death or life. You just make it to the end, completely endless – that’s really my only goal: to be endless to the end.

Most days we fight with numbers and words against what we know as death. It’ll take a minute to figure out what it’s all doing, all the talk of no won’t free anything; Until then, we just need to create space between words and thoughts, with a stupendous gentleness that moves through the night, trying to fill the space forever.

It’s December 22nd and my father and I were given the first dose of the Pfizer vaccine. It’s December and the UK has a new type of Covid. If it feels like the end, it’s not the end.

© 2021 by Selina Mahmood

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