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A Frontline Physician Reveals Hard Realities of COVID-19

Dr. Christopher Haines shares the comfort and hope he has for the future and lessons learned navigating the uncertainties of the pandemic.

From the start of the pandemic, Dr. Christopher Haines began writing about his day-to-day experiences as a frontline clinician. He would send messages to his colleagues in an effort to motivate them to continue their fight and post essays to social media to put the minds of non-providers at ease. He has now compiled the first six months of his essays into a book, “COVID-19 Essays From the Front”, available now at the Jefferson bookstore and on Amazon.

We talked with Dr. Haines about his book and life on the frontlines of the COVID-19 pandemic.

What has kept you grounded and inspired to write about your experiences throughout the pandemic?

When I became a student mentor in Jefferson’s Humanities Program, I began writing about my medical experiences, both personal and patient stories. I recognized how significant this outbreak would be and started sharing stories on social media. People were comforted and counted on these stories. The writing became more complex as time went on. There are essays on statistical probability, antibody tests, and this summer, with the unfortunate murder of George Floyd, the resulting outrage around that. I was motivated by our department’s chairperson at the time, Dr. Christine Arenson, suggesting that I compile them for a CME course, which we held late in the summer. My friends soon gave me the idea to publish this as a book documenting our shared experiences.

Many of the essays involved a history explaining how we got to where we are today in medicine. How did you decide what needed a more in-depth explanation?

In the beginning, I saw a lot of parallels to the 1918 influenza epidemic. I joined The College of Physicians a couple of years ago, which includes the Mutter Museum. By coincidence, in the fall of 2019, they honored the 1918 influenza with an exhibit on the influenza vaccine, specifically how it played out in Philadelphia. As time continued, essays became motivated by questions that people asked me, and I continue to write today in response to questions. This pandemic has its own narrative and one that we’ll be talking about for many decades, and I hope to capture some of what we were all feeling at the time.

You write a lot about learning about COVID-19 in real-time while treating patients with this. How did it feel writing about things that went against something you had previously said because of new information available?

One of the things we need to offer the public, as people of science and medicine, is that we don’t have all the answers. And we do learn as we go along, and we do employ the scientific method. Sometimes, the scientific method means that our assumptions are going to be wrong. Clinicians are here to help, and in an emergency situation, they can’t hold things back until there are longstanding double-blinded studies. When I collected these essays for the book, I had the chance to remove anything that we had been wrong about. I felt it was important to keep the outdated essays to fully understand the reasoning behind what was going on at that time.

How can you show a patient that they can trust you despite the uncertainties they know you have?

There’s a lot out there, and it’s coming at us pretty fast. I think an open dialogue is helpful, and people respect that. At the end of the day, people understand that we don’t have all the answers, but we’re learning and adapting quickly. I think that’s important as we move towards vaccination, saying, “this is what we know, we feel very strongly that the benefits outweigh the risk,” and they almost certainly will when all is said and done, but we can’t know everything with certainty.

You mention “the need to exert some control over the uncontrollable” in your essays. What has made you find comfort throughout all of this?

I had medical problems as a kid, which is likely why I went to medical school—to try and control the things that felt out of control. As I stated in the book’s introduction, I feel like we all have gone through this during the pandemic. Trying to understand science has always been comforting to me, and that’s what’s given people comfort with these essays. I’ve set myself up as an honest broker that represents things as they are without sugar-coating it but doesn’t say that everybody dies. The driver is really to try to understand it fully, or at least as best we can.

You talk a lot about the misinformation in the news and how many things are spreading that are not true. How did you explain the proper treatments to patients when they’re overwhelmed by this type of news?

Patients are just looking for a good, honest account of the information that we have. I share articles with patients and colleagues evaluating treatments, which has made patients feel more at ease when they see where we are getting our information. I had one elderly patient with dementia who had a grandchild taking care of her. She had questions about the medications, received some misinformation from the internet, and was very against the medications. At the end of the day, we decided to continue the Dexamethasone and stop the Remdesivir, making her more comfortable, which is always a priority.

What would you like readers of your stories to take away?

This is the crisis of our lifetime. I hope my stories bring comfort and help others understand what this is really like. Hopefully, this will be something we look back and say, “this is as bad as it ever got.” But also, I hope that it shows how our behavior can change outcomes. Every illness and death that we avoid is a life saved. We are nearing the conclusion of this, but there’s a lot that we can do to help protect people from needless death during this time. I hope this book gives an idea of how physicians think and shows how we’re just all human and bring our own experiences.

What have you felt is a theme surrounding providing care during COVID-19?

As providers, we’re nimble and flexible and able to expand, contract, and deliver different treatments as they become available and proven or disproven. We understand when a crisis is coming; this was not an earthquake where you don’t have a moment’s warning. We did see this buildup over weeks, and I was incredibly impressed with not only the smarts and hard work but the flexibility of the people I work with.

What is something that you want non-clinicians to understand about working on the frontlines?

It’s rewarding, and I think I can speak for my colleagues in healthcare that we’re glad to be here and provide this service. But, we do appreciate all measures to decrease illness. We went into healthcare to decrease suffering, there are limits to what we can do, and there’s no better way to decrease suffering from this disease than to keep it from happening in the first place. That’s where masking and social distancing, washing your hands and avoiding large groupings play a role.

What has COVID-19 taught you?

It’s made me revisit the basic foundation behind medical care. The pandemic has appended things we took for granted in how the human body and illness work. We were intubating patients when they needed intubation based on what we knew from other diseases. We learned with COVID-19 that it might be one of the last things we should do with these patients. We’ve learned about the coagulation of blood and various lab tests. I’m mid-career, I think we’ll be figuring this out for the rest of my career.

What has made you feel optimistic about the future?

I’ve gotten to work with my colleagues in Hospital Medicine and Internal Medicine. They’re all younger than me and all brilliant. I’ve also met medical students, worked alongside physician assistant students, and witnessed medical students come in to help on committees around the hospital. And we have all treated each other as equals; it’s really fantastic. The younger generation gives me hope. And it’s people like my daughter, who did the artwork for this book, which gives me some hope too.

Dr. Haines’ book, “COVID-19 Essays From the Front”, is available for purchase at the Jefferson Campus Store at 1009 Chestnut Street in Philadelphia and on Amazon.

 

Illustration credit: Chloe Haines

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