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with Dr. David Hilden

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A doctor’s diary from a pandemic: We will remember these days

I wrote the following short piece for the Minnesota Chapter of the American College of Physicians of which I am privileged to serve as Governor. I edited it a bit for my colleagues – physicians and all others – at Hennepin Healthcare. I offer it to you here.

We will remember these days.

Some day we will remember standing outside a patient room covered head to toe in hair net, mask, plastic face shield, gown, and gloves. We will remember looking at our nurse colleague similarly covered, look into each other’s eyes, take a deep breath, and walk into that room and once again, for the umpteenth time, be face-to-face with a patient. A patient with COVID-19.

Some day we will remember canceling every CME conference, business meeting, family vacation, wedding, funeral, and family gathering for a whole year and wondered how we will ever re-connect.

Some day we will remember how we learned how to care for our patients over a video connection.

Some day we will remember that crazy time when we put our masks in paper bags so that there would be enough for later.

Some day we will remember taking pay cuts and furloughs so that our hospital and clinics could survive.

Some day we will remember the time when our fellow human beings died without their family by their side.

We will remember these days.

But some day, we will also remember feeling closer to our colleagues than we ever have been and realize that these are our lifelong brothers and sisters.

Some day we will remember that people stood on their balconies to applaud what we do every day.

Some day we will remember that during a pandemic there was still kindness and compassion.

Some day we will remember that we were smart and we were brave.

Some day we will remember that what we do still matters.

We will remember these days. And we will remember what a privilege it is to be a caregiver at Hennepin.

 

 

 

Thanks for reading.

Twitter: @DrDavidHilden

Healthy Matters airs on News Talk 830 WCCO at 7:00 am Sunday morning Central time and streams live at wccoradio.com.

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A doctor’s diary from a pandemic: All about antibodies

Lately many of us are thinking quite a bit about antibodies. When’s the antibody test going to be ready? Can I get a test? Do I have antibodies? Will we be able to give antibodies from one person to another as a treatment? Are antibodies our ticket to resuming our normal lives?

What is an antibody, anyway?

In medicine we talk about antibodies all the time, though I am far from an expert on the subject. I remember learning about them in Immunology lectures from medical school, at least when I wasn’t talking in class. I remember them as Y-shaped thingies in our blood. Yes, “Y-shaped thingies” is the correct medical term. They look like this:

Photo: CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=916435

At least they look that way in the textbook.

Antibodies are the soldiers that live in our blood that fight foreign invaders to our bodies. The really cool thing is that once our bodies have encountered an invader like a virus or a bacteria, our bodies manufacture these antibodies in huge quantities. Those antibodies live in us long into the future so that when our bodies encounter that pathogenic invader at some future point, our bodies recognize it and are able to fight it off much more readily. This is the role of antibodies. When you think of it you may marvel at the elegance of a system that can learn from the past so as to be able to be prepared for future.

But that is exactly what antibodies do. Learn from the past. We as people could learn from our own immune systems about learning from the past!

The big questions in the COVID-19 pandemic may be answered with research into antibodies. So that is why I rolled up my sleeve in the picture above to see if my blood has any antibodies to SARS-CoV-2 (the real name of the COVID-19 virus). I was participating in a research project being conducted at Hennepin Healthcare where I work. The Centers for Disease Control (CDC) is conducting this study at 16 hospital sites around the country to help us understand how the human body is responding to this virus. The study is looking at healthcare workers (nurses, doctors, respiratory therapists, among others) who have been working with patients infected with COVID-19. I guess I qualify. The idea is to see how many of us are developing antibodies.

A quick shout out to Dr. Matt Prekker of Hennepin Healthcare. Not only is he leading the research on this antibody study in healthcare workers, he also is a board-certified doctor in 4 specialties at once: Critical Care, Internal Medicine, Pulmonary Medicine, and Emergency Medicine. Not only that, he is the guy drawing my blood in the picture above and he’s a great guy. He and his team of researchers are worthy of a “thank you” from all of us.

This is really important research. We used to call this virus the “novel coronavirus” because it is indeed novel – new – to the world. Due to that one fact, there was nobody on the entire planet who had any antibodies in their system. That’s also why it is so deadly because nobody has the foot soldiers – the antibodies – yet in place in their blood.

Once we learn more about the human body response to the virus, we should be able answer many of the questions for which our knowledge is currently lacking:

  • Does getting COVID-19 protect you from future infections? We just don’t know but it will depend on the antibody response and how durable that response is over time.
  • Do people develop antibodies even if they didn’t have symptoms?
  • How quickly does the immune response develop?
  • Importantly, can we use the antibodies from one person to treat another person who is really sick?

Vaccine research is based on immune response as well. Vaccines work by exposing your body to a teeny amount of the virus and allowing your own body to develop its regiment of antibodies. So these areas of research overlap.

I’ve heard it said that science will help get us out of this pandemic. Today I got a first-hand look at how that may look and it gives me renewed hope.

Thanks for reading this blog. Subscribe by e-mail if you wish to receive periodic notifications of future posts. My Twitter account is @DrDavidHilden for occasional updates from me as well.

David

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A doctor’s diary from a pandemic: Giving thanks

At my hospital and clinic system, Hennepin Healthcare, we have a method of communication called the Tiered Huddle system. It’s an innovative and really effective way for communication between people in the organization so that problems can be addressed in real time. These huddles happen every day in small work groups and at senior leadership. One feature, every day, is the “kudo” section in which anybody can recognize the contributions of another. It is a way to give thanks.

In the course of my day I see so many people doing so many things to be thankful for so I’d thought I would do a blog-based kudo session. Here are a few of my colleagues who give me great optimism, even though my hair looks like that picture above!

Nurses

I have often said and I truly believe that nurses are the heart of everything we do. So recently I asked one of our hospital nurses how she was doing. She was covered in PPE (scrubs, gown, face mask, plastic face shield, hair cap). You could barely identify who it was with only her eyes showing. In response, she went on to gesture with her hands at the other nurses around the unit. She said with such a great group of nursing colleagues, she was doing “great!” To nurses: thank you for showing that even in the scariest times, a team of supportive colleagues and a positive outlook makes all the difference.

Food service workers

The cafeteria at Hennepin Healthcare is the liveliest place in the hospital. You can always count on the good nature of the staff there. Often you’ll see people singing along to the music that is always playing prominently on the speakers. And the chefs routinely serve up food that is worthy of a great restaurant. But during COVID, things are a bit more limited, for obvious reasons. But our cafeteria staff still manage to provide food options for us in a safe manner (I do miss the salad bar and Chef Donald fixing me up a plate of cajun shrimp!). They still have the music playing and still come to work with their cheerful faces. Only now those faces are wearing masks. To our food service workers: thank you for providing one place in the hospital still available to healthcare workers that is free of worry and full of joy.

Chaplains, social workers and those who comfort

This is a frightening time for many. Not only for healthcare workers but for patients. It is a sad reality that all hospitals need to limit visitors to the hospital during this pandemic. We have done so as well and it is one of the issues we have struggled with the most.

How do you care for a dying person when their family members can’t be at the bedside? And how do you care for those family members? And how do you care for healthcare workers who themselves are frightened and exhausted?

At our hospital, I have seen our group of spiritual leaders and social workers and palliative care workers and patient representatives and ethics professionals all step up with guidance, support, resources to help, and a loving presence. Our chaplains routinely use technology to help families be with their loved ones, at least as best they can when they can’t be physically present. They put on weekly virtual seminars in which healthcare workers can hear the stories of their colleagues, voice their own emotions, and support one another. I’m really proud to work at a place that focuses on “Trauma Informed Care” and to the idea that we are never alone. To our chaplains and others who support patients and families and staff: thank you.

I’ll do more thank you comments in future posts. Lots of people to thank . . . security officers, interpreters, environmental service workers . . . the list goes on.

Hope you are all well! Subscribe to this blog by e-mail if you wish, and follow me on Twitter @DrDavidHilden.

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