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and myself . With guidance from the CDC , American Medical Association and colleagues , we closed the waiting room and checkout area , and we stopped offering coffee or snacks . COVID-19 PCR testing , vaccinations and phlebotomy were performed in the parking lot with staff in full PPE . To conserve PPE , all COVID-19 testing is performed at 3:00 p . m . daily with change of gloves between each patient . The front door remains locked to prevent unnecessary traffic into the office . To limit face-to-face time patients have in the office ( for their protection as well as ours ), we had patients call the office from the parking lot . The interview portion of their appointment has been conducted from their car , and then they are brought inside for a physical exam .
We hold the doors open for patients . Every touch point , including BP cuffs , EKG leads , chairs , exam tables , etc . is disinfected after every patient . My husband created a plexiglass partition to protect the back office . Patients love the fact that we have gone to great lengths to keep them safe .
Gone were my professional clothes , pumps and white jackets ! I bought seven scrub suits and nurses ’ clogs that I leave in our garage before entering our living area .
Sadly , in April , my contracted housekeeping service informed me there was a nationwide shortage of hospital grade disinfectants and they were completely out ! I brought bleach from home to the office . Fortunately , a patient of mine owns a company that manufactures detergents and disinfectants . He kindly provided me with a generous supply .
In late September , despite taking all known precautions , I developed severe back pain and a low-grade fever . I drove to my office and performed my own COVID-19 PCR in my car . This time , it was positive . I was back in quarantine . The fatigue was scary . For two days , I could not sit up in front of my computer . I developed nausea , diarrhea , cervical lymphadenitis and three days later , lost complete sense of smell and taste . Suddenly , the doctor was the patient ! I considered myself a healthy , low risk individual , but the unpredictable nature of this disease was very frightening to me . I took my temperature and O2 sat three times a day and kept a diary of symptoms . I started Vitamin D , zinc and Zithromax . Lurking in the back of my mind was the thought of my longtime church friend ( who was my high school prom date ) who had just died of COVID-19 , leaving behind two young daughters . I prayed every day that I would not be a victim of cytokine storm . Here I am , an internist who counsels patients every day on the importance of Advanced Directives and I myself was not prepared . Whoops ! With my husband in the kitchen and me in the guest bedroom , we contacted an attorney and created a Financial Will and Living Will by Zoom . Prior to the pandemic , I had never heard of Zoom !
As a family , we found some humor while I remained in my quarantine cell . Texting and FaceTime allowed me to stay connected and help my daughter with her homework . However , teaching my husband how to cook was a challenge ! After oatmeal exploded in the microwave and hard-boiled eggs looked like a poached nightmare , we decided to keep Door Dash and Grub Hub in business .
While dealing with my own COVID-19 illness , I continued to conduct telehealth appointments treating some patients who were suffering with COVID-19 illness at the same time as me . This enabled me to create very strong bonds with my patients . I selectively shared my story with some of my patients and we commiserated together . Patients were excited to share a glimpse of their life with me . Through the miracle of audiovisual telehealth , they took me on tours of their home , showed me their pets , shared their creative hobbies , what they were making for dinner and beloved family mementos ( to name a few ).
A big part of my job is providing education . Many times , a good ear and 10ccs of reassurance go a long way . It was a very humbling experience to be a patient and a doctor at the same time . I will likely continue to offer telehealth appointments where appropriate , even after the pandemic . Thankfully , I did not develop any cardiopulmonary symptoms of COVID-19 . After a few more minor symptoms and consultation with an Infectious Disease Specialist , I was able to return to the office after three weeks of being in quarantine .
So far , during the pandemic , I am proud to have been able to keep the office open and keep my staff fully employed and happy . We haven ’ t skipped a beat ! Several Door Dash lunches and ice cream deliveries helped keep my devoted staff optimistic during this very challenging time . They are health care heroes for me and my patients . We are now fully stocked with PPE , hospital grade disinfectants and COVID-19 test kits . We are armed and ready for a possible fourth surge in positive cases .
As I write this essay , six months after being diagnosed with COVID-19 , I still cannot smell the perfume on my wrist , and my previously cherished morning cup of coffee tastes like dishwater . I am grateful to have received the Pfizer Vaccine Series last month . I continue to pray and remain hopeful for an end to this pandemic and return to some sense of normalcy .
A wise mentor at the University of Cincinnati where I trained once taught me that to be a good internist , one must always be prepared to expect the unexpected . And , at the end of the day , my staff , my patients , my practice and I all had to adapt to the challenges thrust upon us by this novel virus . Despite the challenges the coronavirus pandemic has placed on us as a society and me as a private practice internist , it remains a privilege to have a medical practice and a gift to be able to treat patients .
Dr . Karageorge has been in private practice since 1996 . She is the owner of Louisville Concierge Medicine , PLLC which provides internal medicine services on both an inpatient and outpatient basis .
This essay was a submission to the 2021 Richard Spear , MD , Memorial Essay Contest .
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