medical service at UMCNO; because my age put me in the high-risk group for experiencing severe complications or death if I were to contract the disease, it was no longer safe for me to have exposure to patients—or to almost anyone, with the exception of my wife. It was fortunate that I left the hospital when I did because later that evening, my service admitted its first COVID-19 patient. I transitioned to working from home as of March 11, 2020, and on March 16, pursuant to the closure of schools statewide ordered by Governor John Bel Edwards, the LSU Health Sciences Center (LSUHSC) began allowing those employees who could work from home to do so. One week later, Louisiana was the fourth state to receive a federal major-disaster declaration, and Governor Edwards enacted a statewide stay-at-home order, although LSUHSC was recognized as essential and never officially closed its doors. During this time, just like in the aftermath of Katrina, we had to scramble to adapt in order to function in this new reality; however, unlike Katrina, the problem of COVID was not localized to New Orleans, and there was no one outside of the city who could come and help us, or even send supplies, because they were all dealing with the exact same crisis. Like everyone in every city, town, country, and continent on earth, we had to figure out how to handle this on our own. Moreover, unlike Katrina, which hit New Orleans and then was gone, leaving us to try to rebuild our city from amidst the wreckage, the pandemic is a catastrophe that has not gone quickly away, leaving a vast trail of ruin and a finite number of deaths as its lingering echo. No, the pandemic has held the U.S. for a year in its ever-tightening, ever-deadly grip, with spiraling death tolls that seem to know no limits and an unremitting social isolation, among other tragic consequences. The challenges that COVID-19, then, has presented to the LSU Department of Medicine are the same challenges mirrored in medical centers throughout the United States and all over the globe, a knowledge that is peculiarly comforting and of no solace whatsoever all at the same time. CHALLENGES FINANCIAL DIFFICULTIES Like the vast majority of both individuals and businesses throughout the world, the LSU Department of Medicine experienced a substantial impact to its economic well- being due to COVID-19. Paradoxically in this time of tremendous medical need, our physicians’ ability to treat patients actually diminished due to the fact that the UMCNO Medicine clinic was all closed for some time. Furthermore, fear of contracting COVID-19 kept many patients away from the hospital and our clinics, even when the latter were open. In addition to a decreasing patient population, the department lost several high-producing faculty during this time: one died, two retired, and three left the department. At the same time, the LSU School of Medicine instituted a
hiring freeze, so we were unable to either replace our lost faculty (and staff) or hire faculty/staff to fill new positions and needs. Although our department is now, thankfully, on a financial footing that is comparable to pre-COVID levels, the fiscal difficulties of the past year certainly added to our complications.
A DEARTH OF MORALE
Like most people throughout the whole of the country and much of the world, the members of the LSU Department of Medicine experienced a plummeting morale beginning in mid-March 2020. Initially, this was impelled largely by fear. At that time, people were unsure exactly how the virus was spread, and the risk of serious illness and possibly death seemed to be lurking everywhere. This fear was only exacerbated by the concurrent social isolation it necessitated, quickly transmogrifying the world into amuch more frightening place than most of us had ever known it to be. In those early days, there was a belief that this isolation would last twoweeks…then onemonth…then two…. But as time spooled relentlessly out to encompass a no-end-in- sight future, the sharp fear settled into a dull numbness, and morale remained largely nonexistent. Practical matters soon became paramount. While LSUHSC was fortunate enough not to have to lay anyone off, throughout society so many of those who had jobs (including many of our own spouses and other loved ones) were terrified that they would lose them; those who lost their jobs had no idea how they would be able to find another one and, failing that, how they would be able to afford basic necessities like housing and food. People worried about their children and the many known and unknown ways the gaps in their education would come to affect their futures. People worried about their own health and that of their loved ones. And, still isolated, they worried alone. Others—far too many others—died alone. Depression and anxiety were ubiquitous and inevitable.
PROBLEMS SPECIFIC TO PHYSICIANS AND OTHER HEALTHCARE WORKERS
While everyone has been subject to a loss of morale during this pandemic and so very many people and businesses have suffered in their economic outlook, there are a number of problems that are either specific to or heightened for physicians and other healthcare workers during a public- health crisis. The aforementioned depression and anxiety were certainly exacerbated; health professionals have been fearful of the same threats to their own physical well-being and that of their families and other loved ones as anyone else, but unlike most people, they are not able to have any remove whatsoever between themselves and the disease, any illusion of safety. There is no social distancing for those on the front lines in the war against a pandemic. And as has been widely reported, many physicians, nurses, and 45
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