21of breath. She fretted about it all after-
noon and deep into the evening. When
she came across a story online about
an emergency-room doctor who had
symptoms like hers and tested positive
for Covid-19, she made her decision and
texted the director of her residency pro-
gram. He called her right back.
‘‘Stay home, and get tested,’’ he told her.
The next day, she was tested. By then, her
headache was a little worse. Her muscles
ached a little more. She spent much of
the day in bed. Her husband’s symptoms
didn’t change; he still had the same dry
cough. Neither of them had a fever. Two
days later, she felt fi ne; not 100 percent
but close. She went for her usual run.
↓
Guilt Sets In
Given how well she now felt, the young
doctor wondered: Had she called in sick
for a headache, unnecessarily increasing
the workload on her fellow residents?
There’s an informal motto that says
a doctor should either ‘‘round or be
rounded on.’’ You are well enough to
work until you are sick enough to be in
the hospital as a patient. A doctor should
put patient care above everything else.
A 2012 study found that more than half
of all residents surveyed admitted to
going to work when they were sick with
fl ulike symptoms.
And yet she knew that to go to work
with even the slightest chance of a Covid-
19 infection would be irresponsible. She
hoped that the test would be positive
— that she was right to call in sick even
though she wasn’t very sick.
It took four days for the results to
come back. A nurse from her hospital
called to let her know: She’d tested pos-
itive for Covid-19. Her husband, who
hadn’t been tested, probably had the
virus as well. Both of them would need
to stay home for at least one week after
the start of their symptoms, the nurse
instructed. And before going back to
work, both would have to have a nega-
tive test result.
↓
A Sense of Vindication
After the phone call, the young woman
was overwhelmed with relief. Later that
morning, the head of her residency pro-
gram called. How would she feel about
letting her colleagues know about her
diagnosis? This way they might feel better
about calling in sick if they had symptoms
that didn’t seem that bad. Remembering
how important the story about the E.R.
doctor had been in her own decision, she
immediately agreed. She’d already called
the people she interacted with on her last
morning at work.
In an email, she described her symp-
toms and the anxiety she had about call-
ing in sick. ‘‘It can be tough to stay home,
especially at a time like this, but it’s the
best thing that we can do to keep our
patients, families and each other safe,’’
she wrote. Once she hit send, she felt a
sense of satisfaction, she told me. But that
night, although she believed she was done
with this virus, she found that it wasn’t
done with her.↓
Unexpected New Symptoms
On March 21, a week after her fi rst
symptoms, the young resident was
reading a book when suddenly she felt
as if her chest was squeezed tight, as if
there was a band restricting the expan-
sion of her ribs and lungs. She’d never
felt anything like it before, and it scared
her. She stood and felt lightheaded. ‘‘I
don’t feel good,’’ she said to her hus-
band. ‘‘I can’t breathe.’’ The suddenness
with which this came on argued against
its being a pneumonia. Could this be
a panic attack? She tried taking deepbreaths and relaxing. It didn’t help. She
needed to go to the E.R., she told him.
She put on a face mask, and the cou-
ple headed to the hospital where they
worked. The woman fought against a
rising sense of panic. Every stoplight
seemed torture. There were reports of
this virus causing sudden death. Was she
dying? Would it just keep getting harder
to breathe?
In the emergency room, her heart
was beating faster than normal, and she
was breathing rapidly, but her oxygen
level was fi ne. ‘‘Don’t leave me alone,’’
she pleaded with her husband and the
nurse who took her to a negative-pres-
sure room.
Over the course of the next couple
of hours, blood tests were done, and
an EKG and X-ray were performed. Her
doctors wanted to make sure she didn’t
have something on top of her known
viral infection. One blood test looked for
an increase in white blood cells in her
circulation — a sign of a possible bacte-
rial infection. It was normal. The other
tests were equally unrevealing. The EKG
showed no evidence of heart damage. The
chest X-ray showed no sign of a pneumo-
nia. The weight on the young woman’s
chest didn’t get better, but it got no worse.
Early reports of Covid-19 cases in China
showed that some patients who already
had serious symptoms suddenly got
worse a week or more into their illness, a
so-called second-week crash. It’s still not
clear exactly what might be causing this
late exacerbation. After promising the
doctors she’d come back if she felt any
worse, the young doctor and her husband
went home.↓
Getting Back to Work
I spoke with the patient on March 26, and
she told me she was feeling better. She
gets a little out of breath when she climbs
the four fl ights of stairs to her apartment,
but even that is improving.
Right now, she’s focused on going
back to work — she recently tested
negative. Although no one knows for
certain if getting the infection provides
long-term immunity, current thinking is
that she is probably immune to the virus
for now. She is eager to return to the
fi ght and, given the proper equipment, is
ready to take her place at the very front
lines of this war.Lisa Sanders, M.D.,
is a contributing writer
for the magazine. Her
latest book is ‘‘Diagnosis:
Solving the Most Baffl ing
Medical Mysteries.’’ If
you have a solved case to
share with Dr. Sanders,
write her at Lisa
[email protected].