Choi Won Ho, initially a surgeon, works at Masan Medical Center which is a COVID-19 exclusive hospital. Instead of carrying out surgeries, he is treating COVID-19 confirmed patients. Sisain asked Dr. Choi to share with our readers his daily journal at the frontline against COVID-19 . “I do not think I deserve any more attention than anyone here in the field” he said, turning down Sisain’s initial request. But after the subsequent request, Dr. Choi accepted the offer saying, “I will try to write this journal for the sake of the public” In the following, Sisain presents the daily journal of Dr. Choi based on his writings and interviews.
No one knows where life will bring you. It’s hard to predict. It was March 13th that I was told that I may be infected by COVID-19. It has been three weeks since I have been seeing COVID-19 patients. When I heard the news that I may be infected, the furious public was not what made me afraid. Rather, becoming the ‘first patient’ of this medical center concerned me more. Testing positive meant cohort isolation. The isolation quarantine of the entire medical center. And cohort isolation naturally meant a vacuum of medical labor force. Knowing the consequence, I acted extra carefully, wishing that I did not add any extra burden to my colleagues.
It was then that I decided to record my daily life in the center. I started recalling my memory from March 11th. I did not want to put people around me at risk by not being able to remember who I physically contacted. First, I was staying in the medical center accomodation, so there was no physical contact with anyone outside the center including my family. In this journal I wanted to keep track of the people that I encounter inside the center, my body condition, and the days in the COVID-19 exclusive hospital. This is a weekspan daily journal starting from March 11th. I hope this writing will encourage the front line medical workers fighting COVID-19 to share their anxiety and worries
3/11 I had a few drinks with my colleagues.
It was the day when an influx of confirmed patients came in at once. Everyone from staff in the infection control team to the chief physician were suffering from a heavy workload. My colleagues and I had a drink at the end of the day with bindetuk and beer that my senior colleague brought. It was the first and the last get-together since I started working in the COVID-19 ward.
It was three weeks ago when the first COVID-19 confirmed patient was hospitalized in our negative air pressure room. And since then, the name of our center started to be mentioned in the news. Inquiry calls came in without a break. There were calls from family members of hospitalized patients asking whether it is okay for patients to stay in the center or whether this virus will affect surgery schedules. But as much as the family members, medical staff were frustrated as well. Back then, our center did not have an infectious disease division, meaning we neither had much data about the disease nor the manual to combat the disease. The chief physician of the infection division literally lived in his office for a month. He had to assign workforces into the screening center, emergency room, and negative air pressure room. He also had create a manual on how to manage suspected patients and also retain wards in a short amount of time. Because there was not enough space for nurses to sleep, nurses had to sleep in beds in the dialysis rooms and physical therapy rooms or put a mattress on the floor.
While the number of confirmed patients kept on increasing, much of the system in the center was still not in place. I, initially a surgeon, volunteered to see patients in the negative pressure room. I had no other option.
3/13 Had lunch with chief physician B and C at the medical center cafeteria.
I sat and had a chat with the Chief of infection control division at the parking lot behind the medical center. I had not seen sunlight for a while. It was the afternoon of that day that I started to feel chilly. My body shook a bit. I did not have symptoms like nasal discharge and upper airway infection, but I was not able to overlook the possibility of being infected. I wished I could spare a week to distance myself from my colleagues, but it was hard to tell them that ‘I don’t feel so good.’ I knew what they were going through, and I did not want to worry them.
It has been two weeks since I have been living in the center facility. I am sharing a room with chief physician A. This room is furnished with two beds, a small fridge, and a TV. Female nurses used to stay in this room, but now it was accommodated for male medical staff.
The Center for Disease Control and Prevention(CDC) specifies that medical staff treating COVID-19 confirmed patients to self-monitor their symptoms. Meaning I did not have to quarantine myself in this facility and was able to go home. But I stayed. The reason I decided to move into the facility was due to my children. I heard that back in 2015, when MERS spread in South Korea, children of medical staff were harassed in schools. I don’t want my children to be harassed in school. Colleagues around me were in similar situations. They either sent their children to their in-laws or moved into the facility to quarantine themselves. But no one predicted that this pandemic would last this long.
3/14 I encountered chief physician E at the cafeteria
I took my temperature and the thermometer showed 36.7℃. It was normal. I felt relieved. I did not want to fill my stomach with instant noodles. It was my day off, so I went down to the cafeteria thinking ‘I should at least have a decent meal.’ There, I encountered E. I sat diagonally across him and intentionally avoided any body contact with him. But the fact that we are dining in the same table made me anxious. I whispered to myself ‘I am not infected’ throughout the entire meal. But on second thought, ‘ what if I am?’ it was foreseeable that I would cause so much harm to the center if I am really infected.
Life in the facility made me lose track of the date. As the COVID-19 crisis prolonged, medical equipment shortage became a problem. I had to wear disposable medical clothes every time I entered the negative pressure room. So in order to save medical equipment, I made my rounds by calling the patients on the phone. I talked to the patients on the phone asking how well they slept, and how they were feeling. Thankfully, most of the patients in the center did not have serious symptoms, but they were starting to get tired of being qurantined in small wards. They were isolated for more than three weeks. Most of their day and night got mixed up. I wished that they could open up the blinds and enjoy the sunlight, but there was a possibility of complaints from outside. I sincerely appreciated their effort. “I am stuck as well.” I told one of my patients as a consolation, and she answered me with a giggle.
3/15 I intentionally stood two meters away from the nutritionist in the cafeteria. For dinner, I had fried chicken that my wife ordered for me. The delivery man left the chicken in front of the building, and I picked it up afterwards.
I do not have symptoms in my upper airway, but my body is sore. It is not odd. It’s been more than two weeks since I have been confined to these facilities. Workload is less than usual. I do not have any surgery scheduled, and moreover, doctors are only called in to the negative pressure room if something goes wrong. It took me more than two hours when I first wore medical gear and went into the negative pressure room to check on the patients. Now, I got used to it, so it takes less time, but no one here thinks this job is easy.
3/16 I ate two meters apart from my colleagues on a different table. And met B and E.
I took my body temperature before the afternoon shift. 36.7℃. It was a big relief, but I promised myself that I would not physically contact any of my colleagues without a mask. The problem was my roommate A. I told him about my body condition hoping we could stay in a different room. He told me not to worry. “It does concern me a little, but I don’t have anywhere else to go.”
A was right. There were no alternatives. I heard a story of staff at a different infection exclusive hospital. When residents found that the staff were staying at a hotel near the center, the staff had to leave the hotel at once because of the residents’ complaints. A similar experience occurred to me as well. I went outside the center wearing my surgical outfit, and residents that saw me called the center complaining. There were even restaurants that denied to deliver food if the address was the center.
3/17 Had a three minute conversation with C with my mask on.
Body temperature before going into the negative pressure room: 36.4℃.
I woke up early in the morning. I do not feel cold but felt a bit chilly. Turns out the room temperature was low. I saw A kept on sneezing yesterday. We joked to each other saying “we are passing a ticking bomb to each other.”
‘So this is what anxiety feels like’ I thought to myself. I realized that I am trying to sensor every tiny change that occurs in my body. A single sneeze or a short shiver caused by the early morning cold air made me suspect myself of being infected. There are days when I do not feel like smoking or one of my eyes turn red, but these tiny changes makes me worry. All kinds of thoughts come to mind. My children passed on to me an adeno eye infection and hand-foot-mouth virus last year. This made me think I may be more prone to viruses than an average person. While I had numerous rebuttals of my own argument, I was not able to shake off this feeling. I knew that viruses are not fatal in most cases from the studies and experiences. But the fear still lingered. I thought I should be more tolerant of other people’s anxiety. After all, I am the expert.
3/17 A letter from a patient who left the center after recovery.
“I could have spread this virus to someone else.” One of my newly entered patients told me during a phone call check-up. The conversation went on for thirty minutes. He was worried more about the possibility of him spreading the virus to others than his own health. I told him to concentrate on recovering rather than blaming himself, but I could not help feeling sad hearing his story. After all, these people are only sick patients, but the fact that they are suffering from infectious disease adds so much extra burden on them.
Once a person tests positive for COVID-19, paths of that person get tracked, and the information of every single place that person visited gets posted and shared to the public. It seems that this intimidates patients more. There are rumors and anonymous criticisms online towards patients. Many are hurt by these ‘witch hunting.’ One patient told me how she is suffering from these public blames. Despite the fact that an individual suffering from infectious disease is not something to be blamed for, people seem to be hostile anyway.
I received a letter from a patient who was scheduled to leave the center this afternoon after recovery. It is very rare to receive feedback from patients once they leave the center, and I was heavily touched by it.
Dear. Dr Choi
I have been hospitalized in this center for a quite long time. Last week’s test showed that I still have coronavirus in my body, but I did not have any symptoms all throughout the hospitalized period. So I did not take any medication and was cured naturally. I am set to leave now. As commonly known, this virus may be fatal to high risk groups, but it seems the virus is surmountable to most people like myself. My recovery is all thanks to you nurses who checked us patients everyday, and the doctors who explained to us from the viewpoint of the patients. (...) I really wanted to deliver my word of appreciation to all the staff. Public health institutions, like this center, certainly are trustworthy and reliable.
Nothing makes me happier than patients leaving the hospital these days after their receovery. ‘This is why I became a doctor,’ I thought to myself.
3/18 Met chief physician G on the way to work. Chief physician C joined me for lunch. Short conversation with assisting nurse.
I went for a check-up round inside the low pressure room. I was full of sweat after taking off the medical gear. I checked my body temperature after showering, and the thermometer showed 37.1℃. After chatting with colleagues for a while, I checked my body temperature again and it was 36.7℃. It has become a habit to frequently check my body temperature.
My wife called. She told me the children were scared and often woke up at night. The last time I saw my kids was three weeks ago. I really miss them. My seven-year old, the younger one of the two, kept on asking me on the phone, “when are you coming back?” For several weeks, I replied, “I don’t know, I don’t know” and finally mistakenly said “ten nights.” I thought he would not remember what I said, but my wife told me he is counting day by day.The tenth night is coming up, and I do not know what to say to my child. My ten-year old told me, “I love you” several times during our phone calls. I laughed when I heard their voices, but could not help my heart breaking after hanging up. It is not like I am thousand miles away from them and about to die, but I couldn't help it.
I guess people are meant to rely on each other. This stress coming from isolation and being away from my family and friends is unmanageable. I get mad easily, and tears drop spontaneously. The last few days were especially hard. People say ‘social distancing,’ but what I am doing is more like ‘avoiding others.’ Roaming around the center like this makes me feel like I am becoming a cockroach.
3/18 Nurses working without service shift
It is midnight. Head nurses are still on duty. They check blood pressure and body temperature of patients three times a day and also deliver meals and medicine to patients three times a day. They also clean wards and hallways with the care workers. Nurses were the first medical staff to be stationed to the low pressure rooms. Meaning they have been working without shifts for a month. The fact that there are not enough nurses to take turns is the largest problem. Nurses have to work regardless of their body condition, since one nurse out of the ward means the rest of the nurses have to fill one’s spot. This has been going on until mid March. This is a time of the year the temperature fluctuates severely. I am sure someone may have caught a cold but is working regardless. There need for a safe environment where anyone feeling unwell does not hesitate and is encouraged to share one’s body condition and get treatment. In the making, I thought I should not tell people they are overreacting. It was time for overreaction.
3/19 Body temperature 36.7℃. Normal.
Coughing sound of A woke me up. Now at this point, it seems getting infected is not a problem to blame on an individual. Everyday, the news reports about some new patient, and where the patient went, and who the patient physically contacted. But, I wonder whether that is such a big deal now. From the living quarters to the changing rooms, everywhere in this center is full of close contact spaces.
Medical treatment is not something that an individual can do alone. The role of the doctor is very limited. A medical treatment system functions only under the condition that everyone from nurses, caretakers, staff in the cafeteria, cleaning ladies, administration staff, laboratory technologist do their job in their respective field. Consensus and cooperation of patients is also important. The system fails if any one of these field malfunctions. I have known this fact all along, but this conviction is becoming stronger recently.
Two patients tested negative yesterday on their first re-test yesterday. Both of them were hospitalized for more than three weeks. If they test negative on their second re-test today, they get to leave the center. Lots of patients left the center in the last few days. It is a relief. As of March 25th, seventy patients left the center, and there are only thirty patients left.
I checked my body temperature before my shift, and it is 36.7℃. I decided to stop keeping track. One thing that I learned keeping track is that even if I get infected by COVID-19, I cannot blame the transmitter. I also learned that everyone has to live with a certain level of anxiety in this period of time. I wish I could tell someone who is afraid to reveal one’s symptoms that ‘I was afraid too.’ Eventually, we have to overcome this virus together. Even when we are ‘physically’ away from each other, we should not forget our ‘social(relational)’ distance. We should keep this fact to ourselves, and I believe everyone is overcoming this virus by believing so.
translated by Hong Suk Oh
translation supervised by Beckhee Cho