On the Front Lines of COVID-19 Testing
One in an ongoing series.
The patient knocks on the back door of the COVID-19 testing clinic. Inside, the scramble begins.
Matthew Behme, MD, and a colleague from Einstein Healthcare Network quickly don gowns, masks, shields and gloves; they clear the hallway of others in the clinic. They open the door, whisk the patient into a room and quickly get to work.
“We take great lengths to limit people’s time in the testing center,” says Dr. Behme, Einstein’s Chairman of General Internal Medicine. “Every minute that someone is in the testing center is a minute of exposure. People understand. It’s a very fast encounter.”
And it’s an encounter that’s often fraught with anxiety.
Patients are fearful that they’ll test positive; they’re terrified of infecting loved ones – and they’re apprehensive about the actual test itself.
“The swab is long, about six inches, and is inserted several inches into the nose,” Dr. Behme says.” I always prep them with: this is uncomfortable, probably somewhere on the order of the discomfort associated with a blood draw.
“It’s done as quickly as possible,” he adds. “But you have to balance how quickly a sample is obtained against getting a good sample. You don’t want patients taking the exposure risk of being in a testing site and go through this uncomfortable procedure just to have inconclusive results.”
Einstein opened two outpatient sites in early April for Einstein patients suspected of having the virus. Each of Einstein’s 10 primary care practices provided two practitioners for rotations at the sites, where 20 to 30 patients a day are tested.
Dr. Behme volunteered to do the testing in place of others in his practice who have health conditions that make them high-risk; nurse practitioners eventually took over the testing.
These doctors and nurses aren’t necessarily the ones who are the public face of COVID – the ones working to exhaustion and experiencing tragic deaths in intensive care units or emergency departments. But they, too, are putting themselves on the front line because every patient sent for a test is a possible COVID patient.
It worries Dr. Behme, who also supervises the Einstein’s residents caring for COVID–19 patients. He has two young daughters, 4 and 6 years old, and one of them has asthma.
“But I feel a call to duty,” he says. “This is part of what I signed up for. It’s sort of a badge of honor to be able to take care of people in this time. Still, when I signed up for it, I didn’t have kids and I didn’t envision a pandemic, and I would never have guessed that this would be part of my career.”
Dr. Behme takes meticulous measures to keep his family safe. He puts clean scrubs on for the car ride home, jumps in the shower as soon as he gets home after putting both pair of scrubs in the washing machine. Then he goes out and wipes down the car before having any contact with his wife or children.
He then takes over care of his two daughters and his aging Golden Doodle, named Charlie – so his wife, who’s also a physician, can go to work at night.
Family Closer Under Stress
“It’s put a stress on the family, but it has brought us closer together as a family. We spend many more hours of close family time,” Dr. Behme says. “My wife and I have rallied round this as a problem to solve together, and it’s brought us closer as a couple.”
Like many people affected by the pandemic, Dr. Behme has found other silver linings, too.
He plays the guitar and piano half an hour a day and recently resurrected the trumpet he hadn’t played in years. He talks to his brother on the telephone every day and his parents every other day, far more often than he did before the pandemic.
There’s also a silver lining in the work he’s doing, despite the risk of exposure to COVID-19, Dr. Behme says. The intense and urgent mission has fulfilled the purpose he sought when he chose to be a physician: to help people.
“I don’t think I’ve been more engaged in my work than I am right now,” he says.