At the beginning of March, Bonnie E. Gould Rothberg, MD, PhD, MPH, FACP, was looking forward to a well-deserved vacation— not an easy thing to plan as a physician and a mother of five. Her vacation plans were complicated, like most logistics in Dr. Gould Rothberg’s busy life. She would take two weeks off from her role as an oncology hospitalist working at Smilow Cancer Hospital’s Oncology Extended Care Clinic (ECC) to spend time with her family.
“An oncology hospitalist is a new and evolving role across the country,” explained Dr. Gould Rothberg. “It includes internists like myself and some oncologists who have a hankering for inpatient medicine and dedicate their practice to caring just for oncology patients requiring urgent or inpatient care.” She and her husband, renowned entrepreneur Jonathan Rothberg, MS, MPhil, PhD, and three of their children would fly to the Bahamas for a week, then to France to ski, with a stopover to visit their college-aged son doing a semester abroad in London. From London, Bonnie would return to Connecticut, while Jonathan would continue on to Monte Carlo where he was to receive an award from His Serene Highness, Prince Albert of Monaco. But by March 4, two days before they were set to leave, reports of COVID-19 cases overtaking Europe were coming in.
“I was nervous to see that there were 30 cases near the ski resort we’d booked in France, so I cancelled that part of our trip,” said Dr. Gould Rothberg. Nevertheless, on March 6, they got on their flight, landing in the Bahamas to chilly weather and more bad news. “Every day there was an email from the hospital, first saying that medical personnel who were abroad should return to the U.S., then warning that they might have to be quarantined when they did return,” recalled Dr. Gould Rothberg. The world news was equally dire. “We were glued to Twitter and CNN, hearing stories about not enough Personal Protective Equipment (PPE) for doctors and nurses in Italy, in China,” explained Dr. Gould Rothberg. “We were worried what would happen with colleagues in the Yale community.”
Dr. Gould Rothberg knew the vital importance of PPE, particularly in caring for those with compromised immune systems, like the patients seen in the ECC. “In pre-COVID times, if you suspect a cancer patient has the flu, you put a mask on before you go into the exam room, then replace it with a new mask before seeing the next patient, because you don’t want to risk getting anyone sick,” she explained. “Now, with COVID, PPE is treated with more respect.” The Rothbergs would soon decide to do what they could to help keep everyone in the Yale New Haven Health System safe, by donating a gift of $2 million to the Yale School of Medicine, a portion of which was directed to provide funding to ensure hospital staff had adequate PPE, and a portion for COVID-19-related research. “We wanted to be sure the people we cared about would be protected to do their work, essentially, the work of tireless heroes,” said Dr. Gould Rothberg.
Meanwhile, back in the Bahamas, supposedly on vacation, Dr. Gould Rothberg was having what she calls a “knee-jerk response” to return to her oncology patients. “I had to get on that plane,” she recalled. “I said to my family, ‘My shift starts at the ECC on March 25. The last thing I want is to have to call in sick because I’m quarantining after my vacation.’” One thing that influenced her decision was reading the stories coming out of Italy, where dermatologists and pathologists were on the frontlines caring for COVID patients.
“I am a board-certified internist, doing hospital medicine, which is exactly the skillset needed to manage COVID patients. To not be there would have been socially irresponsible.” By March 15, Dr. Gould Rothberg was back to doing 12-hour shifts in the ECC. Then, on March 27, with COVID-19 cases in Connecticut rising, she received news she wasn’t expecting. Because the medicine house staff had been assigned to care for those with COVID-19, there was a gap in overnight coverage for the Smilow Cancer Hospital oncology patients requiring inpatient care. “I was asked if I’d be willing to do overnight shifts there,” said Dr. Gould Rothberg. Since March 28, Dr. Gould Rothberg has been covering the night shift, four nights a week. “I’m back to living like I did in college, with dishes piling up in the sink and eating cereal for dinner. But it’s the best thing I’ve ever done in medicine.” It may also be the toughest thing she has ever done.
For one thing, Dr. Gould Rothberg has not seen her husband or children since hugging them goodbye on March 10th. “I don’t want to transmit the virus to our family,” she said. The kids—all five of them— hunkered down with their father on their boat off the coast of Georgia, while Dr. Gould Rothberg is holding down the fort at home. “It’s been difficult at times,” she explained. “It’s just me and four walls. Mother’s Day was especially bittersweet with all five of my children, including my adult children who don’t gather often, all together but not with me. Celebrating by Zoom was just not the same.” On her off-days, she takes walks with her new puppy, gardens, and does video calls with her family.
Yet, she also says there is nothing she would rather do than show up for Smilow Cancer Hospital’s patients at 6:30 pm, ready for the night shift. “It’s the new reality,” she said. Once she arrives, she gets the lowdown on her patients, then cares for them for the next twelve hours, after which she joins morning rounds to introduce patients she admitted and update the team on overnight events.
As unwavering as the routine has been, it can also be “unnerving,” she said. “We have to be very careful at the hospital, even on our designated COVID-free Smilow service.” The fact that no visitors are allowed during the pandemic also presents challenges. It can be difficult keeping patients’ family members informed about a loved one’s condition via phone or video screen. “It’s especially tough when we have to make hard decisions about a patient’s care, and the family hasn’t been able to see what’s happening first-hand.”
One thing that has been enormously reassuring: “We have what we need to be able to provide hands-on care,” said Dr. Gould Rothberg. And as tough as it has been not to be with her family, Dr. Gould Rothberg says she has “no regrets” about leaving them behind. “Cancer doesn’t care if there’s a pandemic. We can’t forget about these patients, especially now. We need to make sure that there’s a safe space for them here.”