Delay or not, Mads Dam Lyhne has taken leave from his PhD programme at the Department of Clinical Medicine to join the emergency response at the hospital. Here he tells us about his first week as a medical doctor in the corona tent, although he is still thinking about his dissertation while working there.

2020.05.14 | Mads Dam Lyhne

Monday 4 May: Day one in the white tents

In the middle of March, I made myself available for the emergency response during the corona crisis. I am currently completing the final part of my PhD, but when I saw on TV how the hospital system had collapsed in southern Europe, and how everyone feared that the same could happen here, I knew I had to step in. It makes no sense to sit behind a computer if my colleagues in the field cannot cope. Practicing medicine and the Hippocratic oath are part of who I am.

Now I had been called in. I have been given two months leave of absence from the university, and today is my first day in the white corona tents in front of the hospital. We act as a kind of emergency medical service and must assess whether the patients should be swabbed, admitted to hospital or sent home again. Anyone with the slightest corona-like symptoms gets referred to us, even though they probably are ill with all kinds of other things or maybe not ill at all. For example, today I have examined a pregnant woman with headaches and a middle-aged man with stomach pains. The conditions and framework place great demands on our medical expertise. We are placed in an outdoor car park with very little paraphernalia at hand. The patients sit in their cars and we are not even allowed to touch them to examine them more closely.

 

Tuesday 5 May: Hello, is there anyone out there?

The second day in the tent and I already feel more at ease with the routines. My colleague and I have spent a lot of time tracking down the relatively many patients who did not turn up for their test appointment yesterday. All of our patients are referred by their own doctor or a duty doctor, so we know that they need a medical assessment. So when they fail to turn up, we have to make sure that the patients have not become more ill or in the worst case, died at home in the meantime. We got hold of all of them. One did not have a driving licence, and his family would not drive him because they were afraid they would be infected. We sent an ambulance which can swab the patient at home. I had not anticipated that this proactive element was also part of the job, but it is relevant. No one must be allowed to slip through the cracks.

 

Wednesday 6 May: Ward rounds and pigs with blood clots

Today I have had the ward round at the hospital's corona section. This is also part of being a doctor in the emergency response. We do not have very many patients. Because we are an emergency response service, staffing is good and we are many people at work. An unaccustomed situation as the healthcare system has been subjected to large cutbacks for some time. But we also spend a lot of time putting on and taking off protective equipment between each patient. It is laborious and can easily take ten minutes, so I cannot see as many patients as I normally would.

Even though I have leave, I still think about my PhD project every single day, and I check my email several times a day. Normally I am employed at the Department of Cardiology and I am writing a PhD about blood clots in the lungs. We conduct animal experiments on pigs and test different treatment options. It is my very own research project, my little baby, so completely letting go of it is impossible.

 

Thursday 7 May: Cardiac arrest, protective equipment and precious minutes

One of the functions of the emergency response is also to be on call duty at the hospital. When you have on call duty like this, you take care of the acute patients meaning that you are, for example, called to cardiac arrests all over the hospital. Today I had a different type of on call duty prior to my first proper on call duty next week.

By chance there was cardiac arrest training today. While we know the techniques well, it is still good to meet many of the other employees and train how to work together and communicate. We also clarified what we would do in the event of a corona patient suffering a receiving cardiac arrest. Cardiac arrest patients cannot, by definition, get any worse, so they must naturally receive the best help first and very quickly. But in principle they are already dead, and it has therefore been decided that the first priority in this situation is to take care of the staff. We must therefore put on all the protective equipment before we enter the hospital ward and begin the resuscitation attempt. This takes time and precious minutes are used when it comes to saving lives. On the other hand, COVID-19 is a respiratory infection, and it is not difficult to imagine how the virus seeps out of the airways when we are very close to the person as we press on their chest.

 

Friday 8 May: Study day with the kids

Today is a study day. It is also a national holiday in Denmark, so the kids aged three and five are also home. But my wife is not. She is a medical doctor at the cancer department. So working hours are not synchronised very well. My principal supervisor is very satisfied with the draft article I have written. That is always a great relief. Fortunately, I have completed all my experiments and ‘only’ have the actual analysis and writing left. A privileged situation to be in during the corona shutdown. Getting the articles reviewed and then incorporating comments from supervisors and journals is a long process. I therefore try to always move these tasks on to the next phase so they wait on the next person’s desk and so the project is progressing while I am on leave.

 

Weekend 9-10 May: Is it worth the effort?

I have Saturday off but on Sunday I am back in the tent. It is a very quiet day. Quiet enough to consider whether it is worth putting my PhD on hold, as we did not end up with conditions like in Italy. I think it is. The emergency response could also have managed without my help, but I was called in, so they have assessed that I was needed. Neither am I worried about my dissertation or my research career. Extending my PhD a little does not mean anything. The majority of PhDs are delayed for one reason or another. And when we find ourselves in the midst of a global health crisis, my pigs and their blood clots are not that important and my efforts are better used in the white tents rather than behind a computer screen. At least for a while.

 

Read the other diaries from:

• Head of Studies Administration at Health, Anna Bak Maigaard
• Head of Department at the Department of Dentistry and Oral Health, Siri Beier Jensen
• Head of Building Services at Health, Conor Leerhøy
• Associate Professor and Specialty Registrar Christian Wejse