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‘Enraging And Heartbreaking': Jax Doctor’s Audio Diary 16 Months Into COVID

Dr. Jennifer Cowart shares her experience working as a hospitalist during the pandemic.
Dr. Jennifer Cowart shares her experience working as a hospitalist during the pandemic.

"It’s horrible that we’ve retreated into our partisan tribes relating to things like masks and vaccines and whether or not COVID is even real, and whether or not we are lying about the hospitals being full."

With hospitals pushed to their limit in Jacksonville and statewide, WJCT News put out a call for the stories and the perspectives of health care workers dealing with the latest COVID-19 surge. 

Here’s one response from Mayo Clinic hospitalist Dr. Jennifer Cowart. Cowart is the vice chair of the Duval County Democratic Party, and a frequent speaker at Duval County Public School meetings, urging school officials to enact stricter face mask rules. 

“This is Dr. Jennifer Cowart, recording my voice memo on August the 9th at 10 in the morning. I’m a hospitalist. I’ve been working as a hospitalist since roughly 2012, off and on during my fellowship, and full-time as a hospitalist since the end of 2014, beginning of 2015. I’ve always been busy, I always do a lot of extra things outside of my regular work. I do patient safety work, I do quality improvement, I volunteer. So I’m used to being busy. I’m used to running on the edge of my limits. And I’m used to feeling tired. I’m also a mother, I have two small kids. And I can’t remember feeling this tired before. Fatigued in a way that I sometimes wonder how I can keep going with this pandemic raging in this way. 

We’ve been dealing with this since March of last year, so nearly a year and a half, basically a year and a half. For everyone, this year has been the longest time of our lives, but I’ve gone through these phases of extreme and intense worry, and then things will get better for a while, and I feel better, physically and emotionally. For the past two months, really since the beginning of July when this surge started, I’m worn out and and anxious all the time. 

I’m anxious about the patients coming into my hospital, worried about who’s going to make it out, who’s going to be hospitalised for two weeks. I see folks who have been in the hospital for two months with COVID, I look at their CAT scans and I look at their lungs, and I wonder, will they ever take a deep breath again? Some of them may end up needing lung transplants. Some of them will not be a candidate for a lung transplant. 

Some patients get better, and I have a hard time predicting who’s going to be well and recover quickly and leave the hospital, and who’s not going to recover quickly, and who’s going to get outrageously sick. And that lack of knowing is unbelievably frustrating. 

In medicine, we get so used to these calculators. I can calculate your risk of heart attack prior to surgery, I can calculate your risk of bleeding on a blood thinner, and I use those tools all the time in helping patients make decisions. I tell them, here’s your risk of bleeding and here’s your risk of clotting, and then I will give them a medical recommendation, and I ask them what they want to do. And I try to support them in their decision, even if I don’t ... even if it goes against what I would recommend, let’s put it that way. I try to keep my feelings about their decision out of it. I try to support them in their decision, if it’s a rational, reasonable decision. And most decisions are. 

But this, now, coming in where people have been more afraid of the vaccine than they are of the actual illness, people in my own hospital, people who work at my facility coming in unvaccinated and saying they’ve ‘done their research’, in big quotes, and to me that means you found some anti-vax website and you believe that over the actual immunological, infectious disease experts, the microbiologist experts who work for our institution, you trust some YouTube video over actual scientist experts. And that, to me, is so sad. It means we in medicine have failed so badly, and that failure is compounded every time these folks come into the hospital. 

I’m scared. I’m scared for my family, my young kids who are too young to be vaccinated. I’m scared for my parents, who have serious health conditions. They are vaccinated, but I’m worried what a course of COVID might be for them, even vaccinated, with this delta variant being tougher. I’m deeply frustrated with the messaging, how this has become politicized by people on both sides. I think there’s politicization everywhere. 

But it’s horrible that we’ve retreated into our partisan tribes relating to things like masks and vaccines and whether or not COVID is even real, and whether or not we are lying about the hospitals being full. I remember last year feeling like my head would come apart when I was dealing with people accusing me and my colleagues of falsifying death records to inflate the numbers of COVID patients. 

Right now, we don’t have any mask mandates in our state, we don’t have any real support at local or state government for masks. We do have a mayor who’s promoting vaccines, for which I’m grateful. But we have a state government that’s actively pushing against masks.

And we are busier than we’ve ever been in my hospital. All the hospitals in our area are drowning in COVID. They’re opening extra wings and unlicensed beds to take care of COVID. We’re cancelling elective surgeries because of COVID. People with long-standing issues are having to have their surgeries cancelled right now. 

And yet people think that this is all being blown up and made too much of us, and it’s a lie, and it’s … it’s enraging and heartbreaking all at once. And a lot of days I don’t really know how to deal with it. 

So I will say, in terms of how am I taking care of my own mental health here, I’m going to be calling a counseling line, actually, set up for physicians and health care workers to try to take care of myself because I’m not sure how to keep going and care for my family and my patients when I’m this tired and fatigued. 

Maybe let’s try to wrap it on some kind of a high note. I have a 4-year-old, and he and his classmates, a lot of them are wearing masks going into VPK. I’m so proud of him, the teachers trying to keep them safe. And my daughter, going into third grade, and I know the school is trying to keep kids safe in a bad situation, and that makes me proud. I’m proud of my co-workers, who are every day taking care of these patients and all our patients — we have to take care of all our patients, whether you’re coming in with COVID or anything else, and drowning in new information, and yet trying to stay on top of all this changing science and learn all the new things. I work with amazing people, I’m really happy to work with them and be in the trenches with them. 

And my husband, my partner. He’s amazing and always has been, and takes good care of me and our family and our kids, and supports me when I run out and do things like do phone banks to answer questions from the community about masks and vaccines. So those are my high points and bright spots. That’s about all I have right now. And I guess some of the colleagues that I’ve met who all care about this as deeply as I do. I feel like we’re trying to be doctors for the whole community right now, and we’re doing our best. We’re just doing our best. One day at a time. 

I don’t know how any of this ends. I don’t know how we get through this. Just one day at a time.”

If you are a health care worker and you’re interested in sharing your own story, contact Sydney Boles at sboles@wjct.org
Copyright 2021 WJCT News 89.9. To see more, visit WJCT News 89.9.

‘Enraging And Heartbreaking': Jax Doctor’s Audio Diary 16 Months Into COVID