Heroes work here: voices from the front lines of MUSC’s COVID-19 response

Heroes work here: voices from the front lines of MUSC’s COVID-19 response

During this historic pandemic, we no longer have to visit a library, rent a movie, or look to history to find our heroes. On the contrary, we’re surrounded by them every day at the Medical University of South Carolina (MUSC). The MUSC Health care team members who are taking care of total strangers with compassion and empathy while we battle an unseen enemy are all heroes who deserve to be recognized. We have pieced together this collection of anecdotes and perspectives from a variety of Department of Medicine care team members to give readers a snapshot of what fighting a pandemic looks like for South Carolinians on the front lines.

Cassandra Salgado, M.D., professor, infectious diseases and medical director of infection control and MUSC Hospital epidemiologist

"Hundreds of MUSC employees have worked tirelessly over the last three months to prepare the Medical Center for the anticipated surge of COVID-19 patients. Among the top five MUSC leaders bearing the brunt of responsibility for our exhaustive preparations, you will find Dr. Cassy Salgado. As division director of Infectious Diseases in the Department of Medicine and as the medical director of Infection Control and MUSC Hospital Epidemiologist, Dr. Salgado has played a critically important role in developing policies and procedures for identifying, isolating, treating, and cohorting patients with COVID-19. She has personally been responsible for making the myriad decisions regarding isolating infected patients and optimizing the use of personal protective equipment to safeguard both patients and staff. The final chapters of the coronavirus pandemic story at MUSC remains to be written, but Dr. Salgado's herculean efforts have been crucial for assuring that MUSC is as well-prepared as possible.” - John W. Gnann Jr., M.D.

Andrew Goodwin, M.D., MSCR, associate professor, pulmonary and critical care

Goodwin is one of the attending physicians who has worked the COVID-19 intensive care unit (ICU) at MUSC.

“I’m proud to be part of such an exceptionally dedicated multidisciplinary team caring for COVID-19 patients. We took a former newborn nursery and converted it into a fully functioning intensive care unit (ICU) where the highest quality care was delivered by team members from all over the hospital. The innovation, professionalism, and camaraderie of this team truly embody the MUSC spirit.” – Andrew Goodwin, M.D.

Nandita Nadig, M.D., MSCR, assistant professor, pulmonary and critical care, and associate director, Tele-ICU

Nadig is one of the attending physicians who has worked the COVID-19 ICU at MUSC.

“The one quote that speaks to me during this time about the MUSC community is: Darwin’s Origin of Species, talks about how it is not the most intellectual of the species that survives; it is not the strongest that survives; but the species that survives is the one that is able to adapt. I think the MUSC community has adapted (as it relates to staffing, telehealth virtual visits, providing patient-centered care, working from home, etc.) and will continue to do so during these unprecedented times!” – Nandita Nadig, M.D.

Edward Kilb, M.D., assistant professor and fellowship director, Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine

Kilb is one of the attending physicians who has worked the COVID-19 ICU at MUSC.

“As a pulmonary and critical care physician, I have filled a lot of roles during this pandemic. I have first and foremost focused on providing high-quality critical care when called on to cover the COVID-19 ICU. I have managed COVID-19 patients in other ICUs across the state and country through my work in the Tele-ICU. I have continued to run the Pulmonary and Critical Care Fellowship program providing education, but more importantly, helping to prepare our fellows to be leaders in caring for these critically ill patients and they have more than stepped up to the challenge. While this pandemic has certainly changed all aspects of our daily lives as both physicians and citizens, there have been massive changes in how we educate our trainees and students. I have revamped the medical student critical care rotation curriculum to be entirely virtual, including virtual reality (VR) patient case scenarios. We've also created a Grand Rounds mini-series on up-to-date critical care management in COVID-19 patients for non-ICU physicians that has been shared with 13 South Carolina hospitals.”  - Edward Kilb, M.D.

Marc Heincelman, M.D., assistant professor, General Internal Medicine, and clerkship director, Department of Medicine

 

Heincelman is one of the attending physicians who ran 'suspected' COVID-19 services.

“During the COVID-19 pandemic, the General Internal Medicine Team 3 teaching service served as the dedicated COVID-19 rule-out service. Any patient requiring admission to a medicine team would be admitted to ‘Gen Med 3.’ The intent was to minimize potential health care provider exposure to COVID-19 to a small number of providers. While all team members would participate in obtaining patient history using video consults, the ‘Gen Med Team 3’ attending physician on duty would be the only provider to perform an in-person exam, again with the intent of minimizing risk when possible. When a patient's COVID-19 test returned positive, they would then be transitioned to a dedicated COVID-19 service. As you can imagine, this is an incredibly busy service that requires a complete team effort to successfully take care of patients. Nursing, environmental service, and housestaff have all been essential in making this unit work successfully.” – Marc Heincelman, M.D.

Benjamin Kalivas, M.D., assistant professor, General Internal Medicine

 

Kalivas is one of the attending physicians who ran 'suspected' COVID-19 services.

“The hospital’s response to COVID-19 has been thoughtful and comprehensive. What has been most impressive to me has been the team work demonstrated by all members of the care team. Although we haven’t seen a lot of COVID-19 disease in our hospital, it is clear that we’re all in this together.” – Benjamin Kalivas, M.D.

Samuel Schumann, M.D., assistant professor, General Internal Medicine, and associate program director, Internal Medicine residency

 

Schumann worked to bring back ambulatory care volume in MUSC’s outpatient clinics.

“COVID-19 rapidly disrupted the way we practiced ambulatory internal medicine at University Internal Medicine (UIM). Within weeks our clinic went from not completing any formal virtual visits to delivering greater than 80% of visits through different virtual platforms. This undertaking was only accomplished by a coordinated and collaborative effort from physicians, nurses, pharmacists, registration/central scheduling, and of course information technology services. We learned a lot from each other in both interdepartmental and interdisciplinary teams. At UIM we support the internal medicine residents’ clinic. This created additional challenges of teaching almost 100 resident physicians how to provide telehealth (while learning ourselves), coordinating schedules between the inpatient teams which the internal medicine residents cover, and determining how medical education and clinical supervision for the residents were going to occur. We also could not meet in person to discuss or present these changes and relied heavily on emails, recorded videos, and virtual meetings to communicate and spread information. The rate of change was extremely rapid; schedules and work flows changed almost every day. Thankfully, our faculty members, residents, and staff are very resilient and adapted very quickly to these changes. As we enter a phase of recovery, we are trying to anticipate what form patient care and medical education will take once we return to a new normal.” – Samuel Schumann, M.D.