The COVID-19 pandemic has lingered over the medical community for more than two years, bringing an array of challenges, hardships and grief. So, when Richmond magazine asked our Top Docs 2022 survey participants to reflect on life lessons learned over the course of their work, many shared how they were affected by the horrors wrought by the novel coronavirus, professionally and in their personal lives.
Some reflected on patients who left lasting impressions, others recounted recent horror scenes of lives taken too soon and threats to their own health and well-being. The force of medical teams was a theme in many of the responses. The mindset that it is a sacred honor to serve and heal came through strongly in many stories, as well as the crucial role compassion and listening play in treating patients.
Here is a sampling of Richmond-area health care practitioners’ pandemic stories and insights gained.
Build a spiritual foundation.
Dr. Charles Bagwell, chair of pediatric surgery, Children’s Hospital of Richmond at VCU
One night in 2015, Bagwell was called back into the emergency room to save a 4-year-old who had been shot. It soon became clear the girl could not be resuscitated. A medical resident looked at Bagwell with tears streaming down her face and told him at that dramatic moment that she was pregnant.
“It had never, ever occurred to me how traumatic some of these events are,” he says. “They’re traumatic for all of us. If you’ve been around a long time, you get thick skin, you’re used to it enough, and you can move on. But these are young trainees. This stuff is very fresh to them. Especially in [the resident’s] state, this was a raw, raw wound.”
Bagwell was moved to address spiritual needs of the medical community and pursued pastoral counseling training to be better equipped to listen to residents facing burnout and train them to be more receptive to patients’ spirituality. He wants to teach students to ask patients a series of questions that are a spiritual assessment that shows how they deal with difficult situations. “It opens the door to tell you where [the patients] want you to go, so a doctor can help the patient and family,” he says.
He’ll finish in May at Eden Theological Seminary with a master’s in professional studies. The program has given him a perspective of medicine from a different lens. “As a scientist, you look at things as if from a microscope,” he says. “You look at tissues and structures in their infinite detail microscopically. Well, at seminary, you take that microscope and turn it around and look at it the other way, and what you see is the cosmos. And when you put the two together, it is beautiful.”
Heal thyself.
Ryan Ballon, employee wellness director and registered kinesiotherapist, Central Virginia VA Health Care System
Ryan Ballon (Photo by Jay Paul)
Ballon started his job at the Richmond Veterans Affairs facility early in the pandemic. He instated weight-loss programs and discussions to address sleep, nutrition and mental health awareness for the staff, who often neglected their own health even while supporting patients. A farmers market on the property was another successful program that helped to improve overall health. “Not just physical health, but social, mental, spiritual and overall support,” Ballon says. “This in turn has helped shape our staff to not only talk the talk of being healthy to patients, but to also be examples of the healthy mantra.”
Learning is lifelong.
Dr. Stephanie Lacey, advanced imaging cardiologist, Children’s National Hospital Cardiology Richmond
Lacey has always been fascinated with prenatal cardiology and properly diagnosing congenital heart defects. She is continuously learning, and the pandemic has emphasized that. “We know the virus can affect children’s hearts,” she says. “That’s been a very steep learning curve for us. We are asking, how do we approach this, and what’s the best treatment for the children? How do we follow up with these children, and do they heal completely?” Lacey, who is based at the Henrico Doctors Hospital Complex, is taking part in a National Institutes of Health study looking at echocardiograms of children who have had COVID-19 to interpret images to see how the heart is affected and how to treat it.
“I have been in practice for a long time, and I am always humbled when I learn new information from colleagues. I have also learned that we don’t always have the answers and it’s OK to tell your patients that.” —Dr. Stephanie Lacey
Teamwork is essential.
Dr. Atul Aggarwal, director of nuclear medicine, Radiology Associates of Richmond
Aggarwal acknowledges the importance of medical teams in providing excellent quality health care, from hospital volunteers and patient transport staff to therapists, nurses, technologists, physician assistants and nurse practitioners, IT staff, doctors, and administrators.
Personal experience drove that home. “Watching my mother pass away from colon cancer within two years, despite surgery and chemotherapy, provided a very personal view into our own mortality and helplessness,” Aggarwal wrote for the survey. “Also, it gave me a deep appreciation for palliative care medicine and hospice. I will be eternally grateful to all the people involved in my mother’s care, especially near the end-of-life care.”
“Everybody deserves equal importance and respect. I often notice that many doctors forget the importance of this.” —Dr. Atul Aggarwal
Dr. Harpreet Reeba (Photo by Jay Paul)
Hope is an inspiration and a healing element.
Dr. Harpreet Reeba, board certified in child, adolescent and adult psychiatry, Virginia South Psychiatric and Family Services, Midlothian office
When Reeba treats children and adolescents with emotional or psychosocial issues including ADHD, PTSD or schizophrenia, one of the first things she does is apologize to them for what they’ve been through. She also expresses a message of hope and faith while describing the disease to a patient, saying, “You are going to be given all the help you need. The healing process starts right here.”
“[The] most important life-changing experience is that, as a child and adolescent psychiatrist, I am able to get the information from children which they have not told anyone, I have the opportunity to start the healing process right there. I never let that opportunity go.”
She looks to her patients’ strengths, and it helps them move forward with treatment.
The power of nurses is uplifting.
Dr. Vincent Schuler, trauma and emergency general ICU surgeon, HCA Forest Hospital
In the ER, Schuler saw tremendous human suffering and the power of physicians and other health care workers to help to heal, even before COVID-19. The anguish of medical teams pushing far beyond normal demands inspires him. He says he saw “the nurses who cried tears of exhaustion, tears of sorrow, the tracks of which streamed into the furrows cast into their faces by masks. Nurses who, when a young boy’s father died, found the strength to compose themselves in a show of strength as I walked him to see his father for the last time. Nurses who worked around the clock in the emergency department and, after their shift was over, returned to help their comrades because the sick just kept coming. Nurses who gave morphine and held the hands of the dying, and whispered into their ears, ‘Your family loves you so much’ as a last act of compassion and closed their eyes when their long struggle finally ended.”
“I bore witness to the bond of ‘the team.’ thicker than blood, that would not let nurses abandon one another in the midst of a once-in-a-lifetime pandemic.” —Dr. Vincent Schuler
Dr. Stephanie Arnold (Photo by Jay Paul)
Expect the unexpected.
Dr. Stephanie Arnold, primary care physician, InnovAge PACE-Richmond
Arnold had just settled into a new job at InnovAge PACE, which stands for Program of All-inclusive Care for the Elderly and provides health care and social services to seniors without moving them into a nursing facility, when COVID-19 hit her and her patients particularly hard.
“Not only are they at increased risk of complications, but the social isolation and staffing shortages have been particularly difficult to grapple with,” Arnold wrote in response to the survey.
She had recently finished a residency in New York, where many of her friends and colleagues were in the hardest-hit areas. “It has been surreal,” Arnold says. “I felt like my friends had gone to war without me.”
When the pandemic started, she was working at Patient First and caring for her 2-year-old daughter. Being pregnant in the summer of 2020 made Arnold feel more vulnerable. “I thought having my first baby during residency was hard, but navigating the pandemic first pregnant, and then with two small children, has been surreal,” she says.
“Surreal” is also how Arnold describes entering a locked unit for elderly people with dementia before COVID-19 vaccines, where she was struck by the patients’ inability to wear masks. “I felt like I was in a bubble that no one wanted to be with because of my profession,” Arnold remembers about her stressful pregnancy, only feeling happiness when at seven months she was vaccinated.
The pandemic was hard on the elders in her care because of the diminished socialization and lack of physical touch. Patients couldn’t leave their rooms, and facilities couldn’t offer activities.
Arnold still feels left behind with small children who are too young to be vaccinated. “I see people with vaccinated kids out in the world,” she says. “I haven’t eaten out since the pandemic started. I feel like I am in two different worlds.”
Life is fragile and precious.
Dr. Salman A. Khawaja, clinical neuropsychologist, Bon Secours Neurology Clinic at Westchester Emergency and Medical Center
Khawaja is often called to see patients at the end of their lives, to look at them with a cognitive lens when they do not recognize they are dying, as well as cases that pose complicated medical dilemmas. He notes that COVID-19 has presented long-term cognitive issues for patients as well as changing a lot for the medical community, because there was not a template to follow when “ridiculously healthy people were dying,” he says.
“I have lost more patients and colleagues to suicide since COVID than I have in my entire career.” —Dr. Salman A. Khawaja
Watching patients who didn’t believe they had the disease, then die has shown Khawaja how fragile and ironic life is and how powerless people — even healers — often are. He experienced some COVID-19 patients who resisted the reality of their diagnosis to the point of spitting and attacking him. Such actions disrespected his life and were contrary to his pledge to work to save his patients’ lives. “Sometimes we feel just as helpless as our patients and their families do,” Khawaja says. “They are looking to us. It’s very emotional.”
Having seen so much death throughout the pandemic and simply continuing to treat patients shows him the resiliency, humility and humanity of medical professionals. But it’s not all heavy, Khawaja says; there are light moments and sometimes gallows humor to help one survive the challenges.
