When the pandemic is over, the first thing Nabila AZAD ’07 wants to do is safely travel home to Toronto and visit her parents.
Azad is a frontline doctor at Boston Medical Center (BMC), affiliated with the Boston School of Medicine. Originally trained in internal medicine, she devotes herself to the primary care of COVID-19 patients, along with their families' emotional support. As an assistant professor, she also leads COVID-19 in-patient and resident teaching services.
“I’m excited because I just got my second vaccine shot today [January 12],” says Azad. “This vaccine is the only hope we have to get things under control.”
Azad received her degree in internal medicine from Saint Louis University in 2015. Fast forward six years and one unforeseen pandemic later, and the most “not normal” fact of her work is the necessity of conducting end-of-life care discussions with patients on a daily basis.
“They’re very scared,” she says. “And it’s hard to console them. We can’t predict who will worsen. Patients die despite our best efforts, and when they’re admitted we need to have discussion about their potential oxygen needs, if they want to be intubated. As doctors, we should be having these discussions once in a while, not constantly.”
At BMC, six COVID-19 teams, each comprising one attending doctor and nursing staff, work to coordinate care, including much intense risk management, as confirmed cases continue to increase in the Boston region. Azad must decide if patients with “comorbidities” (i.e. two or more diseases), should be sent for diagnostic imaging scans, risking a spread beyond the unit.
“It’s very isolating for patients and we work a lot to connect families digitally,” says Azad. “There’s no clear line between the medical and emotional support.” Now in the wake of the second COVID-19 surge with increased patient load, Azad is heartened somewhat by the lessons learned in the first surge last March.
“We definitely have policies in place to allow for smoother coordination, and we’re more comfortable taking care of these patients,” she says, although she often works six or seven days in a row. Also of assistance is the widespread testing availability, absent in the first wave, and general confidence in the efficacy of properly used protective equipment.
“We weren’t sure how the virus spread in the spring,” says Azad. “At this point, I know I’m protected, but it takes an emotional toll.”
What gets her through is, firstly, her beloved dog, Thea, and also friends she’s lost touch with in different parts of the world reaching out to offer support. As well, of course, part of the virus’ unpredictability is the joy of seeing a patient in her 90s pull through. And never is there any doubt she should desert the cause: “I love what I do,” says Azad. “I never for a moment think that I shouldn’t go to work.”