Assistant Professor
of Family Medicine
Cooper Medical School
of Rowan University
Camden, NJ
This is part of our series, Flattened By the Curve, which features the voices of doctors, nurses, healthcare workers, and others on the front lines against COVID-19. For information on how to submit, click here.
Lately, I’ve been a doctor of telemedicine.
It’s a strangely disembodied way to spend my days as a primary care physician. I’m transported to my patients’ homes and cars, then when they hang up, I’m back in my messy little office, alone. My patients are pixellated images that jerk and flit across my smartphone screen. Their internet connections tend to be shoddy, so when the bandwidth fails us, they’ll appear frozen mid-sentence, while the audio barrels on.
I talk to them on their sofas, kids climbing on them, screaming in the background. Some of them call me from bed. Others call from the bathroom, where they look relieved to have a moment of quiet, sitting on the toilet. Some touch their hair, like I have a tendency to do, fluffing it out for their own reflected image in the corner of the screen. I talk to some of my patients in their cars. That’s where they seem to cry the most, the camera panning to the roof while they set it down to sob, reaching over the upturned smartphone while they grab tissues from the glove compartment.
My days feel exhausting and unglamorous, like I work at an understaffed call center. “Of course, happy to call you back on your son’s cell,” I say. “Just click on the link for the video chat,” I say. “Can you hear me? I think you’re on mute,” I say. I tell myself I’m helping, helping my patients stay healthy, helping them stay out of the ER.
I have no training for this. Med school and residency always assumed, no matter how much time I’d spend charting in front of a computer, that ultimately there’d be a flesh and blood human nearby who needed my help. My training assumed that I could turn to data: vital signs, lab values, my own eyes on the patient assessing, “Do you look well, or do you look sick?”
I sense that I’ve lost some of the power inherent in asking my patients to come to me. Before I practiced telemedicine, my patients would sit alone in exam rooms, waiting for my knock to start the appointment. They had no real sense of how long the wait would be. Now, they tell me to hold on: “Oh Dr. Gordon, my grandma ran out to the store, can she call you back in 15 minutes?” I hear the ambient noise of their households while a relative summons my patient from another room.
Telemedicine forces me to trust my patients. I can’t verify, like I’ve been trained to do, that a patient is indeed hunched over in pain when he tells me that his belly hurts; I can’t squeeze a patient’s ankles myself when she tells me her legs are swelling; I can’t take the temperature of a baby whose dad worries she feels a little hot. I try to ask questions to make their fear and pain more specific: where does it hurt? How long has it hurt? Does the hurting ever stop? Then we hang up, and I call the next one.
Dr. Mara Gordon is a family physician in Camden, NJ, and a frequent contributor to NPR. She misses seeing her patients in person.