As the number of COVID-19 cases rises across the nation, the day-to-day has changed drastically for Justin S. Shafa, MD, and his colleagues. Instead of reading images and spending time in the radiology department, Shafa and his co-residents are now taking on a variety of roles. The Bulletin spoke with Shafa about what it’s like to be on the front lines at the epicenter of the pandemic and how his team is adapting to meet the hospital’s needs.
 

What does your day-to-day as a radiology resident look like now?

Essentially, we're no longer radiologists — we’re more like medical interns and residents. We're doing whatever we can to help the internal medical department. The four of us who are Early Specialization in IR (ESIR) have formed a procedure team that goes around to the medical ICU, the cardiac care ICU, and the oncology ICU — all of which are filled with coronavirus patients at this point. We do whatever procedure we can to free up those nurses, residents, and attendings so they can spend time on other patients and provide high-level care to those coronavirus patients. We do things within the IR realm — like placing central lines, US-guided IVs on hard sticks, and even some blood draws. We're doing whatever we can to help. 

How are you dealing with the daily stress of so much uncertainty?

It’s hard. Most of the ways I typically relieve stress — the gym or my boxing classes — are closed right now. I try to work out with whatever limited equipment I have in my house and give myself down time by playing video games. 

What really stresses me out isn’t the work or the hours, but how bad things are in New York City. I take the subway every day to get to the hospital, which is 12 miles away. It's packed. I’m still seeing people around here playing basketball and hanging out in groups. If it continues like this, it will get exponentially worse. When I walk home, people don’t observe the six-foot rule because in the city, that’s hard. I hope other major cities, like San Francisco, Chicago, and Los Angeles, do a better job than New York. 

Why is it important that the radiology community steps up at a time like this? 

We have to do our part. Yes, we’re radiologists, but that means we are also doctors. All of us have done a medical internship or, as in my case, a surgical internship. All hospitals in the area have nearly 100% coronavirus cases. We can’t have 16 residents sitting on their hands while radiology volume is low. We're not going to have 10 residents at home waiting to be called in. We're going to help out where we need to help out, using whatever skills we have to do so. All hands on deck.

Is personal protective equipment (PPE) access a concern right now?

NYC Health + Hospitals has established conservation measures for PPE to ensure staff is protected given the global supply shortage, but we’ve always had access to the PPE needed. The hospital system follows all CDC and NYS/NYC health department guidelines on PPE. Conservation measures include reusing N95 masks, unless they became soiled, by putting a simple surgical mask over it to shield it. Then, we throw the top mask out and we hold on to the N95 mask.

In a larger sense, I've learned that medicine is a family, and I've seen us all come together — attendings, residents, nurse practitioners, physician assistants, registered nurses, and hospital support staff — during this time of need. There are no more turf wars — just many amazing people doing whatever they can to help.

What is your best advice for radiology residents right now?

Volunteer your services in areas you feel comfortable. Try to recall those skills you had maybe a very long time ago after a surgical internship or after medical school. A lot of opportunities are available. We’re doing medical intern tasks, like e-consults with patients and helping out in research and data collection. If you can perform a procedure in an IR suite, you can perform it in the ICU. Get your US machine and free up an ICU fellow or nurse to take care of other patients. The entire medical community is stressed out, so do whatever you can to help.

What have you learned about medicine during this crisis?

I've learned that the radiologist is first and foremost a clinician. We are so much more than a person behind the computer screen in a dark, quiet room looking at images all day. I'm proud of my team of residents who have stepped up to help, most of them using their clinical skills to act as internal medicine residents, while myself and three other ESIR residents have been using our interventional skills to help place lines throughout the ED, ICUs, and floor. In a larger sense, I've learned that medicine is a family, and I've seen us all come together — attendings, residents, nurse practitioners, physician assistants, registered nurses, and hospital support staff — during this time of need. There are no more turf wars — just many amazing people doing whatever they can to help.