Doctor’s Life on the Front Lines is Just His Job

Posted: September 9, 2020

It’s 6:45 a.m. and Infectious Disease Specialist Gregory Warner, D.O., walks into the COVID-19 pod in the Intensive Care Unit at NorthBay Medical Center. He’s wearing a mask but soon begins donning even more protective equipment — a process he will repeat numerous times during the next hour.

Washing his hands, sanitizing, putting on gloves, changing to an N95 mask, putting on a gown and plastic face shield, he enters a small ante room that connects to the first of several patient rooms where he will check on intubated COVID-19 patients.

“I check with the nurse who has been caring for the patient overnight,” he explains. “I’m asking about any changes in temperature through the night, any new lab results, I check the chart and then I do a physical exam.” The goal is to make sure the patients are still responding well to care or if any change in treatment is required.

When his examination is done, he repeats his PPE process in reverse, discarding gown, gloves and mask, sanitizing the face shield as well as washing and sanitizing his hands.Dr. Warner checks a proned COVID-19 patient in the ICU.

“And we begin again,” he says casually, as he puts on a new set of PPE and prepares to enter the next patient’s room.

It’s all part of the new normal day in the life for Dr. Warner, who helps lead the battle against the pandemic on the front lines at NorthBay Healthcare.

It’s What He Does

He was well-prepared for the job, he says. Before medical school, he earned a master’s degree in public health and was an epidemiology expert for the Los Angeles County Public Health Department before coming to NorthBay. “So dealing with infectious disease is in my tool kit,” he says, simply. “This is what I do.”

And he is quick to praise the entire team at NorthBay.

“In the microcosm of NorthBay we are doing everything as well as we can,” he says. “We provide state-of-the-art medical care and we have a good group of individuals from our ICU and COVID unit staff, to inpatient hospitalists. The chief medical officer (Seth Kaufman, M.D.) and I put our heads together on a regular basis and ask ourselves, ‘Are we doing all we should be doing? Are the right medical treatments in place and are they working?’ So I think we are doing a good job.”

On The COVID Wing

When he is done with visits to the ICU patients, he heads to 2 North, to round on less acute COVID-19 patients. The process of donning and doffing PPE begins again.Dr. Warner cleans and disinfects his face shield after checking on a COVID-19 patient in the ICU.

He says he doesn’t mind the repeated changes, noting that NorthBay has been dealing with the pandemic since February. “You kind of get used to it after a while,” he says.

The constant hand washing and sanitizing doesn’t dry out his hands, he insists. “The sanitizers now have emulsifier in them, so it’s no problem. It’s when I go on vacation that my hands dry,” he says with a chuckle. “Back when I was a resident, we used the old style gel and by the end of shift, your knuckles would be bleeding and cracked. They’ve made some improvements since then.”

After visiting with a 2 North patient, he exits the patient’s room and talks with one of the nurses about whether the patient has been doing everything the patient has been asked to do. In particular, he’s wondering if the patient has been moving into a prone position to allow for better expansion of the lungs which helps with removal of secretions and improves breathing.

“Some patients are resistant,” he explains. “We just need to drive it home to them on why we have to do this. Some patients don’t like it, but if they don’t do it, they could end up being intubated and they really won’t like that.”

Treatment Options

Proning patients is one of the key procedures NorthBay uses to fight COVID-19. Others include the use of the drug Remdesivir and the corticosteroid Dexamethasone, which are widely used by hospitals across the country.

More recently, NorthBay’s collaborative relationship with the Mayo Clinic made it part of a clinical program using convalescent plasma, Dr. Warner says. Through the process, antibody-rich plasma from patients who have recovered from COVID-19 is transfused to hospitalized patients still fighting the disease.

While it is too early in the process for NorthBay to measure the success rate, Dr. Warner is hopeful, explaining that the more plasma is used on patients, the better picture NorthBay will have on how well it works.

The Hard Part Lies Outside of the Hospital

Like his colleagues, Dr. Warner got into medicine out of a desire to help people. COVID-19 doesn’t always allow him success in that effort and dealing with the loss of even one patient is always difficult, he says. But the hardest part of the work isn’t what happens inside of the hospital.

“It’s what lies outside of the walls of the hospital,” he says. “We know the impact of what we are doing here and the gravity of the situation with COVID but the hardest thing is when people outside don’t take it seriously and don’t practice safety by wearing a mask and socially distancing. There is a reason the experts tell people to do those things.”

The best part of the work, of course, is when treatment is successful. “I get to see their faces when I tell them you are better, or you are getting better, and you get to go home,” he says. “That is extraordinarily satisfying and makes it all worth it.”

However, he sends each patient home with a mission: “I tell them you have a job now, and that is to spread the word and tell people what this is and tell them to be careful and wear their mask and socially distance.”

Driving the Message Home

He tries to lead by example, he says. As he travels from NorthBay to VacaValley Hospital to round on patients there and to hold his regular clinic hours, he wears his mask. He practices social distancing when outside of work.

At the end of the workday, when he drives home, his family and children know the rules, too. “No hugs until I change and shower,” he says, explaining that he has established a process at home for putting his work clothes in a bag designated for them, showering and cleaning up before approaching his loved ones.

“I’ve been doing this for months so my kids — while they don’t like it — understand and they know the work that I do,” he says. “They have a good grasp of what’s going on with COVID because it comes up in conversations at home a lot. So they understand and they know that I’m trying to help people.”

 

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