New York City’s Montefiore Medical Center admitted its first COVID-19 patient on March 11. “That’s when the gates opened,” says Kenneth J. Schaefle ’90, a member of the hospital’s global health faculty group.
An assistant professor of medicine at the Albert Einstein School of Medicine in New York, Schaefle was pulled in alongside urologists, rheumatologists, ophthalmologists — almost anyone with a medical degree in the hospital system — to help with the Bronx hospital’s COVID response.
By mid-April Schaefle was working 12-hour, seven-day rotations in the inpatient ward, where up to 90% of the admissions resulted from COVID. Schaefle estimated that two-thirds of those patients were over age 65. “Not only was it a new disease we had never seen before,” he says, “but it's a set of patients who are exceptionally fragile. On top of that we had to exclude visitors, so the patients couldn't get sort of an anchoring visit of a familiar face. Instead it was a parade of people in protective gear.”
“It’s been brutal,” Schaefle acknowledges. To deal with the emotional demands, the hospital changed its rotation system from two-week to one-week shifts because the mortality is higher than most physicians have ever seen before.
“I’d seen this level of mortality because I’ve worked in Africa,” says Schaefle, who spends three months a year in Uganda teaching U.S. medical students and residents how to practice medicine with minimal equipment. “But it is common for an attending physician in an American hospital to do a two-week duty and not have a single patient die. And with this disease people were dying every day or every other day.”
Schaefle says he and his colleagues have implemented some heartwarming changes in patient protocol. “We call families in advance when things are looking bad and use our own cellphones to do FaceTime so these people can see their loved ones and maybe hear them speak for what could be the last time,” he says. “That’s been a very positive development in medical practice because it's very inclusive and loving, and it gives the family something to hold onto.”
There have been other silver linings in the pandemic response. One long-term effect, Schaefle says, is that telemedicine will become much more mainstream. “Four out of five times I can meet a patient’s needs with telemedicine,” he says. “It's an advancement that’s long overdue.”
And he appreciates the unprecedented international cooperation among physicians from around the world. Many doctors in China and Italy shared unpublished research to help establish best practices in the race to battle COVID. “It’s incredible that people would work the whole day and then log in at night, and there would be these open-access conversations,” Schaefle says. “People were very honest. No one was a cowboy claiming to have the magic bullet.”
Open communication is something Schaefle knows a thing or two about. He and fellow Northwestern alumni Andrew Moskos ’90 and Jonathan Rosenfeld ’90 founded the Boom Chicago comedy theater in Amsterdam in 1993. Schaefle left Boom Chicago in 2006 to pursue medicine and graduated from the Albert Einstein School of Medicine in 2014.
“I worked with Seth Meyers and Jordan Peele” Schaefle says, “and I learned from them and other cast members how to speak to the room, include everybody — how to generate enough energy that you’re present but also make it about them so that they’re present and then get a communication channel going. I learned how to address people, and that’s important when you meet a patient or their family for the first time.”