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INTERNIST DR ANDRE GRAHAM by Katrina Welch Alove for science and an interest in the way the human body functions led 31-year-old André Graham to a career in the field of medicine. In 2014, he completed his internship before joining the internal medicine department of the Oueen Elizabeth Hospital (OEH). However, he never anticipated that he would find himself working in the midst of



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Katrina Welch

Alove for science and an interest in the way the human body functions led 31-year-old André Graham to a career in the field of medicine. In 2014, he completed his internship before joining the internal medicine department of the Oueen Elizabeth Hospital (OEH). However, he never anticipated that he would find himself working in the midst of a global pandemic. Dr Graham took the time to share with Better Health magazine about life at the Harrison’s

Point Isolation Facility.

• What inspired your career path in medicine?

Both my parents worked in the finance field, but from the age of four I wanted to be a doctor. I’ve always been fascinated with science, the human body, and medicine in general but the kind of doctor I wanted to be changed many times from neurosurgeon to cardiothoracic surgeon and eventually internal medicine, since I really enjoyed that rotation during my internship.

What is your area of specialty?

I’ve been working in the internal medicine department from January 2015. An internist works with the pathology of all the different organ systems, and is responsible for the non-surgical management of abnormalities of various body systems. We tend to manage patients with lung diseases, kidney disease and cardiovascular diseases such as heart attacks and strokes.

What is your role at the isolation facility?

I am assigned to the Harrison’s Point Isolation Facility. I joined the team almost from the inception of our local COVID-19 cases as one of the residents attending to critically ill patients in primary isolation, the Intensive Care Unit for COVIDpositive patients. COVID is a respiratory illness and as internal medicine manages various lung diseases, internists are experienced in managing varying degrees of severity of respiratory illnesses, including patients on ventilators. Additionally, many patients have non-communicable diseases such as diabetes and high blood pressure, which we have experience in managing, so our role is a multifactorial approach.

As a doctor, are you used to your current role and workload?

We do have hazards in our day-to-day job managing patients with illnesses, both infectious and non-infectious, so there are risks, but I never anticipated dealing with something of this magnitude.

Internal medicine is one of the

services at the OEH with the heaviest patient load, so I am used to that, but this pandemic still far exceeds the extent of critically ill patients we are seeing. Fortunately, my department has been very good in maintaining the support we need, especially when the cases in isolation increased.

What are some of the key differences between working at Harrison’s Point and at the OEH?

Working at Harrison’s Point is completely different as there are more protocols and procedures since all the patients are COVID-19 positive. We tend to be more acutely aware of our interactions with both patients and colleagues.

We always have the extra step of putting on full personal protective equipment before seeing patients; and to avoid multiple exposures to the disease, we need to create a good checklist for patient consultations before entering their rooms.

Then, there are a lot more steps to processes that would have been familiar to me before; for example, there are more logistics in taking blood samples because they must now be taken and packaged a certain way.

What measures do you take to protect your loved ones that you return home to daily?

We all worry about taking COVID-19 home to our families.This experience has really brought into focus a lot of the small things we would previously take for granted because there is always something in the back of my mind reminding me that I could be asymptomatic. So a lot of adjustments had to be made. For example, one of the first things I do when I get home is take a shower and I put my scrubs separate from the rest of my laundry.

As a doctor on the front lines, how do you maintain good nutritional, mental and emotional health?

The lockdown allowed me to pay attention to how I eat because I had more time at home and places weren’t open for me to buy food. Outside of trying to eat healthy, I’ve had to focus on good mental and emotional health because medicine is a very demanding profession and this situation can be very draining. I go to work dealing with COVID-19 patients and at home and on my off days I still hear about COVID. Social media has become a bit more prominent in my life, but simultaneously, there are periods when I have to get away from social media, especially when there are a lot of COVID-related posts.

That’s why it’s been important to maintain connections and open lines of communication with friends and loved ones. I love travelling, especially to New York, and I also enjoy dining out and going to movies as a means of de-stressing, but with COVID there isn’t the option for those things anymore. My time is now spent on a lot more leisure, with books, music and television; and I’ve also been catching up on a lot of rest.

• What provisions were made to help medical front-line workers, like yourself, cope with the challenges of working at the isolation facility?

During the first lockdown there were weekly group counselling sessions to talk about how we were feeling about the situation. Now, there is a full time psychologist who was brought on board for staff and patients. It’s good because everyone can understand how hard it is for patients to be put in isolation, but it’s great that it’s available to staff too because the lockdown affects us as well.

I think a lot of people are familiar with the notion of COVID fatigue.

Everybody sees the strain on the US health care system on television and there has been the fear of something similar happening here. We have limited staff deployed at the isolation facilities, but they ensure we have off days to avoid us becoming burnt out.

• What has been the most trying part of your experience working in this current situation?

It’s very difficult to pinpoint one thing because the situation is so vastly different. In the last year my responsibilities have changed and increased significantly. I’ve had to interface with more departments and personnel such as housekeeping, orderlies, and even Ministry of Health and Barbados Defence Force personnel. That in itself was a learning curve.

Then, keeping the large numbers of asymptomatic patients happy and explaining to them why they needed to remain in isolation was trying.

So, there has been a much greater emphasis on the social aspect of medicine.

• What keeps you and other medical front-line workers going, despite the immense challenges?

When I first got into medicine it was out of a love for science and the functioning of the body, but I’ve come to realise we really do make a difference in people’s lives. It’s rewarding when patients and relatives thank us; and in this pandemic, seeing a decline in the positive case numbers is also rewarding. What also helps is that the pandemic is global, so there is a lot more empathy from other persons who give their support and express concern for our safety. Our teams of consultants, residents, and nurses, rally together and that sense of camaraderie makes it that much more bearable.