Covid-19: A Mexican experience

By Dr. Rocío Carrera

In México, the Health Department has reported over 65,000 cases and more than 7,000 deaths (as of May 24th). and 111 of these deaths have been healthcare workers. It is known that my country’s health system has always had deficiencies; we fight against the lack of resources and physicians and nurses do not receive an adequate salary or benefits. The greatest challenge that national hospitals, administrators, and doctors have faced is to adapt the existing healthcare facilities for the pandemic. When positive cases of coronavirus began to appear in our country, some hospitals were designated as COVID-19 centers; at the beginning, my hospital was just a triage center, but as the cases increased, many places became saturated with little to no availability of ICU beds and ventilators, and it was when most of the public and private hospitals in the country had to be reconditioned in order to receive and attend to these patients. With the increase in the number of infections and deaths, doubts and fear also rose. Healthcare workers protested across the country due to lack of PPE, students were withdrawn from their clinical rotations, massive staff resignations occurred, physicians requested unjustified medical leave, reports of attacks on hospital workers by communities fearing spread of the virus, and many people on the streets were not following the recommendations (stay at home if not an essential worker, avoid public gatherings, use of face masks, frequent hand hygiene).  All of this created an atmosphere of uncertainty.

The government was forced to hire doctors and nurses in a very short time to cover the demand for staff and the workload. Fortunately, in my hospital, we had the opportunity to prepare in advance and to have equipment available for all the staff. After several administrative adjustments, I was named chief of general surgery in March. I was happy because I thought it was a recognition of my work and effort, but soon, I felt overwhelmed by all the things that I had to coordinate and supervise. I also faced the doubt and apprehension of the older and more experienced surgeons in the department that took many of my decisions with mistrust. In addition to fighting their prejudices, I had to deal with my imposter syndrome. Can I really do this? Did they name me chief because I’m the best or because they had no other choice? Many questions like this have hung around my head these days. Overcoming this has been challenging but I have learned to accept that self-doubt is normal and even if I have many flaws I’m also very capable, hard-working, and willing to listen and learn from others. I have set realistic goals for my career and tried to take all this one day at a time. Also, I have mentoring from wonderful and amazing women surgeons who have shown me that it’s possible to be successful and an example for younger female trainees. Fortunately, my family, close friends, and, very importantly, the hospital managers and administrators have been very supportive and understanding.

These have been very hard weeks, with a full hospital since early April, we are tired and overwhelmed  after seeing patients, many of them relatively young and healthy, dying every day. The first time I had to enter a COVID-19 area was to place a central line, and as I put on the full PPE, I felt really scared for the first time in my career. Some colleagues left their homes and many of us took other measures of isolation in our own houses because of the fear of infecting ourselves or our families. All that stress and worry are affecting many healthcare workers emotionally. 

There have also been good days. Many people and some institutions have organized to donate money, equipment, and food to healthcare personnel. Some senior physicians came out  from retirement, and many general practitioners and students volunteered to help. This type of support from society and the commitment of healthcare workers has buoyed our spirits on the hardest days. In addition to the great camaraderie and solidarity that has developed among all hospital staff are what often urges us to continue working, despite the limitations that have always existed in our country.

My most sincere appreciation and admiration goes out not only to the doctors, but also to all the nurses, administrative staff, and laboratory and sanitation personnel, who have made it possible for the entire health system to continue to function, despite the danger and fear. Although it is likely that we can never return to ‘normality’ and that healthcare and the way that hospitals work will change significantly all around the world, we hope that the COVID-19 pandemic will pass soon but that the environment of solidarity and cooperation remain as an example of one of the best lessons learned.

 

 

 

 

Dr. Rocío E. Carrera Cerón is a general and thoracoscopic surgeon and the current chief of surgery at Hospital General Ajusco Medio in Mexico City, Mexico. She received her medical degree from Universidad Nacional Autónoma de México (UNAM) in 2012 and completed her residency and fellowship at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) in 2017 and 2018 respectively. She has been accepted in the Esophageal Research Fellowship Program, at the University of Washington School of Medicine starting this summer. She is engaged in clinical research studies and actively participates in local associations of women surgeons trying to establish mentorship and sponsorship programs for young residents. A native of Mexico City, she is passionate about sports, cinema and historical novels. You can follow her on Twitter @ChioCarreraC.

 

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