This is part three of a three-part story series about Virginia Tech Carilion School of Medicine alumni physicians serving communities across the country. The current COVID-19 pandemic has changed how each of them do their jobs, in big and small ways.

Nine of the alumni, currently located on the West Coast to the East Coast and in between, offered their perspective of how the pandemic is affecting them professionally and personally. Part one explored stories from three alumni on the West Coast. Part two shared stories from the Midwest and Northeast. Today's final installation of the series will focus on the Greater Washington, D.C., metro area and Roanoke, Virginia.

Lindsey DeGeorge and Robbie Varipapa: Washington, D.C.

 

Lindsey DeGeorge and Robbie Varipapa in Washington, DC
Lindsey DeGeorge and Robbie Varipapa, both part of the VTCSOM Class of 2015, are physicians in the Greater Washington, D.C., metro area.

In and around the nation’s capital, Lindsey DeGeorge is an attending physician one of MedStar’s community hospitals just outside of the city, while her husband, Robbie Varipapa, is in his second year of a pulmonary critical care fellowship with Georgetown University Hospital within the district.

DeGeorge and Varipapa were both in the VTCSOM Class of 2015, but did not begin dating until medical school was almost complete. They got married last summer.

They shared a unique perspective of complementary, but different roles related to the pandemic. With DeGeorge in an emergency room, she is part of the team that is the first stop for patients, particularly those who may be worried about having COVID-19.

“The first few weeks, we used electronic health as much as we could,” DeGeorge said. “There were some people who had contact with a confirmed case and had mild symptoms. We would give them direction on what to do virtually instead of coming in the emergency room.”

As the weeks went on, they began to see more cases, with most mild, but about a third needing some care to high levels of care.

It's been an evolving process. Just like with PPE recommendations, the way we're sort of treating patients with coronavirus is evolving over time, particularly those critically ill,” DeGeorge added. “I think the most challenging thing is that it’s just not quite like anything we’ve seen before. We are having to learn and adapt every day.”

The same is true for Varipapa, who spends his time caring for patients in intensive care units. “We are coming up with a guide for treating COVID patients, but it’s a protocol that is constantly evolving and changing as we’re learning more and getting more patients.”

He said they’ve altered their ICUs to COVID-19 or non-COVID-19 units. About two-thirds of the patients Varipapa cares for have COVID-19. “It’s bizarre. We have entire units filled with just COVID patients, and every single one is on a ventilator,” said Varipapa.

For both DeGeorge and Varipapa, a major adjustment has been that patients cannot have guests to try to prevent the spread of the virus.

Generally, half the ICU patients have visitors and now we have none, which is obviously isolating for the patients,” Varipapa said. “We’ve been trying to help by using Zoom or FaceTime, but it’s really hard for the families and patients. And the providers to not have family around to explain what’s happening to them.”

“I think one of the things to come out of this is we're all learning how to, in some way, treat more compassionately. Not that we weren't before, but now, we are all that patient has,” DeGeorge said. “We’re not just being their care providers but also being there to like comfort them and sort of be their surrogate family."

Both said the challenges at work are made a little easier by being able to relate and talk through it all together.

“It's really nice to have someone else to talk through all of this, who is also experiencing the same things,” DeGeorge said.

“She understands where I'm coming from and we can bounce ideas off each other. I think the camaraderie amongst the staff has increased and that makes it a lot easier, having people that you care about and trust to come to work with,” Varipapa said.

Their colleagues and success stories keep them going. “To see someone super sick get better has been incredible,” Varipapa said. “Early on we didn’t get that much, but now we are getting better. Seeing people come out of the ICU and leave the hospital is a good reminder of why we are doing it all.”

Jessica Nguyen: Roanoke, Virginia

Jessica Nguyen at McAfee's Knob
Jessica Nguyen, VTCSOM Class of 2017, hiked McAfee's Knob last year, prior to the Appalachian Trail's closure due to the COVID-19 pandemic.

In Roanoke, Virginia, home of the Virginia Tech Carilion School of Medicine, Jessica Nguyen, class of 2017, is finishing up her last year of residency as chief residency in the Department of Emergency Medicine at Carilion Clinic.

The pandemic hit home for her after she traveled to a Council of Emergency Medicine Residency Directors conference in New York in early March. After her return while she was rotating at Carilion New River Valley Medical Center, she learned a dozen people at the conference tested positive. “In case I was exposed, I wore an N95 mask during all shifts. There had not been any positive cases in our area yet,” Nguyen said.

Thankfully, Nguyen did not get sick, but a few weeks later, the region’s first positive cases began popping up. “Initially, we were truly preparing for the worst, so we were trying to make sure that we had things in place to address a surge in volume,” Nguyen said. “But then we started seeing half the number of patients as normal.”

While the number went down, the severity of cases – both COVID and non-COVID related – went up. “I had several very sick patients that didn’t want to stay at the hospital because they were scared.”

Other safety measures, like no guests for patients and increased PPE use, have been tough professionally. “There hasn’t been a patient who has seen my face in six weeks. They don’t know what my face looks like. They can’t see compassion on my face. They can barely hear my voice because I’m wearing a respirator,” Nguyen said.

The hours have been long and stressful, and now there is added concern the budget because of low patient volume. Still, Nguyen keeps her positivity. “I feel proud. I purposely chose a specialty that was always going to be on the front lines of any disaster that happens,” Nguyen said. “Carilion’s approach has been very positive and supportive. The whole world is going through the same thing. I’m glad I get to go through it here, where I feel we have a good group of people and a lot of wisdom.”

As she finishes up her final months of residency, it will be different than planned. She hasn’t been able to see some of her fellow residents and friends in person and may not before she graduates – a ceremony that has been canceled. “My co-residents are graduating and then many will move away. Will I get to see them before they move?” Nguyen asked.

As for Nguyen, she will stay in Roanoke as an attending physician in emergency medicine with Carilion Clinic.

Read Part One and Part Two of this story series.