Leaving Retirement to Support Other Physicians

Bottom line: Pediatricians pitched in to help stressed colleagues during COVID-19 surge.

Guest post by Dr. Richard Mink. Image from Getty.

In the past year since the World Health Organization pronounced COVID-19 a global pandemic, thousands of physicians and other health care professionals came out of retirement to help care for patients.

In January, I joined them. Pediatrics is not just a career to most of us — it’s a calling. And we respond when called.

I retired from practicing pediatric critical care medicine in October 2019, after 23 years with Los Angeles County-Harbor-UCLA Medical Center. I was looking forward to having more control of my time, even though I continued in my role as Director of the Pediatric Critical Care Fellowship Program, remained on staff as a volunteer, and conducted medical education research.

Early in the pandemic, New York seemed to be getting the worst of it, and Southern California was initially spared from a huge impact.

When the post-holiday wave hit, though, it was much worse in our area. Our hospital’s 32 adult ICU beds filled quickly. Eventually, we had about 70 adult ICU patients scattered around the hospital.

Our PICU was not overrun with cases, but our adult colleagues were running on fumes, so I checked to see if they needed any help. After all, I thought, although the medical issues might be different, treating severe respiratory disease in adults wasn’t all that different from treating a teenager or young adult.

With an inquiry, I quickly learned that help was needed on the medicine service but not in pediatrics. Because of the huge need, the County had developed a way to get emergency privileges approved. My credentials in pediatrics were simply extended to medicine.

First, I rounded with my adult critical care colleagues for a couple of days to see what situations they were facing. There were four ICU teams — two from medicine, one from trauma critical care and another from anesthesia critical care.

The ICU teams were having trouble completing rounds because there were so many codes and rapid response calls. The adult critical care attendings came up with a system to have the critical care fellows on the medicine consult service go to rapid response calls and codes. I would go with them as the attending physician.

The medicine fellows were well-trained and knew management of complex adult diseases that I hadn’t needed since medical school, but I had expertise with ventilators that proved valuable for several patients. Medicine and pediatrics have somewhat different techniques with ventilators, so we learned from each other. It was a learning experience for me as well as for them.

Not surprising, another difference from pediatric care is that adults typically have more comorbidities. For example, almost every patient who was intubated had diabetes and at least half were obese.

When the patient load began to subside around the end of January, and the usual ICU teams were able to handle the work, I went back into my version of retirement.

I am glad that I volunteered. It gave me a sense of doing something to help in a crisis. Doctors, nurses, trainees, and other health care professionals who staffed hospitals in Los Angeles County and throughout the world have worked practically around the clock to treat COVID-19 patients. The mortality in these patients was high, which was depressing. I believe that the moral support my presence provided was as helpful to support my colleagues treating adult patients — maybe more so — than the medical support I provided to the COVID-19 patients.

I am grateful to be part of a community that cares so deeply for patients.

About the Author

Dr. Richard Mink

Richard Mink, MD, is Professor of Pediatrics at the David Geffen School of Medicine at the University of California at Los Angeles (UCLA) and Director of the Pediatric Critical Care Fellowship Program at Los Angeles County/Harbor-UCLA Medical Center. He is a researcher at the Lundquist Institute for Biomedical Innovation and the Director of the APPD Subspecialty Pediatrics Investigator Network (SPIN). Dr. Mink was certified by the American Board of Pediatrics (ABP) in General Pediatrics in 1987 and in Pediatric Critical Care Medicine in 1990. He was a volunteer on the ABP Education and Training Committee from 2014-2019. Currently, he is a member of the ABP Competency-Based Medical Education Committee.