In a valley of the Andes Mountains lies Cusco, Peru, where Wi-Fi is spotty and U.S. news limited.
As Gabriela Ulloa, MD, conducted qualitative breast cancer research at a clinic there in early 2020, she would get occasional COVID-19 news in the form of phone calls from her mother, who was stateside.
“Her updates went from, ‘I don’t think it’s going to end up coming to the U.S.’ to ‘It sounds widely infectious and is hitting China hard,’” Dr. Ulloa recalls. “Eventually, Mom’s calls transformed into panicked updates.”
Dr. Ulloa and her husband, Jorge, who had joined her in Peru to explore the region and then visit his family in Bolivia, made it back to New York City just before the borders closed.
Soon after, Dr. Ulloa vividly remembers receiving an email from the dean of her school, NYU Grossman School of Medicine, to ask if any students would consider cutting short their final year of med school to work on the front lines.
“I was sitting on the couch crying for 40 minutes after I read the email,” Dr. Ulloa explains. “I felt that if you receive an email at 7 pm on a Sunday from your dean offering early graduation, the hospital really needs [you]. I felt the urgency of how much the med school was willing to go through for us because they needed help.”
After talking it over with her husband, Dr. Ulloa signed on.
“It was a no-brainer for us,” she says. “I saw my friends in their intern year struggling, not having enough [personnel to] allow them normal working hours and conditions. I really commend them. We always have to recognize that they were working very hard before we even got there, which prompted us to be able to volunteer to join them—and hopefully help them.”
Dr. Ulloa was assigned to NYU Langone’s Tisch Hospital, where her first patient’s COVID-19 symptoms had improved considerably and she was being discharged.
“She reminded me of my abuela, my great-grandmother,” she recalls. “The patient had a lot of co-morbidities—chronic heart failure, chronic kidney disease. In my very short career as a doctor, I had never discharged somebody who was so scared to go home. We spoke to each other in Spanish. She had a lot of questions about COVID-19 side effects. Would she get sick again? And it was hard to answer any of those questions at that time because so little was known. I just remember feeling lost and very scared for her as well.”
Dr. Ulloa’s fluency in Spanish became invaluable, as the Tisch population grew heavily Hispanic during the pandemic surge, which was in contrast to Dr. Ulloa’s past experiences on the internal medicine floors there.
“This felt like a completely different population than I was used to at Tisch,” Dr. Ulloa says. “Now, I was using my Spanish every single day. On a personal note, it was tough to see people who looked like my family, who had similar occupations to my family, be really sick and really scared at the same time. But I was happy to be able to speak with them, and hopefully calm their fears a little bit.”
In addition to the parallels she felt with her patients, Dr. Ulloa found that her pediatric training served COVID-19 patients and families well.
“In pediatrics, you’re constantly dealing with the patient’s family, which is why I love the field,” she says. “You’re used to explaining things in lay terms, and sometimes you need to articulate honestly that you don’t know what a certain symptom means in a way that is not upsetting to the family. I was able to apply these skills to COVID-19 care and help communicate with family members of geriatric patients especially—a population [for whom] it’s normally taken for granted that loved ones will be by the bedside.”
The experience has also shed new light on a possible new area for Dr. Ulloa to pursue: pediatric intensive care. She says that working on the COVID-19 floors presented stressors similar to those that intensive care units (ICUs) often experience—and that she thrived in this challenging environment.
“Even though it was really, really tough, I felt satisfied in that I was coping,” Dr. Ulloa says. “I could not only tolerate but do well in an ICU setting, where patients and families are typically quite upset. I also felt impassioned speaking to people in Spanish who didn’t understand their diagnoses or what we were doing with their care. Being able to connect like that with the Hispanic population through a difficult medical experience is rare, especially in an ICU setting.”