{"id":10783,"date":"2020-06-18T10:24:28","date_gmt":"2020-06-18T14:24:28","guid":{"rendered":"https:\/\/www.monmouth.edu\/magazine\/?p=10783"},"modified":"2020-11-11T16:40:11","modified_gmt":"2020-11-11T21:40:11","slug":"dispatches-from-the-front-lines-5","status":"publish","type":"post","link":"https:\/\/www.monmouth.edu\/magazine\/dispatches-from-the-front-lines-5\/","title":{"rendered":"Dispatches From the Front Lines"},"content":{"rendered":"\n

It was the second week of March when the unavoidable, intense reality of COVID-19 hit home for Dr. Jeffrey Miskoff.<\/p>\n\n\n\n

As a pulmonary, critical care, and sleep medicine specialist, Miskoff had been forced to close his office at Shore Pulmonary in Ocean Township as he and nine other doctors from the medical group shifted their focus to intensive care units at Jersey Shore University Medical Center, where Miskoff serves as chief of pulmonary medicine. It was an all-hands-on-deck situation comprising long, exhausting days trying to understand the novel virus and devise the best treatment options for infected patients. And it was during that first week of the outbreak that Miskoff recalls treating one particular, younger physician.<\/p>\n\n\n\n

\u201cLuckily this man wound up doing very well, but there was a point when he was pretty sick with COVID in the ICU. I think that\u2019s when it hit home for me,\u201d says Miskoff, who graduated from Monmouth University in 1993. \u201cI\u2019m 48 years old, and seeing a doctor younger than me get that sick really struck a chord. If it could happen to him, then it could happen to me.\u201d<\/p>\n\n\n\n

Unfortunately, this was only the beginning of a tense, confusing, and sometimes macabre journey that would unfold as Miskoff spent March, April, and much of May helping to diagnose and treat COVID-19 patients. In the context of his 20-plus years as a physician, Miskoff says, \u201cI\u2019ve never experienced anything like this\u2026or the angst associated with it.\u201d<\/p>\n\n\n\n

I\u2019ve never experienced anything like this\u2026or the angst associated with it.<\/p><\/blockquote>\n\n\n\n

To be sure, Miskoff\u2019s angst was multifaceted and nuanced. Yes, there was the overarching concern of becoming infected, but this actually paled in comparison to both the stress of the unknown and the peripheral humanitarian sorrows he witnessed throughout the spring.<\/p>\n\n\n\n

\u201cIn March, we really just didn\u2019t understand the virus, and in those early days we were all very fearful when hospitalizations ramped up because we didn\u2019t necessarily know how to deal with it,\u201d says Miskoff, recalling how protocols, treatment suggestions, and hospital management often changed on a daily basis. Additionally, Miskoff says more than 90 percent of newly admitted patients were suffering from COVID-19 in March, and all 10 hospital floors were being used in some capacity to diagnose and treat them. \u201cWhen every case is COVID and nothing but COVID for a month straight, it starts to give rise to anxiety, and I think there will probably be some PTSD from those who worked closely with very sick patients.\u201d<\/p>\n\n\n\n

For Miskoff, the most emotionally taxing aspect of working on the medical frontlines came from seeing such a high volume of patients on ventilators. More specifically, Miskoff points out that when patients are ventilated, they\u2019re placed on their bellies to allow for better oxygen circulation, a procedure that led to a surreal landscape of extremely sick individuals suffering in veritable anonymity.<\/p>\n\n\n\n

\"Visit<\/a>
On his YouTube channel, \u201cA Concerned Doctor,\u201d <\/a>Miskoff shares videos that focus on statistical analyses of potential COVID-19 treatments while also trying to answer specific questions that crop up in public discourse.<\/figcaption><\/figure><\/div>\n\n\n\n

\u201cEveryone was flipped over and heavily sedated, and all the patients just started looking similar. I experienced some anxiety with that,\u201d says Miskoff. \u201cAnd then you add to it the fact that these people were severely sick but also alone because family weren\u2019t allowed to visit. I just kept thinking how traumatic that must have been for patients\u2019 loved ones.\u201d<\/p>\n\n\n\n

Despite the chaos and emotional turmoil into which Miskoff had been unexpectedly flung, he decided that he wanted to do just a little more, which is why he started a YouTube channel during the second week of March called \u201cA Concerned Doctor.\u201d It was an admittedly uncharacteristic move for someone who is \u201cnot a big social media guy\u201d and who didn\u2019t even know how to use YouTube before March 14. Nonetheless, the spontaneous project\u2014which features Miskoff talking directly to his webcam from the comfort of his Toms River, New Jersey,  home\u2014has proven to be both valuable and therapeutic to himself and others.<\/p>\n\n\n\n

\u201cI think initially it was helpful for me. In the beginning there was definitely some self-reflection. I also saw it as a journal of sorts, where I could create a record for myself and others to watch as the situation unfolded,\u201d says Miskoff. \u201cBut I\u2019ve now seen how it\u2019s been helpful to others as well, and over the past few months I\u2019ve run into maybe 20 or 30 people who have thanked me for doing it.\u201d<\/p>\n\n\n\n

Thus far Miskoff has more than 1,000 subscribers and has posted close to 40 videos, most of which focus on statistical analyses of potential COVID-19 treatments while also trying to answer specific questions that crop up in public discourse. And while the overall topic may be serious, Miskoff does take the occasional opportunity to insert some levity. For instance, he started one of his early videos by playing the opening riff from Black Sabbath\u2019s \u201cCrazy Train\u201d on his unplugged electric guitar. The title of that video: \u201cIs COVID-19 Driving You Crazy?\u201d In another video from late March, Miskoff can be seen wearing a long, voluminous, unruly wig, a site gag used to accentuate the importance of social distancing\u2014even if it means you can\u2019t visit the salon.<\/p>\n\n\n\n

Notably, Miskoff avoids using his videos to make predictions or insert himself into the myriad political elements that have inevitably played a role in how the U.S. is handling the pandemic. For him, it\u2019s all about the science of studies, treatments, and new information.<\/p>\n\n\n\n

\u201cHere\u2019s the thing. Clinicians don\u2019t look at this like the rest of general society. I don\u2019t care if this thing was created in a lab or it came from Mars. We have patients we need to heal,\u201d says Miskoff. \u201cAnd I try consciously to not project where we\u2019re going. We just don\u2019t know. So most of my videos have a question mark in the title. Will this particular treatment help you? Will x, y, or z be the silver bullet? I didn\u2019t want to be controversial. I wanted to be comforting.\u201d<\/p>\n\n\n\n

Speaking in late May Miskoff says the worst of the outbreak seems to be behind him for now, and he\u2019s looking forward to reopening Shore Pulmonary in June to begin telehealth consultations with non-COVID-19 patients.<\/p>\n\n\n\n

\u201cI\u2019m happy that I was able to help when I did, but I certainly don\u2019t want to continue as nothing but a \u2018covidologist\u2019 for the rest of my life. I think that would be somewhat depressing, because I trained for pulmonary and<\/em> sleep care. Things like asthma and narcolepsy and sleep apnea. And I very much like taking care of those other types of patients,\u201d says Miskoff. \u201cPatient care was definitely delayed because of the virus, and we now need to get back to taking care of those people as well.\u201d<\/p>\n\n\n\n

As to whether or not Miskoff considers himself a hero, the doctor quickly demurs.<\/p>\n\n\n\n

\u201cI actually feel that there many other people more deserving of that title than myself. From a cerebral standpoint we gave a lot of our brainpower to figuring out what may be the best treatment. But the ones with higher risk of exposure are equally, if not more, heroic,\u201d says Miskoff. \u201cFor instance, the nurses didn\u2019t come up with a regimen of medicines to give, but they had to go into rooms with very sick people on a repetitive basis, and I believe that put them at a much higher risk than myself. I\u2019ve tried to live my life humbly, so it\u2019s difficult labeling myself as anything other than a man on this earth. I was no more of a hero than anyone else in that hospital.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

A pulmonologist takes on COVID-19 in the ICU and on social media.<\/p>\n","protected":false},"author":60,"featured_media":10815,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"image_focus":"{\"x\":49,\"y\":32}","hide_title":"","footnotes":""},"categories":[10],"tags":[93],"class_list":["post-10783","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-features","tag-alumni-donor-profiles"],"thumbnail":"\"\"","catString":"Features","issue":"Summer 2020","_links":{"self":[{"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/posts\/10783","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/users\/60"}],"replies":[{"embeddable":true,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/comments?post=10783"}],"version-history":[{"count":17,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/posts\/10783\/revisions"}],"predecessor-version":[{"id":12654,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/posts\/10783\/revisions\/12654"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/media\/10815"}],"wp:attachment":[{"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/media?parent=10783"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/categories?post=10783"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.monmouth.edu\/magazine\/wp-json\/wp\/v2\/tags?post=10783"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}