Faces of Cedars-Sinai: Internal Medicine Resident Dr. Matt Macfarlane
May 18, 2020 Cedars-Sinai Staff
Dr. Matt Macfarlane is an internal medicine resident currently working with hospitalized COVID-19 patients at Cedars-Sinai. Dr. Macfarlane and his colleagues care for patients who aren't ill enough to require a ventilator, or those who are recovering following a stay in the intensive care unit (ICU).
When he finishes his residency, Dr. Macfarlane plans to go into primary care with a focus on LGBTQ+ patients.
"The toughest part is having serious discussions and trying to break difficult news to patients and families when you can't see their faces or be there to comfort them."
We talked with Dr. Macfarlane to learn more about his work during the COVID-19 pandemic.
What are your workdays like?
Dr. Macfarlane: Since the COVID-19 pandemic started, residents have had to limit our exposure to patient rooms, so we're working remotely. We're consulting with the attending physicians and nurses who are in the patient rooms and speaking with patients by phone.
Normally, we spend our days examining patients in person, building a rapport with face-to-face, meaningful interactions. It's really weird to have never touched the patient you're taking care of and only hear their voice over the phone.
How has COVID-19 changed the way you work with your colleagues?
Dr. Macfarlane: It's quickly solidified us as a team. We're all putting faith in the different players to work together and a lot of trust in nurses' assessments.
It's extraordinary what the nurses are doing, taking on so many roles and doing the tasks we would normally do ourselves. They're generally the ones most in touch with the patients, but right now they're really on the front lines.
What are the specific challenges in caring for COVID-19 patients?
Dr. Macfarlane: Normally, patients have their support systems there advocating for them and asking questions. Now we're talking to everyone on the phone and really focused on keeping families updated because they can't visit their loved ones.
The toughest part is having serious discussions and trying to break difficult news when you can't see their faces or be there to comfort them. Right now, we realize how important that is.
Policies and procedures for how we treat patients change every day as we get new data. It really helps to have a team of mini-experts following guidance from leadership and the Centers for Disease Control and Prevention, because it's hard to keep track. One of the things we've learned most as residents is that you have to be flexible and adapt.
How do you cope with the restrictions of the pandemic on your life and work?
Dr. Macfarlane: It is hard when you feel like this virus is everything that everyone is experiencing. You want to read all the articles and the updates first thing when you wake up and before you go to bed.
Personally, I want to know the latest to prepare for how to take care of people. I'm glad my co-residents and I are friends and we still rely on each other, but it's hard to just talk about normal stuff.
It's difficult thinking about what it's like for healthcare workers and patients in other parts of the country that have been hit harder, like New York. It feels like Cedars-Sinai and our residency program have been really forward-thinking, and the medical center feels very organized.
How do you keep up morale at work?
Dr. Macfarlane: Every time we discharge a patient, it's really rewarding. Things change so quickly—we've had patients who didn't appear that sick, and then they needed a lot of help breathing, went to the ICU and came back to us.
When we send them back home to their families, they still have a long course of getting better, and even that can be really scary. But it's exciting to watch people get better.