Alex Schmalz, MD, MPH, was finishing his final year of emergency medicine residency at University of California-Davis when the coronavirus pandemic exploded in New York City. With his future Vituity partners, Dr. Schmalz traveled across the country to assist hard-hit hospitals as part of California’s disaster medical relief delegation. We recently caught up with him to talk about this life- and career-changing experience.
Q: Welcome, Dr. Schmalz. To start - what inspired you to take on disaster relief work?
Alex Schmalz, MD: As an emergency physician, it was hard watching COVID hit while working in a less-affected area. Once I realized this wave wasn’t going to hit as hard in Sacramento, I started looking for where I could go and help more. Early on, I worked with a mobile health unit that traveled to test people in nursing homes. It wasn't quite like being on the front lines, but it was a way to contribute.
Q: How did you find out about this opportunity?
AS: I found out about the opportunity through some of my attendings at UC Davis. I had already accepted a job with Vituity and was excited to hear that most of the physicians in the group were Vituity doctors. Not only would we have a chance to impact patients and support our fellow healthcare workers, we’d also be working with Gov. Gavin Newsom and the State of California to improve the local pandemic response. It really was the best opportunity I could have hoped for.
Q: How did your Vituity teammates on the delegation receive you as a resident?
AS: They were very welcoming. I met most of them shortly after arriving in New York. The moment they found out that I'd accepted a job with Vituity, there was lots of warmth and congratulations all around.
In New York, I got to work alongside some of them at Elmhurst Hospital in Queens and see what great doctors they are. I admired their approach to medicine and their resilience in the face of challenge. It’s always a little nerve-wracking accepting your first attending job, but now I’m convinced I made the right choice.
Q: What was the situation like when you arrived at Elmhurst?
AS: Several of us from Vituity were assigned to a COVID ICU. In some ways, the situation was pretty grim. We had so many patients — all ventilated or struggling to breathe.
On the other hand, there was an immense amount of camaraderie and positive energy among the volunteers and Elmhurst medical staff. I was blown away by how many doctors had traveled from around the country to help. Despite the difficult conditions and the long hours, there was a tremendous sense of teamwork.
Alex Schmalz, MD, MPH
Q: What was it like emotionally, caring for so many critical patients?
AS: It was definitely tough sometimes. We had one patient on BIPAP who was able to talk while she was still on the floor. She was motherly, warm, and spoke in one-word sentences because she was so out of breath. Then she deteriorated and was moved to the ICU. When I broke the news to my Vituity teammate who had also cared for this patient, her eyes teared up. I could see the news hit her like a sledgehammer.
As hard as that moment was, seeing such compassion in one of my coworkers reminds you why you’re here, why you’re doing this, and that you’re with the right people. It ultimately gave me hope to see such kind, compassionate people in healthcare.
Q: What was rewarding about your experience?
AS: On days when there wasn’t much to celebrate, the cohesive, communal nature of New York City really had the power to lift me up. If I had energy after my shift, I’d always walk the two miles back to my hotel. At 7 p.m., all the locked-down New Yorkers would come to the windows of their apartments and celebrate, shout, sing, bang pots, play musical instruments. For a few minutes, you’d literally see people leaning out of windows for blocks and blocks.
When you’re treating COVID patients, they’re often sedated and their faces are obscured by masks and ventilators. So seeing the faces of hundreds of New Yorkers really helped me to make a deeper connection. I realized I was caring for the parents, grandparents, brothers, sisters, friends, and spouses of the people in the windows. Knowing that made my work a lot more vibrant and real.
There was one really bad day when we’d lost a few patients, and I stepped outside the hospital to watch the 7 p.m. celebration. A lady came up to me holding a sign that said, THANK YOU ELMHURST! YOU SAVED MY MOM. She said, “You look like you’ve had a really tough day. I just want to let you know that all the work you’re doing is worth it.” I started tearing up so hard that I could barely talk to thank her.
In New York, I’m just a visitor who’s there for a little over two weeks. But it made me think about the local providers who are doing this for months on end, and the impact it has on them.
Q: Now that you’re back, what are you doing to process that whole experience?
AS: Volunteering in New York City was very intense, but I feel like I’m in a better place emotionally because I was able to help. In a weird way, I’ve come back with a sense of direction in regard to the pandemic, because I understand it a little bit more.
Q: How has disaster relief work changed you as a doctor?
AS: It definitely reconnected me to why I do what I do. As a resident, it’s easy to get lost in mountains of work. Even though I was exhausted in New York, it reminded me every day why I practice medicine. No matter what, basic kindness needs to be at the core of patient care. I was lucky to have this experience to remind me of it.
Q: Has this experience changed your career direction?
AS: I absolutely see disaster medical relief in my future, and I’m excited that Vituity has emerged as a leader in this area. One of the great things about joining the delegation was seeing firsthand how Vituity supports its physicians in pursuing their passions.