If history has shown us anything, it’s that time and time again, Black women will continue to show up for everyone else, even if we don’t deserve it.The COVID-19 pandemic that has created a hellish experience for many of us, has centered awareness on frontline workers such as hospital employees. Dr. Elizabeth Clayborne, a 36 year-old Black Maryland based emergency room (ER) physician is one of the many healthcare workers changing how we view who is essential in this fight for our lives — she and her unborn daughter.
In a country where Black women make up only 2% of physicians, Dr. Clayborne, pregnant and all, reinforces that Black women always rise to the occasion, even when they’re inconvenienced. In a detailed interview with Blavity, Dr. Clayborne shared some pertinent info about the COVID-19 pandemic, what she has witnessed in the ER, and why she's risking her and her unborn child's life to fight this ravaging disease.
Photo credit: Dr. Elizabeth Clayborne
Blavity: Thank you so much, Dr, Clayborne for taking the time to interview with us. Could you start off by telling us a little bit about yourself and what a regular day looks like for you in the ER?
Dr. Elizabeth Clayborne: I'm an emergency medicine physician and I’m also a faculty member, so I'm an adjunct assistant professor with the department of emergency medicine at University of Maryland. I also work at UM, which is the University of Maryland, Prince George's (PG) Hospital Center. It is a pretty busy, county hospital that is just outside of DC. We serve a primarily African American population and would probably consider it to be an underserved area. So a lot of people that do have a lot of chronic issues and are a little bit poorer in the community. It's considered to be a busy ER.
I have an academic focus on policy ethics and end of life care and that comes from my interest in ethics. I actually have a dual degree in medicine and bioethics. I've always been really passionate about issues related to ethics. A lot of the challenges that I deal with at work are that the community that I serve doesn't have a good outpatient resource. So a lot of them may not have primary care doctors or don't have access to getting their prescriptions filled or follow up appointments. I see the extremes of human nature, so we kind of see people at their lowest and most vulnerable moments in medicine. We also see the best human qualities of compassion and care.
Blavity: We've seen data that shows Black communities are hit the hardest by COVID-19. Why do you think that is?
Clayborne: Well, I think it's certainly because it's exacerbating the underlying health disparities that have been existing for a very long period of time. We actually see that very clearly at PG, where I work. In fact, right now, PG has more cases of COVID positive patients than the rest of the university of Maryland medical center combined. We serve a primarily African American population. There are a couple other hospitals that also serve a primarily Black population, but some of it is kind of dependent on where these hotspots are erupting.
Where we work in particular is an area that is mostly Black and mostly underserved, meaning that the population has a lot of chronic comorbidities, multiple diseases essentially that they've had for a long time, and they have a lot of issues with their health, before the pandemic hit, that have basically put them at risk for doing very poorly if they get COVID-19. I think those are the primary reasons that you're seeing huge exacerbation of health disparities in the Black community.
Photo credit: Getty Images
Blavity: Now as an ER doctor, you're on the front lines. You see things that many people do not. Can you share some of what you've seen that may get people to continue practicing precautionary measures?
Clayborne: What we're seeing, especially this week in the ER, is that this virus is impacting people of all ages. I think the first misnomer is that it can only affect the sick and elderly. Our ICU has people in their thirties and forties who are on ventilators and potentially can die. It doesn't really care who you are, as far as your education background, your job, your religion. It is going to impact anybody at any time. We're having a hard time really understanding why some people are doing really well even if they don't carry certain risk factors such as a past medical history that puts you at risk or older age.
If we don't continue to flatten the curve, a lot of people like me, who have an ethics background, are preparing our hospitals for what we're going to do if we have to make extremely difficult decisions about scarce resources such as ventilators in ICU and beds if we run out of stuff. The other thing I always like to emphasize and want to make sure that the public thinks about and understands is that they should, right now while they're home, be talking to their loved ones about advance care planning. And what I mean by that is at any age, whether you're 18 or 80 years old, you should be thinking about what you would want done if you suddenly became acutely ill. If you would be comfortable going on a breathing tube, how long you would want to be kept on a machine to keep you alive.
Blavity: Reports state that there is likely to be a surge in COVID-19 admitted patients in the next few weeks or so. What is your hospital doing to prepare for the surge?
Photo credit: Dr. Clayborne (Clayborne with pregnant colleagues).
Clayborne: We've already seen a little bit of the surge because we've had to initiate surge protocols in our ICU. Surge protocols are in place to basically expand our bed capacity in the areas of the hospital we would not normally use — primarily for the ER and ICU. We have areas of the hospital that would only be for outpatient services that are going to be utilized to accommodate the COVID patients.
We're actually reopening a hospital as well. Laurel Medical Center is going to be reopening an entire floor just to deal with some of that overflow. Outside of that, I think a lot of us are just trying to keep ourselves as efficient as possible. There is a lot of anxiety about what's going to happen with the surge. No one is really experienced activating an operational life protocol. They're planned but I'm not really sure how well they're going to work when we reach our surge.
Blavity: What can people do at home, if they are experiencing mild COVID-19 symptoms (to keep from crowding the hospital)? When would you advise them to seek medical treatment?
Clayborne: Another thing that people can do that's very helpful, in addition to the basic routine of social distancing and hand washing, is to stay home unless they have severe symptoms. A lot of people who get this virus will have fever, coughs, sore throats or body aches. Those are all things that they can take care of at home. They can take Ibuprofen or Tylenol to treat those symptoms. And they should self-quarantine and stay home. The time that you need to actually present yourself for medical attention is when your respiratory symptoms become more severe.
If you get short of breath or you have severe chest pain or you're just becoming so weak that you cannot function, those are things that would prompt you to seek medical attention. If you're just feeling really terrible and those things aren't going to kill you, you need to stay home and just monitor yourself and make sure you're not worsening. That is very helpful in preventing us from being overwhelmed by seeing a lot of people who don't need to be there at the time that we are hitting our surge.
Photo credit: Getty Images (Silver Spring, Maryland – April 16).
Blavity: We've seen many Black patients turned away from hospitals, during this pandemic? Are there any rights we should know about when seeking treatment for COVID-19?
Clayborne: There's a federal law that says we have to see everybody. All emergency departments are required to see anyone, who presents to an emergency department, into a screening exam to make sure that they're stable and then they can be transferred at that point. But you can't turn people away.
We serve a predominantly Black population, so most people that we see are African American. A lot of our staff is actually African American. We certainly are a community that feels like we serve our own communities.Tests are still very limited right now and we're reserving them for people who are sick enough to be admitted to the hospital. If they're sent home, it's because they don't need to be there. They have to manage their symptoms at home. They're mild enough to do that and we have to make room for people who potentially could worsen and die from the virus.
I do think that some patients get really frustrated in the sense that they're not kept in the hospital or they don't get the services that they feel that they want. Everyone has to understand that these are trying times and we're not going to send anyone home that we think is at risk for having a major negative outcome.
Blavity: What has been the most challenging part of this pandemic for you?
Clayborne: I think that right now for me, the most challenging part is just mitigating all the emotion and fear surrounding the virus, both at work but also at home. I have a lot of friends and family who are constantly texting me, who are worried about me, but also because they're scared and they don't know what to do. Then there's people who just feel so uncertain and overwhelmed. We feel consumed with the fear and anxiety about what's going to happen with the pandemic. I try to go outside, take a deep breath and go on some walks. I have an 18 month old daughter at home who has no idea what's going on.
Photo credit: Dr. Clayborne.
Blavity: What are you most concerned about?
Clayborne: I'm certainly most concerned about jeopardizing the life inside of me. The way that I think about it is that I could get sick, I certainly could die and I'm very cognizant of that. As a pregnant mother, I would hate that I made a decision that actually impacted the life of my baby. The way that I could see that playing out is, if I become ill, I would go into preterm labor and have the baby early.
I would be delivering a premature infant into a hospital that is potentially full of very sick people and that doesn't have ventilators or doesn't have the resources needed to support my daughter. I see bad things happen everyday and so I try not to focus on that particular outcome but it's always at the back of my mind. My daughter is seven months so she's moving around and kicking inside me all the time. It is a reminder that she's there and that she is experiencing all of this with me.
Blavity: What gives you hope?
Clayborne: I've seen a lot of overnight shifts and it has really brought out a renewed sense of community. I think that this time people are spending at home is going to help us to re-center and refocus on what's most important in life. Even though I feel like there's a lot of dark days ahead because we have to deal with not just the medical fallout, but the economic fallout from this pathogenic, I'm hoping that it provides a renewed sense of community and resilience that is going to make us a stronger group moving forward.
Blavity: What general advice do you have for Black Americans at this time?
Clayborne: Our African American communities really need to step up and take care of each other more than we ever have before because we are likely to be the population hardest hit by this pandemic. And a lot of us are at risk for dying. I would just encourage African Americans to reach out to your friends, especially the elderly, the vulnerable populations and people who don't have a lot of support. Also, people who might be struggling financially and are too prideful to say anything. We need to just go ahead and send all those people the resources they need and offer a helping hand without being asked. Those kinds of actions can actually save lives. We're very resilient people, as we know, because of our history and this country. This is going to be a very trying time for a lot of people. The solidarity in the African American community is going to be the only thing that's going to bring us through this.
Blavity: Do you recommend any foods, vitamins or nutrients that we should be consuming to boost our immune systems?
Clayborne: My general advice is to use common sense. Eat a balanced diet. That means a lot of fruits and vegetables, drink lots of water, get lots of rest and avoid things that harm you. Those are the best things that you can do for yourself. Keeping yourself mentally and physically well as possible by just doing those basic things is the best that you can do.
Blavity: Any last message or messages you'd like to share with our audience?
Clayborne: I just want to thank everybody who's been really supportive of me and all healthcare and frontline workers. We hear the messages of support and love, and they do give a lot of energy and fuel to move on. Make sure that you don't forget to say hi or reach out to people who have impacted you in your life and your everyday life. You're never aware of how little things like thanking them or checking in on them can go a long way. continue to do what people are telling them to do as far as staying home, as long as this is going to take. That's what's going to help bring us through it.
HBCUs are facing many challenges managing coronavirus responses and need your support. Donate to the UNCF fund today to help students impacted by the pandemic.
