You Should Be Tested: An Oncologist's Personal Experience With COVID-19 Symptoms

Narjust Duma, MD

It was Wednesday night, and I was feeling tired with new muscle pain. I have been working long hours and exercised more than usual. My mind started justifying every little symptom. “I could be feeling this way because of lack of sleep. This could be because of yoga. This new anorexia is probably due to stress.” That night, I fell asleep finding reasons for all the symptoms I was experiencing, while repeating a mantra to myself: “I am not getting sick. I am not getting sick.”

Thursday came around and the muscle pain was slightly worse. I noticed that the pain was present even when my body was at rest and it was affecting large muscles. At this point in time, I had also developed a dry cough; it was intermittent, not productive. That morning, I completed a re-assessment: What was new? Fatigue was new, but could that be due to lack of sleep? I have not been able to sleep for 1 week. I decided to work from home, setting up telemedicine encounters with my patients. Around noon, I noticed I was not hungry. I was busy, and that became a second thought. I had a conference call and a round table to record and time was limited.

That afternoon was busy; I continued to meet with patients over telemedicine while my husband was trying to cook and do laundry in the background. I had a deadline and a new article to write. Some of my symptoms were ignored. It was finally 6 PM, but I was still not hungry; however, this was not entirely new to me. When I am busy, I tend to not eat much. Again, I was justifying my symptoms. That evening, I started isolating myself from my husband. We discussed limits around the house. “You will use this bathroom, and I will use this one. I will sleep in this bedroom,” and so on. We could not kiss or hug anymore. I was getting sick.

I went to bed, but I could not sleep. Like I said, I have not been able to sleep for days; that was not new for me. I was not worried about my new symptoms, but I was worried about the consequences of getting sick. I made a list of all the people I have seen in the past 2 weeks. Luckily, I did not see many people, but some were essential workers. I was trying to recall if I was wearing my mask and shield when speaking with them. I was mortified by the fact that I may have unknowingly exposed them to something. However, at that time, I did not have symptoms and I was washing my hands so many times that they were turning red. I knew that I was wearing my mask during all patient contact, and that provided me with a slight sense of relief.

Friday morning arrived. Symptoms were present, but I had a full clinic, all via telemedicine. I stayed home and evaluated patients by video and phone. My nurse was serving as the ship captain in the cancer center, triaging requests, and “eyeballing” patients receiving chemotherapy. I wasn’t hungry, but I was busy. During the first encounters, I did not mention anything about my symptoms; I usually don’t when I have a common cold. Was this time the same? Probably not. For the first time, these symptoms were concerning. For the first time, these symptoms could mean more than a regular cold.

Around noon, the fatigue was worsening, and I started telling my patients that I have some “questionable symptoms.” I used that same phrase to write an email to my division chair and colleague. I did not have a fever, which I found to be reassuring. I had completed all visits at this point in time. The adrenaline of a busy clinic day disappeared, and the symptoms were becoming more noticeable. I was experiencing anorexia, fatigue, and muscle pain.

I finally made peace with reality and called our employee health department. I shared my symptoms and that I was attending the oncology inpatient service around 10 days ago. The nurse on the phone was clear: “You should be tested.” I knew it, and maybe that was the reason I did not want to call in the first place. After 10 minutes of instructions and getting a “password,” I was placed on “administrative leave” and scheduled for a drive-thru test.

Should I tell my family? My mother will probably freak out; my family members are far away, in different countries. They have already lost friends and medical school classmates to the virus. I decided to tell my father, as he is the most rational of the 2. He was expecting this call; he knew 1 of us would develop symptoms. I shared the symptoms I was experiencing with my 2 closest friends who are also physicians; they remained calm and they justified all my symptoms, as I had done before.

Saturday morning came around and my symptoms were worse. I do not know whether it is a regular cold, influenza, or COVID-19. I had to practice what I have been teaching my patients. Anxiety was present, as well as a new headache and a dry cough.

I am writing while waiting in my car to be tested. I have my password, my mask, and my car windows are up. It feels like a movie, seeing colleagues and friends in full-body suits walking around this parking lot. We were not expecting any of this, but we will overcome this new challenge. In several hours, I hope to get my results.

Narjust Duma, MD, is an assistant professor of medicine and a thoracic oncologist at the University of Wisconsin Carbone Cancer Center. At the time of publication, Dr. Duma was still waiting for her test results.

At 3 PM on Thursday, I was seeing patients by video, discussing their symptoms, and informing them of the adverse events associated with therapy. At one point, one of my patients asked me, “How are you?” In that second, I realized I was getting worse. My symptoms were more pronounced, I had not eaten all day, and I was in my fourth cup to coffee to cope with the fatigue. I answered, “I am okay.” But was I really? I decided not to mention my symptoms to my patients that afternoon. I did not want to add more anxiety to their day. I did not want them to worry about me.