Interview with an ID Doctor: Dr. Amenini

Infectious Disease Interview with Dr. Amenini

So I am basically an ID physician (infectious disease doctor), and I’ve been working for 20 years. Since I was a child, I was always interested in medicine, trying to see. I went to med school back home in India, and as you know 20 years ago it was still a developing country, and we didn’t have a lot of advances in medicine like we could use right now. So I had a lot of closely related people, especially back home, who were sick and who needed lots of medical attention and we did lose a couple of them. So kind of looking at that I always had a passion that maybe I need to go into this field to get to the depth of the problem and see how I could help people. So, really those days it was more infections that were killing lots of people because it was still a country where there wasn't too much obesity and diabetes, and the mortality was high among infections. But now, I think technology has changed, and the whole field has changed. Now it’s a completely different world, and it’s pretty compatible to hear. Everybody is dying because of heart disease rather than infections.

Lot of it is on the back burner right now because a lot of the care and attention has gone into COVID. And also you see the facilities overall completely filled with COVID patients so lots of elective surgeries have to be postponed in order to accommodate the COVID patients. So definitely I think for the last couple of years, patients that were supposed to get elective surgeries were definitely put on the back list. Number 2, I also know some patients who really need help, but are scared to come to the hospital because they would catch COVID. Like for example, the other day, we had one of our colleague’s dad who had prostate cancer which was metastatic. Pretty much he was on treatment, chemotherapy until COVID hit. He was scared; he was like “it’s okay I’m not going to go to any of the clinics or hospitals to continue my treatment.” That led to rapid progress of his disease, and he literally passed away. And I felt like this patient if he continued his treatment would have lived longer. COVID has changed lots of people’s lives in every aspect. It’s kind of sad.

I know COVID has put a lot of pressure on doctors, how has this affected you personally?

It’s a lot of work, a lot more hours, a lot more days. And also you see that because the hospital numbers have gone up, the patient load has gone up, but the manpower is the same. We are not able to recruit new physicians that quickly. We also see a lot of physician burnout, a lot of physicians at the retirement age, but they still have time, maybe in their 50s and 60s. But all of the sudden, they are like “nope I’m retiring.” Giving up and retiring. So, even though the workforce we have is cut down quite a bit, that is putting a strain on other physicians as well. Most of the physicians right now don’t even take a day break. It’s like continuously for the past 2 years we have been working. And it is exhausting, and I think pretty much one of our colleagues, about 2 weeks ago, said “that’s it, I'm quitting.”

It is stressful, but what to do, if all of us throw our arms up in the air, and say that’s it I can’t do it, who will do it; who will step up that's the problem. So one of our partners retired and the 2nd partner said “that’s it I’m quitting” so instead of 5 of us we are down to 3 of us. You can already imagine the load is high. So, this is my take on it. This is a once in a lifetime pandemic, so I’ve been working for the last 25 years actually, and we have not seen anything like this. Hopefully, it won’t recur; this will be the end of it, and we won’t see any of this pandemic again. I feel once you join this profession; you have to be ready; you have to be willing to cope with all this stress. Be prepared for these kinds of things; that’s why we go into this profession. Because something like this comes up, you cannot step down, and say I can’t do it; be prepared to face anything.

To tell you the truth, my perspective has changed. Initially, I used to be very mad at them, and when the patient starts saying I don’t believe in this. We used to have lots of arguments, trying to explain and trying to prove it to them. But, then after like 2 years, I feel like these guys are all educated and smart people, and I feel like this is not the time that I have to spend so much energy trying to educate these people. If it was something new, then I would say “alright fine”, but after 2 years, they still behave like this; I think they are being irresponsible, and they are being selfish because they don’t care about other people. That's my feeling. They get sick, and come, and demand for all the help at that time. Even then, they sit and argue and say “this is all a hoax.” and “you guys are misdiagnosing me, and I don’t think I have COVID.” What do you say in those situations? It’s kind of sad. I pretty much gave up on all unvaccinated people to educate them. I felt like there was no point.

What do you think about the change of CDC guidelines from a 10-12 day quarantine to the 5 day quarantine?

This is basically…I think they are doing this to make sure we have enough manpower in the hospital because as you know a lot of staff are getting sick. We are already short staffed and then now if the staff takes off for like what they were doing 10-12 days staying home. That puts a lot of strain on healthcare. And also you see it’s not only on the healthcare field also filling down to other places like the grocery store or going to other places. They don’t have enough manpower due to the fact that the CDC has reduced the number of days they can isolate themselves. But, then again, if you look and read more detail about it. They say you have to wear the mask (surgical mask) and make sure you do all kinds of protection when you go back to work. But they are still infectious. I think they changed the guidelines to make sure the system does not collapse.

We see mostly diabetic foot infections, endocarditis, and meningitis. In Arizona, we see lots of valley fever. So we see a lot of valley fever. We see pneumonia and UTI (urinary tract infection). And we see any kind of abdominal infections. Here and there, we do see some cool cases. We did have a patient with mad cow disease which we always read in textbooks so it’s a once in a lifetime we see. We also had one patient with flesh eating amoeba. Here and there, there are pricks.

There are a lot of them though. See, the good thing is though the reason I like infectious diseases is because we can cure them. Like 99.9 percent of the time, the patients do get better and go home. So it’s really rewarding compared to cancer patients where 50 percent of them die. So, if you look at them, the best part for me is when a patient gets better. The patient and family are so happy and thankful. That is so satisfying for me, and this is what means there are a lot of patients like this for me. There is not one occasion; there are several occasions.

So you think you are happier in infectious disease because of lower mortality rates?

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