From his home office right outside of Downtown Dallas, Dr. Pritam Ghosh treats patients across Texas.
“This is where I round on patients, day and night,” said Ghosh, a critical care pulmonologist with Access Physicians, a Dallas-based company that provides inpatient telemedicine care.
It would take Ghosh about eight hours to make the 500-mile drive to Rio Grande City, home to Starr County Memorial Hospital.
It is the only hospital in a county that has recorded more than 1,700 COVID-19 cases and at least 38 coronavirus deaths.
The hospital has no ICU.
As the novel coronavirus began to overwhelm the facility, administrators hired a team of telemedicine doctors.
Ghosh has been practicing telemedicine across Texas for several years but has never seen anything like the burden COVID is placing on small rural hospitals across the state.
“I describe it very much to be like a war zone,” Ghosh said of Starr County's situation. “It’s, at times, chaotic.”
While he is not on the ground walking the halls there, he works 12-hour shifts and virtually keeps an eye on multiple patients at a time.
“We have a cart that has a 27-inch screen on one end. It gets wheeled in, so the patients get a magnified view of us when we’re talking to them,” he said.
“There’s a stethoscope attached to the machine so that we can listen to their breath sounds, heart sounds, and their belly sounds and do an exam," the doctor said.
Ghosh has access to the patient’s medical records and can look at lab results and images from scans or ex-rays and coordinate care.
He cares for the same patients day after day.
“Our goal is to stabilize them and try to make them better,” he said. “But in the back of our minds we know we are trying to also arrange for them to transfer to a higher-level facility to get those advanced treatments like convalescent plasma or Remdesivir that may not be available at these smaller hospitals.”
Transferring patients has proven to be a “huge challenge," because hospitals across the state are at capacity.
Ghosh grew up in Dallas and attended medical school at UT Southwestern.
“To be honest with you when I went through my training and was embarking on my career, I didn’t envision treating anybody 500 miles away, let alone in the middle of a pandemic," he said.
He now treats patients virtually full time in many rural parts of Texas, where specialists like pulmonologists are rare.
Despite the physical separation, Ghosh easily forms emotional bonds with his patients.
He's found it challenging to treat young patients in their 30s or 40s who are gravely ill with the coronavirus.
“These are people with families. People with kids. Young mothers, young fathers. That has been extremely challenging from an emotional standpoint,” he said.
“Whether you are a thousand miles away or 5 feet away, that emotional connection remains.”