She can look back now with ironic relief and say that the past year may have been the healthiest of her life. All the precautions required of anesthesiologist Alicia Lopez Warlick ’97 to prevent the spread of COVID-19 not only protected her from the disease, but from run-of-the-mill cold and flu, too.
As a doctor on the front lines in Raleigh, North Carolina, she’s now fully vaccinated along with her husband, who serves in the military. That helps ease the mental strain that has been among her greatest challenges during the pandemic. The physician and personal trainer has documented her experience on Instagram and TikTok (@alifitmd), and she recounted the ups and downs in a recent interview:
When the pandemic began, what changed day-to-day from a medical perspective?
We started to see eerie signs in the hospital. I saw that something was brewing. In the operating rooms there are these little stations where the surgeons scrub up, and they usually have PPE [personal protective equipment] there. And I noticed that those started going away, either because maybe the hospital’s rationing them or because maybe people were using them. I don’t know, but that was the first sign that we had that something was sort of off.
The first days of the pandemic were really scary. We didn’t know how it was transmitted. All the doctors and nurses — some people slept in their garages. I was considering just going to a hotel. I didn’t know if I was going to contaminate my kid and my husband. And so, I would do this sort of stripped-down routine where I would decontaminate in the garage and then run in and shower. And it was just this bizarre world for a couple of months.
They canceled elective surgery in April or late March — that was something I had never seen before. My livelihood as an anesthesiologist is surgery, right? If there’s no surgery, then I become a critical care doctor or an emergency room doctor. I go somewhere else. And so, when that shut down, we initiated the COVID call teams. So we would just designate, OK, this doctor is on call for COVID. We would intubate all COVID patients. We would be fully exposed 24 hours in the hospital. And you just went through that 24 hours, praying a lot.
What is the process of putting on and taking off the PPE?
Say I was going to do an epidural in a COVID-positive patient. There was this sort of ceremony outside their room, where I would don all the gear, like out of a movie. There would be somebody watching, called a door officer, to see that I did all the moves. And it’s like four layers of gloves. It’s the shield. It’s very ceremonial. As I do that, I kind of mentally play out what I’m going to do not to contaminate myself. I say a prayer before I go in, that I can still do the job. It takes a while, 20 minutes to put all the gear on. So you have some time to think: “Please just let me do this correctly so that I may serve the person that’s on the other side of this door.”
I go to a place where I tell myself, I’ve put in 60,000 epidurals, you’ve done this so often. You know how to do this. It’s just another day. And I imagine myself, just another day, a happy day, not in this gear. And I go to that place where it’s just a regular old day, do the procedure, say goodbye.
And then I go out, and I go back in the zone because I’ve got to doff. I’ve got to take everything off. And I’ve got to remember that you could contaminate yourself just as equally when taking things off. OK, first pair of gloves, wipe, throw away. Second pair, the boots, the hat, the respirator. And it takes about a half hour for all of that. So [the donning and doffing of PPE] turned a 20-minute procedure into an hourlong procedure. I’ve done that multiple times a night, five, six times a night, and it gets mentally exhausting. But I always go back to the fact that I am on this side, and I am healthy, and I’m here for service.
Deaths are the number we all look at, but what hidden tolls have you seen among survivors?
The thing that I’ve seen the most is the cardiac effects of it. It affects your heart system in a very, very big way. Not just your pulmonary system. Of course, I see the people that decompensate pulmonary-wise and they need tracheotomies, they need to be on respirators for long, long periods of time. But I also see COVID is doing something to the vascular system, causing blood clots and problems in your cardiovascular system. I’ve seen terrible, terrible effects where people need amputations — things that maybe it changes your life. You have a heart attack or you have a stroke. I’ve seen all those things happen from COVID patients. It’s not just a cold or a cough that you can get over. If you get this virus, you can’t predict what’s going to happen. And I’m not saying that out of fear, I’m just saying the long-term effects — we know a lot about it, but we don’t know everything. People ask me, “Should I get the vaccine?” Absolutely. Absolutely. Because getting the disease, getting the virus, you can’t predict what’s going to happen.
How do you communicate your message about masks or vaccine acceptance?
I’m not a person that’s ever going to say you have to get something. I think Americans are really resistant to people telling them, “You have to get a vaccine.” And that even goes for mask wearing. I think half of Americans aren’t wearing masks in public. So clearly we’re not into people telling us what to do. I think the way to deal with that as a doctor in my community or a doctor on social media is just to give information that people can relate to. And people are really receptive to hearing about the inside story of what I’ve been seeing and what I can offer as education. I think, “education, education, education,” and that’s my goal on social media as a doctor and then in my community, too: to just educate people on what is happening behind the scenes.
How has all this changed you?
There were goals that I had before the pandemic started about the job or, “I’m middle-aged, what am I doing now? Have I really lived up to my goals?” That sort of all went to the wayside. I’m a different person.
There’s a saying that goes, “If you ask a healthy person what they want, they’ll list five to 10 things, but if you ask a sick person what they want, there’s just one thing.” I think I became that person. I just wanted one thing. I just wanted to survive this. And I did, so far. I’ve survived it, and it’s a miracle.
Interview by Jason Kelly ’95, an associate editor of this magazine. Hear more from Alicia Lopez Warlick on The Endless Conversation.