Ostrow alumna finds herself at ground zero of the coronavirus crisis while completing her dental anesthesiology residency in New York
Rining in 2020 New Years Eve, Tiffany Neimar DDS ’18 couldn’t have known the personal and professional transformation the next few months would bring.
Working at Jacobi Medical Center in the Bronx, N.Y., as part of the second year of her dental anesthesiology residency with the Albert Einstein College of Medicine, Neimar had just finished her surgical intensive care unit rotation in February when what would become a tsunami of Covid-19 cases began to surge through ERs and ICUs across the city — sparing not even Neimar, herself.
“In the middle of March, I felt extremely weak and feverish,” Neimar says. “My program director said ‘I really think you should get tested. Everyone’s getting sick right now,’ and that’s what I did. A week later, my nasal swab came back positive.”
Though Neimar’s coronavirus case was moderate — with mild respiratory symptoms and physical fatigue — it kept her isolated for 14 days in her studio apartment.
In the time it took her to return to her residency, the world had seemingly shifted on its axis.
“Covid-19 presented us with a unique challenge, and as the only anesthesia residents in our hospital, we had a new role to step into — critical care management for Covid-positive patients,” she says.
Overwhelmed with Covid-19 patients, the hospital assigned the dental anesthesia residents to help run a “stepdown” unit — a unit that’s not quite an ICU and not quite a medical/surgical floor— where they cared for dozens of critically ill patients at a time.
“I had nights where three people would die on me,” Neimar explains. “I did CPR countless times, which often was a futile effort for these patients, because they would not recover from that at all.”
Neimar was also forced to have many difficult conversations with family members who could not see their loved ones for fear of virus transmission.
“I realized that, when I communicated with these patients’ families, it allowed me to connect with the patients themselves, because they were all intubated, so they couldn’t communicate with me,” she says. “I got to know more about them as people — their hobbies and personalities — through their family members.”
The difficult life-and-death conversations also proved therapeutic for Neimar who, during her first year in dental school, lost her own father to cancer.
“When my father was dying in the hospital five years ago, nobody returned my calls or gave me updates on his condition,” Neimar says. “From that experience, I knew what these families need to hear, and I felt as though I was healing my own old wounds.”
Taking the reins
For weeks, Neimar worked around the clock, finding herself naturally stepping up to leadership status within the unit.
“I really threw myself into managing and running the ICU because I knew that putting in the daily work and organizing a great team would ultimately result in a structured workflow,” she says. “These patients needed consistency of care, especially during the most critical times.”
She would bargain with other units to get supplies her staff lacked; she would check in on her colleagues and offer moral support (and caffeine); and she worked with local restaurants to make sure the healthcare workers were well fed.
“There were days when I was standing in the middle of the unit, having five different people asking me, ‘Should we do this?’ ‘Where do these labs need to go?’” Neimar explains. “My autopilot was to create structure and provide leadership, and I don’t know where that came from. When I say I evolved into this person, it came out of a part of me I had never experienced before because I was never put in such a position.”
At least part of her abilities come from her days at USC, she says.
“USC taught me to be committed to my work and really prioritize my commitment to patients,” Neimar explains. “I definitely developed my strong work ethic and perseverance during dental school.”
Finding strength within
Fighting in the trenches, day in and day out, certainly took its toll on Neimar, who often found herself in tears when she was alone, just struggling to process the magnitude of the uncertainty and death she saw every day.
Certainly, there were good times, too.
“It was always such a special day for us when a patient would actually walk out of the hopsital,” she says. “The whole hospital would play songs for patients when they were extubated and discharged home.”
News of Neimar’s compassion, organization and leadership skills made its way to hospital leadership.
“My greatest lesson came from the strength I found within. I found this person who run into the fire without hesitation and is capable of incredible perseverance”
“My trauma attendings told me everyone was talking about me and our unit, that we were doing great work,” Neimar says. “They said ‘You guys are helping people, and you are an exemplary resident. You stepped completely outside of your scope of practice and handled something that was above your pay grade.’”
Consequently, Neimar has been selected for the chief resident position in her program. “There’s a lot of work involved, but that’s OK; I’m not unfamiliar with work,” she says.
But, now, that New York City’s coronavirus curve has flattened, Neimar finds herself, finally having the time and space to process all that occurred to her this year. She’s even started channeling some of her feelings into painting.
More than anything, she realizes she’s no longer the person she was when 2020 began, with a very different perspective, both personally and professionally.
“My greatest lesson came from the strength I found within. I found this person who would run into the fire without hesitation and is capable of incredible perseverance,” she says. “Today, the depth of my passion for healing and helping others has taken on a new form and has, once again, changed my journey in unimaginable ways.”
By John Hobbs