On Rotation in Italy, a Medical Student Gets Her First Glimpse of the Pandemic

Elise Steinberger, M20, was far from home when the novel coronavirus became a serious threat

First-year resident Elise Steinberger wearing a mask and scrubs in a hospital. She was on rotation in Italy when the pandemic hit.

Tufts University School of Medicine graduate Elise Steinberger, M20, was on a surgical rotation in Italy in late February and early March last year, just as COVID-19 was beginning to sweep across Europe. Italy would go on to be one of the hardest hit countries that spring. Now back in the United States, Steinberger is completing her first year of residency at Grand Strand Medical Center in Myrtle Beach, S.C.

For our retrospective on the Tufts community's early response to the pandemicTufts Now spoke with Steinberger as she looked back on all that she experienced last spring, and in the time since, during an unforgettable transition from student to physician.

Tufts Now: How did you come to be in Italy?

Elise Steinberger: Back when I was doing my surgery rotation as a third-year medical student, I was on a case late into the night. As I was walking out of the hospital that evening, I called my parents—my mom's from Italy and my parents met there, so we speak Italian at home. My attending recognized the language and said that he had a friend in Italy, if I was interested in doing a surgery rotation there. So, in my fourth year, I reached out to that friend—an attending physician at a hospital in Rome—and started setting things up. It all worked out, which was amazing, and so I was scheduled to spend a month doing thoracic surgery in Rome, beginning in late February.

On February 22, the morning that I was supposed to fly out, I woke up to this email from my uncle writing from Italy, saying, “I don't think it's a good idea for you to come. We have this outbreak of COVID and things are crazy here.” But my bags were packed, and I knew that there are always people with infections in a hospital, so in a way I felt we were used to viruses being around.

My uncle and his family are in the north of Italy, where COVID was the worst, but my rotation was in Rome, where COVID still seemed like a distant problem. As I was preparing to leave Boston, one of the residents in Rome did say, “You know, maybe you should grab a mask with a filter before you fly out.”

Now, looking back on that email from my uncle, I think, “Wow, that was the start of it.”

Elise Steinberger, M20 Photo: Courtesy Elise SteinbergerElise Steinberger, M20 Photo: Courtesy Elise Steinberger
What was it like when you got to Rome?

I took a bus from the airport to the train station. And I remember there was someone coughing on the bus and people were definitely uncomfortable about it. You could tell people were a little bit on edge.

And then we got our first cases. Initially, people in the hospital were going about their business. There were still sick patients with other problems that weren't COVID. So, to some extent, it was kind of a secondary problem. And then, suddenly, there was a big shift, when the cases started increasing. I remember the blue United Nations tents going up outside, screening people for COVID before they went in the emergency department.

I was in constant contact with Tufts. Everyone was looking out for me. It seemed like I was going to be able to stay, but it became a logistical issue when the airport in Milan shut down literally overnight. That was a huge shock because flights were being canceled left and right in a matter of hours.

I made it back to the United States in the beginning of March, right before Italy had a nationwide lockdown on March 9. I had been in Italy for a little over two weeks.

How is your family in Italy doing?

My family in Italy has thankfully been very lucky, to the extent that no one has gotten COVID. I have a grandma in Italy who's well into her nineties and we try to keep her from going anywhere. My relatives, their work shut down and their kids aren't going to school. Everything's on hold just like for the rest of the world.

As a medical student, did the pandemic make you look differently at your career choice?

It was very humbling. Most illnesses, we have a very good understanding of them. And even the ones that we don't, we at least know more or less how to treat them. We take it for granted that we have so many treatments for so many things. Whereas with COVID, all of a sudden, it was this thing that we don't know anything about.

When I think of what our understanding of COVID was last March, and where we are now—how far we’ve come—it amazes me. It's really a feat of science and medicine.

What has your residency during COVID been like?

The hospitals try to not have residents on COVID teams. The idea is that if residents and the attending physician have to see the patient, you're just exposing multiple people unnecessarily. I feel pretty lucky that the hospital's been really working to make it as safe as possible for everybody. Residents are with COVID patients on the ICU, however. That’s where you just have to be even more careful.

Have you been very worried about getting COVID?

I actually did have COVID. I don’t know how I got it. I got it in December and I hadn’t had any COVID patients in that time; I wasn't in the ICU at the time. I hadn't been anywhere outside of the hospital. I just go to the hospital and then home and back to the hospital. So I think it was probably an asymptomatic patient that I was taking care of, or maybe from a surface in the hospital. COVID had been around for months, but I was still kind of shocked when I got it.

It's not a joke. People compare it to the common cold, but it’s definitely not. I was very achy and tired and had this horrible headache. I was sleeping 12, 14 hours a night. It took me a long time to get my strength back. I'm an otherwise healthy person and it was a pretty tough couple of days.

When you think back on this past year, what do you think will stick with you?

Just that everybody is doing their best. It's nice to see that the hospital is trying to adapt to the medical risks of COVID, but also keeping a firm grasp on the humanity of it. There was a time when patients couldn't have any visitors. People were dying alone and that’s tragic. At that point, we didn't know much about COVID and so we were trying to be extra careful. For now, at least, patients can have one visitor. When people are in the hospital, they're sick and they're stressed and just having one person there with them makes a huge difference.

Our ICU is on the first floor and there are these big windows and visitors will stick cards and balloons on them. Their family will stand outside and talk to them. There’s a room right now that has so many balloons taped to the outside.

How are you feeling about the pandemic right now?

I think the whole world thought that it wasn't going to last this long. I thought it would get under control more quickly, you know, maybe by Christmas, everything will be okay. Somewhere in there, there was also exhaustion of this new kind of life that we have to lead. I think everybody felt that the staying at home, the distancing—people just wanted to hug their families and see their relatives.

When we started noticing treatments that were working, that was a nice thing to discover. But I think when the vaccines came out recently, that was the first real glimmer of hope.

I do feel like there's light at the end of the tunnel now. Most of the residents in the hospital are vaccinated. I actually got my second dose yesterday.

Please visit Tufts Remembers March 2020 for more stories from our retrospective on the university’s early response to COVID-19.

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