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May 3, 2020
On March 30, McLean’s Joel Solomon, MD, and his 1,200 crewmates on the USNS Comfort docked in New York Harbor. The Comfort, a U.S. Navy hospital, came to New York City to provide urgent care and support to the tens of thousands in the region affected by the coronavirus pandemic.
Solomon, the medical director at McLean’s Community Reintegration Unit and a member of the Navy Reserves for seven years, said he was answering a call for help by joining the Comfort’s crew. “With the pandemic, there was an outreach to the military to see who could be helpful and supportive,” he explained. Eager to bring his psychiatric expertise to the effort, Solomon worked with McLean’s Chief Medical Officer Joseph Gold, MD, and Scott L. Rauch, MD, McLean’s president and psychiatrist in chief, to clear his way to serve.
“They made sure my work at McLean was covered so I was able to support the mission,” Solomon explained. “I was able to serve in large part because of their efforts.”
With his McLean responsibilities in order, Solomon packed his seabag and took a flight to Norfolk, Virginia, to board the Comfort. The ship soon set out for New York, where Solomon took on several roles to support the health and safety of both patients and crew.
“Working under the Directorate for Medical Services, I was given the responsibility of department head for behavioral health,” Solomon explained. “As the sole psychiatric resource for the ship, my role was both to coordinate behavioral health care for 1,200 crew as well as serve in a consultative role for patients treated in the ICU and on the wards. We were a team of psychiatry, psychology, and behavioral health techs available 24/7 to provide support in case of emergencies.”
Solomon also served as co-chair of the ethics committee. “I had to address issues, in a consultative way, to leadership, medical providers, and patients,” he said. He also played a more informal role as a liaison between the ship’s command and crew. “Part of my job was to keep people mission-focused and bring issues and questions to leadership,” said Solomon. “I was a connector, a bridge for crew concerns.”
Solomon’s multiple roles kept him busy during his time on the Comfort. “I wasn’t working 24 hours a day, but I was available 7 days a week,” he said. “I did not necessarily get a day off.”
A typical day for Solomon started at sunrise. “We had reveille at 0600 and meetings early on,” he stated. “Then, we would go to the wards to see patients and staff. It was an ever-changing mission, and it was tiring.”
Solomon provided psychiatric support for patients onboard, but he also assisted crew members with mental health concerns. “We dealt with a wide range of issues, but the majority of the crew-based concerns were adjustment issues,” he explained. “There were many folks who were new to the Navy, and they were facing new challenges.” Chief among those concerns was the chance that they would be dealing directly with patients who had tested positive for COVID-19.
“We were originally going to treat people without COVID, but this quickly transitioned, and we became inundated with COVID patients,” Solomon reported. “We had to determine what that would mean for the crew, and we were able to go into the ICU, into the medical wards, and help foster conversations and give reassurance.”
Solomon reported that “part of the work also involved serving as a resource about suicide prevention and helping in case there was a ‘battle buddy’ who crew members or leaders were worried about.” He said he was able to work with other medical providers in a consultative role to address these issues on the Comfort.
From his experience in New York, Solomon gained valuable insights into dealing with psychiatric issues during a pandemic. “There is a lot of stress out there, and the chance that providers will need mental health care is high,” he stated. Health care workers, he said, “understand that they are at risk of actually contracting COVID-19, and some are struggling with the feeling that they were putting others at risk or that they were marginalized” while caring for coronavirus patients.
“The best way to address people’s anticipatory fear is by sticking with the science. Wear appropriate PPE, stay safe, and follow the guidelines.”– Dr. Joel Solomon
“Those are concerns that have to be addressed,” he said. “We have to make sure we are all comfortable and respectful and accepting.” Going forward, Solomon believes that “the best way to address people’s anticipatory fear is by sticking with the science. Wear appropriate PPE, stay safe, and follow the guidelines.”
Also, Solomon recommended “keeping lines of communication open and remembering that social distancing is not the same as isolating. We can still be supportive.”
Looking back on his time in New York on the Comfort, Solomon stated, “As we sailed past the Statue of Liberty on arrival, with all the excitement and fanfare, I couldn’t help getting caught up in the spectacle. As we prepare to sail out, I now think more about the poem inscribed there: ‘Give me your tired, your poor, your huddled masses yearning to breathe free.’ That’s what the mission was truly about. We were treating a lot of folks who didn’t have many resources or advantages, and I am proud we were there to answer the call.”