By Saphia Suarez
As part of our “Meet Yale Internal Medicine” series, today’s featured physician is Denyse Lutchmansingh, MD, assistant professor of medicine (pulmonary, critical care, and sleep medicine).
Denyse Lutchmansingh, MD, was attracted to the culture of innovation at Yale Internal Medicine, and less than two years later she is working at the center of it as associate director of the Post-COVID-19 Recovery Program.
As a pulmonologist, Lutchmansingh, associate professor of clinical medicine (pulmonary), was anticipating ongoing pulmonary issues in her COVID-19 patients.
“One of the challenges early on in the pandemic was anticipating the needs of patients who were infected with SARS CoV2 following the acute phase,” said Lutchmansingh. “The Recovery program began mainly as a pulmonary clinic, but as we continued interacting with patients post infection we realized they had multisystemic symptoms and needed more than just pulmonary care.”
“We have six physicians including myself,” said Lutchmansingh. “Each day we learn something new from our patients as we try to understand why some patients have persistent symptoms. We call it treating by learning, because post COVID-19 care is still evolving and complex.”
It was through this “treating by learning” that Lutchmansingh and the rest of the recovery program team realized they needed multidisciplinary input. “We started hearing about things like impaired memory, significant fatigue, cardiac issues and joint pains,” says Lutchmansingh. “After each patient interaction, we would convene and compare observations. As we started noticing common trends, we reached out to other specialists in those areas.” The clinic became multi-disciplinary, and now collaborates with cardiology, neurology, otolaryngology (ENT), psychiatry, rheumatology and physical therapy.
“That’s one thing Yale is great for—collaboration across disciplines,” said Lutchmansingh. “People are always willing to meet and explore options together. We’re always able to find someone to help us, and more importantly help our patients.”
Lutchmansingh’s work requires constant problem solving—which, she says, is one of the reasons she went into medicine in the first place. "The more I learned about science and medicine, the more intrigued I was, because I am very analytical and I like to problem solve,” said Lutchmansingh.
She was then drawn to pulmonary medicine where she says most physicians fall in love—the Intensive Care Unit. “Those are the patients we are most exposed to in training,” said Lutchmansingh. “The critically ill patients, the patients who are complex and challenging.”
Since most intensivists are also pulmonologists, that felt like the natural path for Lutchmansingh. “But I think when you learn about something, the more you understand it, the more you like it,” said Lutchmansingh. “That’s what happened with pulmonology. It also allowed me to form relationships with patients in a way that was different from the Intensive Care Unit. I’ve cared for patients and shared many milestone events with them including birthdays, children’s weddings and deaths of family members. It was not something I thought I would have enjoyed when I was younger and just wanted to work in the ICU, but I’ve grown to appreciate that ability to not just help patients feel better but to help them stay well and manage symptoms so they can enjoy life.”
Looking forward, Lutchmansingh said COVID-19 taught her that one must be flexible and that five-year plans can often change suddenly and unexpectedly. “A lot of my time right now is focused on post COVID-19 care,” she said. “There is a lot of uncertainty associated with it, because it is not clear what the trajectory is for those patients—How long will they need us? Will they ever feel like they did before their infection? What are the long term consequences for them? It sometimes feels as if there are more questions than answers.”
As Lutchmansingh continues building the Post-COVID-19 Recovery Program, one thing is clear—she will be working at the edge of innovation.
The Section of Pulmonary, Critical Care and Sleep Medicine is one of the eleven sections within YSM’s Department of Internal Medicine. To learn more about Yale-PCCSM, visit PCCSM’s website, or follow them on Facebook and Twitter.