A month ago, I laughed about coronavirus – or as Facebook memes called it, the “WuFlu.” It was a world away, and it was never going to affect us here in the US of A. Today, I had actual, physical palpitations when I parked my car at work. I am scared to go in. I am a nurse. I have worked in healthcare in some form or another for the last 14 years, and there has always been risk. But it has always been calculated. It has always been small. Now, I can bring it home and hurt my children.
Oh, I’m careful. I strip in the doorway where my wife leaves the laundry bag. I Lysol my shoes and my watch. I wash my hands at work so often my knuckles hurt. I wear a gown. And gloves. And surgical mask. An N95 particle shield strapped against my face, so tight I have marks for hours after I leave the building. And splash guard. And hair cover. And I worry. Is this enough? I am told that it is, but I worry. Because my kids mean more to me than my own life.
I teach my children that if someone asks for help, we cannot say no. And I live this credo. I volunteer time in EMS as an EMT when I am available. I run toward emergencies. And I will continue to do this for as long as I am able. But, G-d, this is hard. Not the time, or the effort. That part is easy. I am in healthcare because I can’t stand to see people in pain. I need to hasten its end, to hear the sigh of relief as a patient feels better. But there is so much pain now! So much pain. Endless. It is horror for healthcare workers now. Lean back in your seat, mouth agape, eyes wide horror. The suffering is unrelenting.
We do what we can, but it is not enough. Not nearly enough. Our medicine is excellent. Our skills are sharp. And it means nothing. If Corona were a movie villain, it would be laughing right now. Our people are dying. And so much pain. Families, desperate for information, calling the hospitals. Hospitals doing their best to give them some news with the little time we have. And not enough supplies. And med shortages, because being on a ventilator requires sedation and comfort medication and, occasionally, paralytics to stop a patient from unconsciously “fighting” a ventilator.
So many meds that we are running out. So we figure it out. Because this is what we do. We daisy-chain IV tubing to make them longer so we can keep the IV poles outside the patient rooms. We swap one med for another, similar med that we still have in stock. It also requires staff. But we, too, are running out. There is simply not enough staff that have the training to keep up. So we are overloaded with patients who need us. And we come in for extra shifts. And we feel the emotional burn. So we find an empty hallway, sit down on the floor, and cry. And then we go back. I have said the Prayer for the Dying more times than I care to say out loud. Maybe more than I can handle. But no one dies alone.
This is a 34 bed ICU, one of several in this building. When I left yesterday, there were 34 patients. When I came back, 34. But not the same 34. Three patients passed while I was gone, each bed now filled with another patient, just as sick as the last. Each patient had a name. I remember two of their names right away, but I struggle to recall the third. I can’t, and feel guilty. Too many people here, too much to do. One of the names I remember was my friend’s father. I am slowly breaking.
I am not an emotional person by nature. But in the last few weeks I have found myself minutes or seconds away from tears at any given moment. This past Friday night I was with my kids and struggled not to break down while singing a song about baseball.
I get asked frequently by friends and neighbors to check up on people at the hospital. “Just see if they are OK, please?” They aren’t. If they were sick enough to be admitted in this time of national crisis, things are not good. Maybe they will be fine. Oh, they were intubated yesterday? I hope they will be OK, I tell them. I wish them well.
And I do wish them well. I truly do. But an intubated patient that’s Covid+ in an ICU? This is not a pretty picture. A triple lumen central line in the neck. Each port hooked up to a separate line of medication, likely pressors to keep their blood pressure from dropping too critically. A central venous pressure port on one of those ports hooked up to a monitor to see the filling pressure of the heart. Another one or two IVs in their arms for some other IV meds. Maybe an antibiotic, maybe an anticoagulant to prevent a blood clot. A line in their radial artery for continuous invasive blood pressure measurement. A tube coming out of the nose attached to wall suction to prevent gastric filling of particles they aren’t capable of digesting right now. An endotracheal tube out of the mouth connected to a ventilator to breath for them. The ventilator itself, a mass of dials, buttons, numbers, waveforms and screens to interpret and control a breathing pattern. If kidney function is bad, maybe another two-port central line coming out of the chest connected to a dialysis machine to filter the blood. A urinary catheter to keep track of fluid output. Cardiac monitor. Don’t want any arrythmias, can’t have that. Oxygen saturation. Labs. Blood gases. Glucose checks.
Normally we have one of these patients. If we are tight, or someone calls in sick, we can get two. Now we have three of these patients. Maybe next week we will have four.
I am the person I was a few weeks ago. Maybe now even more. But I am also less. Like a chipped and repaired glass, I am technically all here. But run your fingertip along the glue line. You can still feel the crack. You can see the imperfection. I will never again be exactly who I was. My wife knows this. She is the emotional support holding me together, though I don’t think she realizes quite how much. My kids do not yet understand, but in time I believe they will. Daddy is a Super Nurse, Mommy tells them. Daddy is a Super EMT. I’m not. Just another guy trying to stem the tide in our favor. Maybe help somebody feel better. But we are outnumbered, outgunned.
I do work with some amazing people, though. EMTs and paramedics that do the utmost for our people. Waking up at 2 a.m. to get dressed and run to help someone in need. Then another call, 15 minutes after they get home and back to bed, at 3:30. Guys who would give the shirt off their backs to spare someone else discomfort. Angels wearing human skin. I have no other descriptors. They just aren’t adequate.
Respiratory therapists – maybe until now the most undervalued healthcare workers. Not anymore. Intensive care docs, PAs and nurse practitioners. Freaking rock stars. Doing what they can to keep up with the tidal wave of patients. Treading in choppy waters, but somehow staying afloat. Custodial and building services staff who are nonstop disinfecting rooms and surfaces to keep us safe. Patient care techs running everywhere and back to grab needed supplies. Pharmacy sending the meds and keeping track, so nobody gets the wrong med or incorrect dose. And nurses (I’m biased). The caring professionals who have gone so far above and beyond the job description that words to describe it are meaningless. And all the restaurant owners sending wave after wave of food and coffee to keep us fed and alert. Without them, I would literally have not eaten for 13 hours straight while tending to those who need it. Say what you want about New Yorkers, but when push comes to shove, we have each other’s backs.
I know there will be movies made about this. And I imagine I will feel about it the way a soldier must feel when watching a war movie. Film will never be able to capture the moment the way human eyes do. Suffering does not digitize. It is real, and it is raw, and it has ragged edges. It hurts.
Never have I been more heartbroken or filled with so much sorrow. Never have I been more proud to be in healthcare.