Megan Buckley, MD
Lenox Hill Hospital, Internal Medicine PGY-1
May 29, 2020,
New York, New York
You hear about this novel coronavirus from Wuhan and picture it being something that while devastating for those it impacts, is more like SARS or MERS, terrifying but distantly so. And then it emerges in Italy. You stay up until 2:00 AM one night scrolling through panicked reports of Italian doctors, doctors who describe a healthcare system completely inundated, begging for those to recognize the severity of the problem. And yet, still you feel protected by an 11-hour plane flight, a perhaps false notion of American invincibility, and the sense that a global pandemic is the plot twist of blockbuster movies, surely not that of your intern year. You see preparations being made, N-95s, thin plastic blue gowns, face shields, and surgical masks arriving in bulk, a vision that manages to be simultaneously comforting and alarming. And you wait.
The hospital becomes quiet, eerily so. You play Jenga with a group of interns on call one night because there are no new admissions, and you celebrate this moment of camaraderie, this golden call. You will later look back on this moment and recognize that it was the proverbial calm before the storm, feeling pangs of nostalgia and wondering how you could have been so naive. On the inpatient floors, a handful of COVID-19 rule-out patients begin to trickle in, and you sigh at the cumbersome process of donning and doffing, the 48 hours it takes for a swab to result, and the anti-climactic, but relieving feeling when these initial rule-out tests result negative. Maybe it won’t be so bad?
And then the wave hits. It feels like almost overnight the hospital has transformed into a refuge for COIVD-19 patients exclusively. You skim the ED board and see the only chief complaints listed are “fever, hypoxia, shortness of breath, dyspnea on exertion, viral symptoms,” and the story already starts to feel stale. COVID-19 resident teams now staff the entire hospital, overflowing into units and floors that had previously never before had medicine residents. Even the inpatient psychiatric facility becomes a home to those with COVID-19. Anesthesia is paged multiple times overhead each day. On night float, you go back and forth between patients on 15 liters per minute non-rebreather mask, coordinating with nurses for extra vitals checks on those deemed most tenuous. Morning sign-out takes an hour because you go to 10 different floor teams to relay overnight events, and one morning you stand there, exhausted from the night before, but marveling at the fact that your hospital has so swiftly met an unprecedented demand that you almost no longer recognize it. You feel a sense of pride thinking about your tiny place in it all.
The once busy New York City streets remain empty, and the days drag on. In one day, you write 3 death notes, all of them with a cause of death that reads ‘cardiopulmonary arrest secondary to acute hypoxic respiratory failure secondary to COVID-19 infection,’ and you wonder how much longer this can possibly last. In the MICU, you spend hours over the course of a week relaying updates to family members who aren’t permitted to visit their loved ones in the hospital. At the end of each phone call, these family members thank you profusely, asking that you please take care of yourself and your family, a gesture so sweet and so genuine, it stings. It stings in the way only a true act of human compassion can. It makes you think of your parents. How would you feel if they were the ones being intubated? You try to suppress these thoughts, after all, like you, your dad is busy treating patients.
Days become weeks and weeks become months, and you celebrate your hospital’s 1000th COVID-19 patient discharged. You walk home that day taking an extra second to stand in the Central Park sun, relishing in those victories big and those small, for while it’s impossible to say what comes next, the journey has been unparalleled.