COVID-19: A Dispatch from NYC, Part 2
I continue to receive messages of support from so many of you, many of whom I’ve never met. To all of you, I express my sincere gratitude, these messages are a real source of strength and inspiration to me, and they are most appreciated.
As time has passed, I have learned much about COVID-19. I am becoming more comfortable working with the team here every day. My team consists of a fellow and two residents, both of whom are dedicated workers who make my job much easier. Returning to my adult ICU days has been tremendously rewarding, and I have learned and relearned a lot since I’ve been here, including how much I love the practice and the challenges of running an ICU.
Overall, our patient population matches that of other hospitals around the country. Most of my patients are elderly and those that are younger have preexisting conditions. The most common preexisting conditions in my patient population are obesity, diabetes, coronary artery disease and cardiac and renal dysfunction. All these patients need very aggressive ventilatory support, which usually starts out as non-rebreather facemasks and quickly progresses to CPAP or BiPAP support. Contrary to popular belief, we have plenty of ventilators, and, thankfully, we continue to have plenty of personal protective equipment (PPE), at times the types and brands change, but we are never without PPE.
This experience treating patients and learning their stories has humanized the epidemic for me. At the beginning of my service, I approached the crisis in a very academic way. I did a lot of reading, got to the hospital early, reviewed patients extensively and familiarized myself with hospital procedures and current standards of care and expectations. As a doctor in the ICU, we treat the most challenging COVID-19 cases who often have complex life-threatening problems that require split-second decision making. At first, I was focused on knowing everything I could about the virus to provide the highest quality of patient care.
It was through the eyes of a patient’s son that I was able to see the human side of the disease. I had the experience of resuscitating this man’s parent while he was at the bedside with me. The son was silent for quite a while, patiently watching what I was doing. We talked while I worked; at first, the questions were about what I was doing and why. Eventually, he started to ask the questions he really wanted to know the answers to, which were the chances that his parent would survive. I was honest with him and told him that with his parent’s preexisting medical problems on top of this horrible pneumonia, there was an increased risk.
He then shared with me that two weeks prior, he had lost his other parent to the coronavirus at another hospital and expressed to me how hard this was for him and his family. Once we stabilized his parent, I walked out with him. He shook my hand and thanked me for spending time with him and caring for his parent.
I witnessed firsthand, coronavirus cannot be defined as a clinical challenge, or a statistic, it is a parent in critical condition and a son who may, within a few short weeks lose both his parents. This experience reminded me why I got into medicine — to be there with people on their hardest days and try my hardest to impact the outcome.