"Headlines Don't Capture the Horror We Saw". "I chronicled what COVID-19 did to a hospital"
https://www.theatlantic.com/ideas/archive/2020/12/new-york-doctors-know-how-bad-pandemic-can-get/617302/
Headlines Don’t Capture the Horror We Saw
"I chronicled what COVID-19 did to a hospital. America must not let down its guard."
DECEMBER 6, 2020
Kasey Grewe
Anesthesiologist and critical-care-medicine fellow
But headlines from distant states do not capture the horror of a hospital without enough intensive-care beds.
I was an anesthesiology resident in a large academic medical center at the peak of the pandemic in New York City this spring.
During a time when journalists had little access to what was happening inside New York hospitals, I wrote regular email updates to friends and family.
These messages—edited for length and clarity below—showcase the frightening reality of what care looks like in an overwhelmed hospital. (Where I describe individual cases in significant detail, I’ve obtained the consent of the patient or family in question.)
The emails relate the experiences of health-care workers, and young doctors in particular: the anxiety, the fear, the overwhelming responsibility, and the ethical burden of hard decisions. Even after the pandemic is over, the weight of these experiences will remain with us for a lifetime.
These messages form a chronicle of what COVID-19 has already done in America and a reminder of what it could do again this winter.
Here begins the chronicled story:
THURSDAY, MARCH 26
A senior anesthesiology resident holds the stat intubation pager, which goes off when a patient anywhere in the hospital needs a breathing tube right away. My co-residents and I first noticed that things were changing when the pager started to go off every few hours, and then every hour. When the hospital ran out of ICU beds, my department swiftly converted our operating rooms into a giant ICU.
A co-resident and I spent Tuesday pushing beds and anesthesia machines around to plan how to fit up to four beds in an operating room. The “OR-ICU” fits multiple COVID-19 patients into one operating room, ventilated via the anesthesia machine’s ventilators.
Their daytime doctor, an anesthesia resident in PPE, doesn’t leave their side until their nighttime doctor—another anesthesia resident in PPE—comes to take over.
On Tuesday night, one of my co-residents did 17 emergency intubations. Upon running to respond to yet another intubation page, she was horrified to see that the patient was one of our supervising physicians.
SNIP
..
.We saw for the first time that this patient was a teacher. The website had hundreds of comments from students and parents: “We are thinking of you every day!” and “We are praying that you make it through this!”
There were dozens of photos of a middle-aged man with his students—in the classroom, at school sporting events, wearing different silly costumes. He had a huge, toothy grin.
My intern stared at the website, stunned. It took my breath away.
My attending physician said, “I can’t look at this. Please close it.” We get through our day in the OR-ICU by compartmentalizing—by ignoring the fact that our patients are people who are deeply suffering.
When reality cuts through our fantasy, the job can be unbearable.
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