In the Northeast, the rate of Covid-19 transmission and infection is dropping down to the point where I only have two Covid patients left on my service.
Both of them are relatively young and strong men who will likely need oxygen for the rest of their lives.
Be that as it may, the focus of life as we emerge from isolation, is now on prevention of spread and trying to keep the horror of March / April / May from happening again.
(We all know it’s going to come back in the fall, but for our own sanity, we’re “whistling past the graveyard” and trying to pretend it didn’t happen)
But it did.
I’m Sorry
When I unilaterally declared on a previous blog post that it was over, I was only thinking about it for us… here where I live. Not for the rest of the country.
For that I am sorry.
It isn’t over.
I will not go into politics, but I will go into the discussion of willful ignorance and stupidity.
I would have thought that when the New York area was going through three months of death and upheaval, the rest of the country would have paid attention. When every outlet (official and unofficial) was advising us all on how to stop the spread of this virus, society as a whole would have listened.
Really?
But no.
The medical professionals have listened and are now using the best practices that we developed while we were in hell, to attempt to salvage life. But the populations in the Southeast and Southwest do not honor their healthcare workers, they do not honor their elderly, and most of all do not honor themselves, and do not take measures to protect themselves.
I’m not saying that everyone is doing it, but enough people are blinded by selfish desires couched in the finest rationalizations, to cause spread of Covid and invite death into their midst. The way to stop the spread is well known.
It’s easy.
Grow up, wear a damn mask. Wash your hands. Social distance.
It’s not political, it is human.
In this season of exposed lies, of exposed fear, and exposed hatred… be that spark that exposes love for one another.
I live and work in New York (Long Island specifically) and things have pretty much settled down at our hospitals.
The make-shift ICUs have been dismantled, COVID patients on vents relegated to a small area in the back of the MICU (Medical ICU). The non-intubated people housed in three hallways of the unit that had always been designated for infectious diseases. Those areas still have the COVID look to them, bags taped to walls and blue plastic gowns hung from hooks, but there is less desperation than there was.
The patients that were going to die in the ICUs are slowly dying, regardless of what the families want and what any doctor could ever do. Those not on vents are going home (with oxygen and forever damaged lungs -pulmonary cripples) or still short of breath on high concentration of oxygen and clearly going nowhere.
At least the families can come to the windows and see their relatives from outside the buildings. And we’re beginning to let some families come visit those near death.
Everywhere else in the hospital it’s different. We still all wear masks (a habit that will probably live on for a good long time) but the rooms are now immaculate, the floors shiny and the walls all freshly painted. All hint of the horror covered in bright white with earth-tone trim.
I was rounding with my team this week when our social worker (a brilliant woman who was “parachuted” into the hospital from our hospice affiliate on a grant to help us – she arrived as the “tide” was washing out) noted the look in our eyes and the blank eyes of the nurses on the floors and asked us, “but how did it feel?”
It Was Dark
The lights weren’t bright enough
As a group, including some floor and ICU staff, we all had similar recollections.
It was dark. Not literally, but no matter how many lights were on – the hallways, rooms, and offices felt darker than they should have been. The atmosphere inside was “heavy”, hard to breath.
We all agreed that we actually couldn’t remember what it was like… more like we didn’t want to remember it, but we all had individual “moments” we remembered. One nurse said that she couldn’t remember anything about those weeks, but vividly described an incident in which two young patients coded in the same room and they had to choose which one to intubate first and which one to let die.
A social worker recalls helping a group of nurses communicate with a patient who spoke Greek and was isolated and scared, they didn’t have to care so much, she said, but it was the act of caring so hard that maintained their sanity.
I recall the surreal nature of one of our make-shift ICUs towards the end of the first wave, messy, music from phones in the background, “bunny suits” tied around everyone’s waist (they are hot to wear all day).
When these snippets of shared memories are recalled, everyone looks the same, they get glassy eyed, as if peering into a dark distant place, then everyone says the same things.
“I can’t remember much about it.”
“It’s too soon-I don’t want to think about it.”
“I had no one to talk about this with anyway. “
“It pisses me off that everyone outside is bitching and moaning about being BORED!”
“I’m scared, I don’t think I could do it again. But I’m scared that we’re gonna have to, no one is paying attention!”
I don’t know how I’ll be able to do it again, but I will… as will everyone else, no matter how scared they are. It’s what we do.
Covid Update
So, I don’t care what you think of New York or it’s governor, New York and the Northeast (except Vermont) has done an amazing job in decreasing cases of Covid.
I fear for all those states that thought we were joking or that we were over dramatic “snowflakes” ( I invite you to see the refrigerated trucks behind the hospital). You are now being hit with it worse than we were.
Wear all the PPE.
I address the new Covid Warriors (healthcare workers) :
Patients should get high flow O2 and lay them prone. All of the meds we have now DON’T WORK!
Isolation is important as is hand hygiene.
Eat well, sleep, wear your mask it’s not political, it’s reality, exercise. Keep relative isolation from vulnerable family members.
Scrubs, head covers with buttons on the sides for the mask straps (look on Etsy) and “Covid sneakers” that you change out of outside your house and throw in the wash before walking in.
Be good to yourself, it’s gonna suck and you’ll likely end up as damaged as we are in the NE. We’ll be here when you need help like you helped us.
New Mask
On a not serious note, I got a new mask.
Base Camp Mask
Since we’re all going to need masks for the foreseeable future, I ordered a very cool looking and comfortable mask. It is super comfortable with a Velcro strap around the back of the neck (takes the strain off the ears) very breathable with replaceable filters inside.
Called Base Camp masks, it’s good quality, solid shipping and less than 40 dollars.
You’ll spend more on boxes of cheap masks of poor quality that don’t look near as cool. Btw, I’m not getting paid to show you the mask, I just think it’s cool.
As always, wash ya hands, wear a mask, social distance, and love each other… we are all we have.
So the “inside” is looking a lot less like the “inside” every day.
When I resumed these posts, It was at the run-up to the surge in New York (Long Island more specifically) and I watched an orthopedic floor turned into an ICU, I saw nice clean step-down beds (were people go to have some cardiac monitoring – but nothing too “serious”) turned into ICU beds, a holding room for elective surgeries turned into “the fishbowl” of Covid patients were patients watched each other suffocate, and even ambulatory surgery units turned into Covid – care floors.
Like the receeding tide, I am seeing units being returned to their former functions, being made “clean” again. More and more, we are allowing families to at least come and see their sickest relatives before they are necessarily near death. We are even going to open a new cafeteria expansion next week (3 months late because of Covid).
There is a sort of strange melancholy to this process, as the huge bags of “dirty” supplies get thrown out and the rooms are “terminally cleaned” it feels like the day after christmas, after the superbowl, after the world series… the world returning to whatever passed for normal, the exploits and adventures spoken only in “remember whens”.
I look at the sparkling clean rooms and still see the hundreds of patients who suffered and died in them and I don’t want them to be forgotten, their suffering should not have been in vain.
And then I see the crowds rushing to bars and swimming pools and such flouting common-sense self protections and think, “yeah they did die in vain, and it is going to happen again, somewhere else if not here”.
I want it to be over.
I am afraid it is not.
As Always
Wash your hands
Don’t touch your face
Wear a mask… you aren’t freaking superman / captain marvel.
Exercise, eat right.
Love one another, hate doesn’t make anyone better.
Life, Health, and Policy. 