Diary of a Covid-19 Physician: 14 Days in a NYC Hospital | WIRED

published on July 2, 2020

we had two patients died during the day

today and four more almost died I don't

know how people have been working like

this I just too much for me

[Music]

today is April 14th I am headed to New

York I really have never seen the same

resistible Airport this empty I mean

there's just nobody here so I got a long

flight ahead of me but be there soon and

get settled in when the covin pandemic

hit i really had a strong sense of guilt

about not being on the frontlines not

taking care of patients and not feeling

like i was doing all that I could was

everybody is on oxygen and almost

everybody is a Cove occasionally about

8:40 in the morning I'm heading in to

the hospital like I'm guessing this is a

later start than most of my days will be

but I'm just gonna get orientation and

get tested for my mask and so on Here I

am so home hi PPE on my head I just came

out of the unit so I took off my gown

and gloves but you see its head these

goggles are a little big on my face I've

got my n95 under here my head is small

this is a lot of equipment with my face

anyway I'll check back more later so I

just got back to my hotel

I just wanted to capture what my face

looks like after not even that many

hours so I'm probably gonna start using

band-aids like pre-emptive band-aids I

was told that the hospital typically has

50 ICU beds and they've now got 200

because of all the conversions they've

done to help take care of patients in

the current pandemic

[Music]

it's about 10:00 pm on April 17th

pretty early in my shift I had a patient

who got a lot worse very quickly and he

was actually of the five pages I was

taking care of he was the healthiest one

so I really hadn't mentally prepared for

that we were able to give him the

treatment that he needed and he's doing

much better now

but I think that was a very quick

introduction to how patients do when

they've got this disease that they can

be fine one minute and then just really

not the next they're very very dependent

on the oxygen support that they're

receiving is April 18th pretty early in

the morning so here we are it's my

second night here in the ICU so far I

had one patient who coded meaning nearly

died last night and I had another

patient who coded tonight and

unfortunately he didn't make it and I

just got off the phone with the

patient's family and I can definitely

see how doing this day in and day out

would get very very hard it is almost 2

am on April 20th I really feel like

I'm on a roller coaster right the first

couple of nights I was here were worse

than I thought they would be in terms of

how the patients were doing tonight from

the time I walked in

there were a number of patients who

really needed kind of emergency care I'm

not sure what's gonna happen with those

patients it's too soon to tell but we've

had to be pretty aggressive in our

interventions but you know the patient

who almost died last night is still here

so that's some cause for hope a lot of

these patients even if they had normal

kidneys before have had injuries to

their kidneys from the disease and from

their blood pressure being low and

having trouble with oxygen and so now

they need to dialysis there's only so

many machines there's only so many

nurses there's only so many hours in a

day so who gets it who is deciding who

gets it hmm I'm signed up to be

rationing care I don't think any of us

did so that's kind of the latest

struggle noticing a lot of things that

are different from you know normal times

for example in the ICU typically if we

need changes made to a ventilator if we

have patients who need suctioning or

anything like that there would be a

respiratory therapist who provide that

care I think that there aren't quite

enough of them to go around so I've

learned how to manipulate all sorts of

ventilators we also have many different

kinds of ventilators usually an

intensive care unit you have the same

model throughout the unit but we have at

least 3 or 4 different kinds here many

of which are not intended to be used in

a continuous basis they're made for

transportation so temporary use from to

get a patient from one place to another

there are challenges in getting x-rays

challenges

and getting certain types of medications

these are all things that are different

from what would normally be happening I

mean if we had all the resources it is

the morning of April 20th around 9:00

am I gotten home from my shift and

showered and I'm getting ready to go to

sleep last night we had a couple of

patients who were close to dying but

neither of them did one of them had

gotten quite sick overnight and we

wanted to call the family so that they

could have a chance to communicate with

her an anticipation that this might be

the last opportunity that they would

have and this was the first time that I

actually watched it happen so one of my

colleagues called the patient's family

and then stood over the patient's bed

holding her her phone up so that they

could see her and I listened to them try

to say goodbye

over the phone they couldn't help but

think about you know that were my mother

how awful that would be to not be able

to hold her hand don't you know that she

was alone anyway I just wish it didn't

have to be like this and I'm glad I

haven't had to watch that 20 times or 40

times or however many times in the last

few weeks because I don't I'm not I'm

not cut out for that but I'm gonna try

to watch something like hard-headed

didn't go to sleep it's position for

used to fixing problems and helping

people that's why we do what we do but

when we don't have medications at work

when there aren't ventilator settings

that can help people get enough oxygen

and get rid of their carbon dioxide it

feels very frustrating on top of that a

lot of the doctors here have friends or

colleagues who are critically ill in

other hospitals in New York and so

they're constantly thinking about and

worried about those people in addition

to being worried about their patients

and many of them are living apart from

their families in order to prevent

infecting their family members so

they're going through this very

stressful challenging time basically on

their own so far it seems to me that

most of the people are coping by really

not thinking about it and not processing

it I'm just showing up and doing the

work as best they can and hoping things

get better now I'm working days feeling

less like the vampire and today somewhat

miraculously was actually kind of a good

day we had a patient who was able to

come off the ventilator which is pretty

incredible because I think that hasn't

happened actually in this unit since the

unit opened we're at the point now where

we're starting to see fewer people get

admitted every day

so things are I think starting to slow

down a little bit which is great

the patience we have now though are all

really really sick and probably will be

here for quite a while so it's not like

it's totally over it is April 24th

I had a patient today who was writing

notes so he's on the ventilator with the

breathing tube but he was hand writing

notes to people and we FaceTime with his

family and you know he's mentally very

with it and knows what's happening

but he's requiring a lot of oxygen from

the ventilator to get oxygen into his

tissues and he's also on the younger

side so it's very hard to watch because

I just don't know whether he's going to

get out of this so far of all the people

I've seen on the ventilator who have

been really sick the way he is only one

person in the last 10 days has been able

to get off the ventilator but he wrote

today I'm not giving up so even with a

breathing tube and all sorts of IVs and

tubes coming out of everything and being

on all the medication that he's on he's

not giving up it is April 25th at least

today when I came in no one had died

overnight and hopefully no one will die

today if that happens I'll be the first

24-hour period since I've been here that

we would have had no deaths in our

little unit I'm supposed to be leaving

the hospital a few hours ago but one of

my patients I almost died just as I was

about to leave so I stayed to try to

take care of him and to talk to his

family here

anyway so it's 11:30 now we had two

patients died during the day today and

four more almost died it's just just in

the last couple of hours you have one

good day and then have a really really

awful day right after what I miss my

staircase I don't know how people have

been working like this I just too much

for me I know I'm gonna sleep even

tonight because I'm gonna be worried

about this guy and whether he's gonna

make it I can't stay here all night I

gotta be here so I'm gonna go see if I

can get some rest

that is April 26 yesterday was it was a

rough day and it was long and we lost

two patients during the day neither one

was totally unexpected but it's still

hard to see as I was about to leave

we actually had four patients who got

really really sick at the same time and

came close to dying one of them was a

patient I was falling closely and I felt

I guess sort of attached to I just

didn't feel like I could leave when he

was that sick so I ended up staying

until we got him

sort of stabilized um I mean he was

still quite ill but it seemed like we

had helped him a little bit so I had to

call his family and help them to

FaceTime with him because I wasn't sure

if he was gonna make it through the

night and I always feel like I'm

intruding when I'm when I'm there and

I'm hope I have to be there except hold

the camera we don't have a holder the

patient obviously can't hold it

themselves so it's it's very hard to

hear people tell their family member to

fight and that their they can get

through this especially when as a

physician I I'm not really sure in that

moment that they are gonna get through

it

but we all need a little hope I also

think I'm just very sleep-deprived I I

don't think I've slept more than five

hours at a time since I've been here and

I haven't had any days off which is my

choosing I think I think he would have

been happy for me to have a day off but

I just felt like I'm here for a limited

time and I wanted to do the most that I

could do it is April 28th and I'm about

to head out to the airport just been

reflecting back a little bit on my

experience here in New York you know I

don't really know exactly what I

expected

I hadn't really thought about the

emotional toll I had thought about you

know the medical care and how

challenging that could be since we don't

know much about this disease of the

people I took care of with Kovan ammonia

they all either have died or remain

critically ill in the hospital at this

point just in two weeks here seeing this

much death has been really really hard

for me so they're already 5 or 6 weeks

into this now and even as things slow

down and get a little bit better they

really need time to recuperate and we

don't know when things will get worse

again which i think is really

psychologically challenging I'm thinking

about if there's a second wave you know

I would like to come back and what are

the skills I should try to gain between

now and then to be the most helpful to

people here so I'll be thinking about

all of them and hoping for the best

I am back home now in California I just

had a nasal swab done yesterday to see

if I was Co fit positive which was not a

pleasant experience they take a swab and

put it basically straight back going

back towards your brain and then they do

that on both sides just you know in case

and I got my result tonight and I am

magically somehow negative I really am

perplexed as to how that's possible

given that I was really exposed to a lot

of kovat for a couple of weeks for many

hours a day but I'll take it as a win I

mean it could be a false negative I

suppose but I'm just gonna I'm gonna

roll with that

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