Part of the Series
Despair and Disparity: The Uneven Burdens of COVID-19
“CAC Foreman 8th floor.” “Rapid response Klau 4th floor.” The voice that echoes in my head is the voice that blares overhead every few seconds in my workplace, indicating where to go for yet another cardiac arrest or another patient on the verge of death.
I am a first-year internal medicine resident in New York City, and the physical and emotional toll placed on me is immeasurable. My attending physician reminds me of someone commanding a battlefield. I’m surrounded by “allied” residents (doctors who had chosen different specialties but are now deployed to my floor), and “coalition” doctors (students who graduated early to help us). The regular hospital terminology has been replaced by wartime rhetoric. Unlike soldiers in war, however, none of us ever expected to lose our lives by practicing our chosen profession of medicine.
Being on the front line of a global pandemic at a tertiary care center in one of the most populated cities in the world is surreal and scary. Until I came down with COVID-19 myself, I was scared of potential cases I was coming into contact with, scared that my mask wasn’t fitting properly on my face and scared that I would touch it with dirty gloves by mistake. My face hurt from wearing a mask 13 hours a day; my head hurt from trying to find a mask in the chaos of people frantically searching for them.
Walking into a shift one morning, I was handed a Yankees poncho to use as a gown. “Treat it like gold,” one hospital administrator said at a weekly COVID town-hall conference. I feared for my life.
As the death toll began to spike, I started taking a few seconds out of my day just to hold my patients’ hands as they neared death. I closed my eyes and stood in silence in each patient’s remembrance. I reminded myself that tomorrow is never promised.
A few mornings later, I started having fever and chills. I was in stern denial. But in reality, this should not have been a surprise. I was given a Yankees poncho and sent to war.
Then, I began to hear my 84-year-old grandfather, whom I live with, coughing violently. What’s his O2 saturation? How’s his breathing? These are questions I’d asked about strangers a few weeks ago. Now, I was asking them about my grandfather, as I brought him to the ER.
One of the horrors of being in the hospital during this time is that no family members are able to be by your side. Meanwhile, in New York, medical workers are stretched so thin that there are not enough to look after everyone; the care for each patient inevitably becomes compromised.
One morning, as I was doing my daily checks on my grandfather, I noticed he was much less alert and responsive. I couldn’t shield him from the hospital any longer.
Day after day, as my grandfather remained in the hospital, I saw him through FaceTime. Truthfully, I felt blessed to be able to see him at all. I got to see him and he got to see me, even if it was through a 5-inch screen. It was our lifeline.
It was also through this screen that I noticed my grandfather’s sudden change in breathing one day and no one within reach. I called out, “Rapid response!” as loud as I could into my phone. Undoubtedly my first over FaceTime.
The truth of the matter is, much of the care that patients receive during this time falls into the already overburdened hands of the people taking care of them. Most patients are lucky if providers enter their room without feeling the immediate need to rush out.
One of the calls we dread making as doctors is telling a family member their loved one is dying. That was the call I received when my grandfather’s oxygen levels were dropping. We grow accustomed to making the call as clinicians, but we never expect to get it ourselves.
I rushed to the hospital. I felt for his pulse. Slow but faint. As a doctor, you become desensitized over time. You frantically think of the next steps that will save a body’s life, until you realize that body is someone you know.
The physician inside me took a pause, and the human inside me was overcome with emotion. From the beginning of our training, we strive to separate medicine from emotion. But when it’s your own grandfather lying lifelessly on that bed, you can’t help but cry. I started crying for him, calling his name, nudging him to wake up like I would those early Sunday mornings to come play outside. His pulse kept getting fainter and fainter. My one job as a doctor is to keep people alive. I was failing at that moment. My one job as a family member was to keep my grandfather happy. I felt like I was failing at that, too.
“Time of death, 3:12 p.m. I’m so sorry for your loss,” the doctor who was caring for my grandfather told me.
Death during this time of pandemic has no dignity. Patients are not allowed to have visitors and often die scared. No matter which side of the “I’m sorry for your loss” you’re on, you can’t help but feel helpless. Someone deteriorates, someone dies, and on you go to try to save the next life.
A few days later, I prepared to head back to work. I thought about all the patients I’d treated for COVID-19 before I knew that my grandfather would be stricken with the disease. As I headed into work around 7 p.m., I heard the sounds of people cheering outside the hospital. But at that moment, I was no hero. I had just lost a war. And I was returning to the battlegrounds that had altered my family forever.
If this pandemic has revealed anything, it’s the frailty of the health care system in this nation and the lack of preparedness with which it has left hospitals. So many of our leaders refuse to support policies that lead to better health outcomes for all. The result is hundreds of thousands of needless deaths, including my grandfather’s.
Meanwhile, at my hospital, a resident I worked with a few weeks ago is now in critical condition in our ICU. Still, hospitals are firing personnel for speaking out, nurses are on leave for bringing their own protective gear and physicians are seeing their compensation cut. Heroic rhetoric means nothing when you are treated almost like a villain.
Society needs to redirect energy to alleviating the struggles of workers rather than glorifying them. Nobody wants to be a hero right now. We just want to live to see another day.
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