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As the COVID-19 crisis continues to unfold, the medical staff at Mount Sinai Brooklyn is providing regular dispatches about the daily experience fighting the virus. At the end of March, with an overwhelming number of people out sick and the hospital overwhelmed with critically ill COVID patients, some staff wondered how they would be able to keep going. Thankfully, reinforcements were on the way. Dr. Luke Northern is an anesthesiologist from Chicago and one of the many health-care professionals from around the country who came to New York City at the beginning of April to support hospitals, like Mount Sinai Brooklyn, that had been stretched to their limit. Here, his dispatch:
I was an undergrad in Boston when I saw the airplanes go into the Twin Towers. I just remember feeling so helpless, and I vowed that if ever there was a situation like that again where I could help, I would and should help. My father was in the military, and my brother-in-law did two tours in Iraq. They put in years, and I felt that it really wasn’t all that much for me to go to New York and give a month of my time to do what I do every day. I guess it felt like a calling, like every generation has its moment.
I came down from Chicago, on Friday, April 3, and my first shift at the hospital was overnight on Saturday. It was extraordinarily odd to fly out. You go to O’Hare and hardly see a soul, get on an airplane with five or ten people on it, fly in to La Guardia with no people. It was eerie. A bunch of out-of-town volunteers were staying at the Marriott Marquis in Times Square. I was one of the first people at the hotel in our particular group, but then as time went on, you see people starting to arrive. Now it’s full of people who came to help.
When I got to the hospital, in a sense it was exactly what I expected. The hospital was out of physical space, and there was so much going on. Yet even though it was exactly the way it was described, it was completely mind-blowing to actually be there. It left me speechless and just really sad. It was clear that this just struck the community so, so hard, that this hospital was completely overwhelmed with patients, and there were stretchers all throughout the ER full of intubated patients, patients with tubes in their lungs.
I could definitely see [the relief] on the staff’s faces when we came; they looked very tired and worn out. In terms of my role, I’m an anesthesiologist by training, but we deal with critically ill patients, so I was asked to help in ICU B, which is an upstairs recovery room they converted into an ICU. So I was stationed up there to help care for those critically ill patients, and there were also critically ill patients out on the floor, and we would help out with them. When I first got here, it seemed like every five minutes there would be a code overhead.
You can feel overwhelmed with this disease. I work in a critical-care unit, and almost 90 percent of the patients die once a breathing tube is inserted, so it can be just emotionally devastating. At one point, I was sitting there with another doctor saying, “I just don’t feel like I’m helping all that much.” And he put his hand on my shoulder and he said, “If you came out here, and you save just one life or just help save one life, then it’s worth it. And we’re happy to have you.” That kind of put it in perspective for me and kind of helped me rally.
There was one instance where I was getting ready to intubate a patient, which is where you put the breathing tube in. We now know that once you put the breathing tube in, there is a 88 percent chance that that person will die. I didn’t know that at this particular time; I just knew that inserting a breathing tube meant that this person had an uphill battle to fight. But he wanted to call his family before he did so. I was standing behind his bed, waiting to put a breathing tube in and watching him fight for breath on a machine trying to blow air into his lungs and watching him say essentially good-bye to his wife. I saw her face and I saw his face and I almost lost it. They were both in tears and the patient was gasping for breath and he wanted to say something to the effect of “I wanted to see you one last time before they put the breathing tube in me.” And she was obviously in tears and said something to the effect of “I love you.” You could tell in both of their demeanors that they were saying good-bye to each other. It’s something that I’ll never forget.
I followed that particular patient through the course of his hospital stay. He ended up passing away about a week later. To watch these patients die without their families is one of the things that we don’t train for. We were always taught about the last moments, how important it is for family to be involved and say good-bye. That is one of the most painful parts of this disease, to have that ripped away.
I haven’t really thought about that day in a while. That was one of the few times that I felt really emotionally overwhelmed. When you get a day off from time to time and you get to talk to your wife — that’s really when you deal with the emotional tax. That’s really when you think about things and get to be like: This isn’t normal; this patient died and there was no one there.
You don’t process that kind of stuff in the moment because you’re so overwhelmed with work. You pay the emotional price when you’re alone. Right before you go to bed and you think about your day, or when you’re trying to blow off some steam with a workout, that’s when your mind starts to wander. It’s tough because I’m away from my family, too. We’re used to having our support system as well, and we’re kind of deprived of that.
The staff has been overwhelmingly heroic. They’re the real heroes, these hospital staff who are over 60 and do have these comorbidities and are at risk of getting this disease and being seriously afflicted. I am not in that range. I am, you know, 39 years old and otherwise healthy.
I know it’s easy for someone like me. I’m in a hotel room by myself, and I just go to work every day. But I also left behind a wife and three kids whom my wife is trying to homeschool, and it’s really emotionally taxing and difficult for all of us. I kind of want to send a shout-out to my wife and my family. They’re really sacrificing a lot. I’m missing my youngest’s 4th birthday. And I know that’s hard on her and hard on my wife. But it’s such a small sacrifice to make for the greater good.
At home, we’re used to taking care of all kinds of patients, but definitely seeing a lot of minority patients in poor health over and over again, you could certainly ascertain that they were not, you know, particularly well cared for because they didn’t have the socioeconomic situation that others had. It’s heartbreaking to see that. It made me realize how important health maintenance is. I think it would be a good thing in a country as wealthy as this to get the people the basic care that they need to fight common diseases so everyone in our country is less susceptible to diseases like this. It has galvanized my feelings that health care is a right, not a privilege. It is abundant from what I’ve seen at this hospital that those in the lowest socioeconomic situations are hurting the most, and something has to be done to give those patients a better chance.
This is a horrific disease, but I really hope that this brings us together. I hope we can learn something from this. I’m certainly inspired to be a better doctor and a better person by what I’m seeing out here.
Working in the ICU, we don’t see the patients who get better. It’s hard to work so hard and see these patients fight so hard ultimately to no avail. But it makes those moments that much sweeter when it does happen. I’m into my fourth week now. One patient, we got the breathing tube out, and later on that afternoon, he was FaceTiming with his family and saying hi to them, and that’s what kind of makes this whole thing worth it. I was working with a nurse last night, and she was showing me pictures of a different patient, one of the few who made it out of our ICU, and he was celebrating his birthday. That’s really going to help me get through the next week or so before I go home.
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