I see EMS stretchers lining down the block.
Jam-packed waiting room filled with 30 to 40 patients next to each other,
coughing and giving COVID-19 to one another.
There is physically no more room in the emergency room.
You bring any more patients in, then you cannot walk.
We had a few patients die in the emergency room because the hospital's full.
All I'm seeing are people who are vulnerable, people who are weak, people who are scared.
And I'm not gonna lie.
It's making me scared.
You hear about people dying and suffering from it,
but it’s a whole other thing to see this stuff up close.
The proportion of patients that are critically ill,
younger, people that look just like us, and older… it’s overwhelming.
The morgues are already getting overwhelmed.
It just feels like you're standing on the shore looking at a tsunami
and the federal government is offering you a life preserver.
If you get x-rays every few hours on these patients,
you tend to see them get worse in real time.
You can actually see those cloudy patches increase
over the course of one, two, three, four hours.
I saw a gentleman in his 70s.
He looked really well.
When I came back the following day to check his chart,
he had passed away within the 24 hour period of time.
They’re talking to me like I am talking to you.
And then a few hours later, they go into sudden respiratory arrest, they stop breathing,
and they need to be intubated.
This is one of the most dramatic things that I've ever seen.
So let's think about this. The building is on fire.
We’re all firefighters inside trying to put out this fire.
But we're naked, right?
Because they didn't protect us.
You see the PPE of other countries--chemical suits--and we are wearing trash bags.
I was told that if I had to intubate anyone,
I would be using a sheet protector with two
industrial sized paper clips, and clipping that
to my goggles that we were given.
Did you feel safe wearing that?
Absolutely not.
We feel like guidelines are changing, not because science recommends they change,
but because we just need people.
We need warm bodies in the ER.
This is very distressing to me because
I don't know if this is going to be the next shift that I go in and I get the virus.
There's nothing that differentiates any of us
from the people who become devastatingly sick.
That's scary.
I thought I was just out of shape and totally tired
from the anxiety of everything that had been going on so quickly.
And then I started getting a cough…
I was COVID-positive…
There's a sense of anxiety around the idea that, "Oh my God, this is positive,"
and knowing that the disease course is unpredictable.
One of my colleagues had the disease and we found out that he passed away
a week from yesterday, so that's been difficult.
That made it all seem too real.
Everyone's talked about their contingency plans,
if they did get sick.
We've talked about who gets our pets,
which is somewhat of an easier discussion than
who gets your children.
If all of us are calling out sick…..There are no more doctors left.
No more nurses left.
I intubated a nurse the other day from COVID-19.
We're going to be faced with this decision of:
we've got two patients that need to go on a ventilator or they'll die.
We have one ventilator.
Which one's going on the ventilator?
The idea of splitting a ventilator is a little contentious right now.
If you split one ventilator for two people,
you’ve now taken a tool that gives someone optimal chances of survival
and you’re taking that and splitting that in half,
so now two people have suboptimal chances of survival.
Are you going to put both of those people on that suboptimal tool, risking both of them?
Or are you going to choose?
I definitely did not go into the practice of medicine to play God and nor do I want to.
I just want to treat people as best I can and take care of as many as I can.
How are they going to live with the guilt after all of this?
Knowing that if they'd had equipment that could have saved somebody's life,
they would have used it, but because they didn't, they watched somebody die.
and they chose person A over person B.
One of my colleagues told me this amazing story where
he was talking to a patient who was infected.
He was talking to this patient and saying,
"Look, if this escalates quickly, would you want a breathing tube?
Would you want to be on life support?"
And the patient said, "Absolutely I would want that."
And then the patient paused and said,
"But if someone else needs it, give it to them."
The intensive care unit is a busy place, pre-COVID.
What’s different now is that we don’t have any visitors in the whole hospital.
The worst part about COVID-19 is that patients die alone.
Without their families by their side.
Just imagine that you're dying alone
and you're not able to say goodbye one last time
to your parent, grandparent, son, daughter, friend,
or really anybody you care about.
I'm seriously starting to think this is really starting to
take a toll on me,
between seeing people die and...
having to work 12, 13, 14-hour shifts.
It’s really taking a toll on me now.
People are getting tired and worn out and
unfortunately this is just the very, very start of this thing.
I am in a lot of moral distress because I'm not
able to help patients the way that I'm accustomed to.
I'm simply just trying to mentally stay well
enough to take care of them and keep them alive.
So that has been a very great moral dilemma for me.
I know it's just a matter of time before
I hear that one of my good friends has passed away because of this,
because they were working on the front lines.
And that's what terrifies me.
Now we've all kind of resigned ourselves to...
This is what we do.