COVID: The Emergency

That damn N95 mask. It cuts into the skin, along the cheekbones, above the Adam’s apple, and most glaringly across the bridge of the nose. Strategically placed band-aids could prevent further abrasions, but they don’t lessen the discomfort. In addition to the cuts, the masks place a persistent pressure that bores into the lower jaw. By hour 11 of the shift, it feels as if I’ve spent the day grinding my teeth. By hour 12, we all start to doubt whether the life-saving properties are worth the trouble.

COVID-19 made it’s first appearance in New York on March 1. At that time, we were all naive as to the ravages to come. The naivety dissipated by mid-March when sports leagues were cancelled and the Paddy’s Day parade was called off. Our visit to Houston to celebrate Dad’s retirement would have to wait.

Work continued, though the oncology census numbers began to dwindle. Patients didn’t feel comfortable coming to the hospital to receive chemotherapy. Studies were postponed. Given the COVID mess, I felt my position with the myeloma team redundant. A conference call with PAs throughout the hospital system elicited a call for volunteers to be reassigned to COVID units throughout the hospital.

I volunteered on a Thursday. By Friday, I had been reassigned to the Emergency Department. Tears welled in my eyes as I considered the stress-inducing and potentially life-threatening deployment. Anxiety. Fear. Why was I doing this?

I wish I could give a concrete answer as to the why. For starters, I felt it was the right thing to do. It sounds cliched, but I entered this profession with the goal of helping others. This was my chance. Also, this will likely be the biggest medical story of my lifetime. We were about to storm the beach and I didn’t want to be left in the boat! Neither of those fully tackle the question of “Why?” though. I still don’t have a good answer. There’s always been a part of me that has wanted to join a cause that’s bigger than the individual. This is that cause.

As my transfer was completed, the hospital was undergoing a massive renovation. Beds were being built in the hospital lobby. Surge tents were being erected outside. Every morning, emails announced new policies, new procedures.

I was assigned to the ED Intake. Initially, my role was to accept the patients who were not being seen for COVID-related symptoms. STDs. Pregnancy. Crohn’s flair. Despite the intent, I did more than my fair share of COVID swabs. By the third day, I was one of the primary COVID -swabbers. It’s a job that should be done by attendings to minimize exposure. “I’ll do it,” I told my attending. “I’ve been swimming in this shit all week.” He had just come on.

That first swab, I didn’t know what I was doing. I watched a YouTube video the evening before. Pretty straight-forward. The swab went in easier than expected. Before long, I was in and out of those rooms with swab tests. Protocols changed daily and our nerves started to fray. First we doffed PPE inside patient rooms. Then outside. Then trash cans went missing. Tests had to have approval before starting. Then they didn’t. Then maybe they did, but first we had to order more swabs because we were out. Emotions of fear and anxiety quickly gave way to frustration.

My first week in the ED ended in the PA conference room. A small group of us listened in on a conference call detailing new protocols and next steps. There was banter. A free meal. Relationships forged in the intensity of the moment. It felt as if we’d always worked this way together. We’d always been teammates. By the next day, there would be a new assignment. A new team. There always was.