I've not seen my family in 14 days. I miss them. I'd love to go home to hold them, but I can't. I'd love to cuddle up with my dogs, but it's been 14 days since I've seen them.
While many people are enjoying a lengthy "vacation".........working remotely........ soaking in precious family time......... binge watching netflix............ I, and thousands of other emergency medicine professionals are functioning inside of a living hell.
Never when I began my medical career could I have ever foreseen a time where I would be mandated to reuse gloves, masks or gowns on multiple patients. Never in the wealthiest country on the planet would I have believed that I'd be responsible for finding my own PPE. Never outside of battlefield medicine did I imagine having to crisis-plan color-code patients.
This is a nightmare.
All of the comforts of home, family, connection seem so far gone now. All of the typical self-care strategies are a thing of the past. I can not walk on the beach to reflect. I can not go to the gym for a hard workout to clear my mind. I can not meet a friend at a pub for a drink. I can not even see my own baby.
6 months ago, our ER was a busy but manageable place. A challenging but uplifting atmosphere. If I'd had a particularly difficult case, I could vent to my colleagues. Now we are all overwhelmed and scared. There is no casual chatting, no humorous banter, no familiar smiles from which to seek support. Many of us never leave the building; while we didn't sign up for this risk, we dutifully accept it.........but not for our families. We are fighting an invisible enemy that is literally dropping bodies at our feet. Many of my colleagues are sick. Three have succumbed, I know more will follow.
I am seeing people younger than me require ventilators to survive the night. I am watching perfectly healthy adults deteriorate in a matter of hours to the point they are critical.
We have just entered our "surge". And we are all battle worn already. Even with a field hospital set up to provide overflow care, we are functioning in contingency medicine. If our numbers continue at this pace for another 48 hours, we will be in crisis medicine.
How do I look at 4 different human beings and decide which 2 of them will get medical care and the chance at life.........and which 2 will simply be given comfort meds, as not to waste medical resources?!?!?
I try to provide the best care possible. I do not give up; but I have lost some of these battles........too many, and each replays in my mind as I try to seek solace in 4 hours of sleep. I struggle to show compassion to my ailing patients while donning gear equivalent to an astronaut on a space walk.
"Can they see my sincerity through this mask?"
"Can they hear the compassion in my tone through my respirator?"
As exhausted as I am, as my colleagues are, our trauma must be tabled for now...........because there are more patients and they desperately need us. We are not only providing life-saving care, we are also their sole support, as our hospital can not allow any family, friend or visitor. Our patients are alone and they are scared.
I am now not simply the provider...........I have been thrust into the role of mourner as well. My patients will not die alone.......I am there. I am holding tablets and listening to spouses, children, parents and siblings say their "goodbyes". I am holding the phone when clergy call to perform last rites.
And just when I think I can not possibly take any more, when I sink down to the floor outside of a curtain and bury my face in my hands...........another ambulance is backing in. Another patient is in respiratory distress and needs my help. And suddenly a small burst of adrenaline has me back on my feet and rushing to meet the bus in the bay.
As badly as I want to rush home to see my child..........facetime will have to do for now, because someone else's child is struggling to breathe and depending on me to help them.
Stay home. Stay safe.