Monthly Archives: March 2020

“When you’re exhausted, weak, and tired and everyone around you looks just as bad as you or even worse – that’s the perfect time for you to make a statement.”

– David Goggins

I’ve had an internal debate over how honest I should be in this blog concerning COVID-19, somehow feeling like it’s my job as an ER nurse to reassure anyone reading this. People are panicking already and I certainly don’t want to feed that fear.

But I’ve been an ER nurse for ten years, and I’ve never seen or experienced anything remotely like this. When I say “breaking down,” I’m not referring to myself, although I’d be lying if I didn’t admit this is pushing me to my limits. No, I’m talking about a breakdown of our entire healthcare system, something I never dreamed I would see.

What’s happening in ER’s all over NYC right now is unimaginable. What EMS in NYC is dealing with is unimaginable. The virus is spreading unchecked, completely out of control, and the healthcare providers on the frontline will carry this experience like a huge disfiguring scar the rest of their lives.

If anyone is reading this I want you to know this: We are trying our best, but I’m afraid it’s bigger than us.

It’s already beyond anything you could ever imagine in your worst nightmare. And I’m afraid the worst is yet to come.

Trying to find a good book to read, something to get my mind off this mess between shifts. After starting and stopping a few, I finally found one. It’s a doozy…

“LaBrava” by Elmore Leonard, circa 1983. Drew me right in – I can be sitting in the dirty cafeteria at work, trying to eat and get my mind off the madness of the ER and this goddamn pandemic, and all I’ve got to do is start reading and boom! I’m instantly transported to the underbelly of early ‘80’s Miami, with indelibly written characters right out of a 1950’s film noir. His style is spellbinding – almost the entire novel is written in dialogue.

So right now this is my drug of choice.

Like I’ve said before, sometimes you’ve just got to tune out if the world is making you too crazy and there’s nothing you can do to fix it. Nothing wrong with that. Right now, for me, it’s meditation, Elmore Leonard, and the usual vices.

It’s enough.

Item 1:

A good man and brilliant ER doc I work with tweeted this today: “Finally home after 13 hours in the ER. Today >90% of my patients were confirmed or likely #COVID19. Many really sick, some in their 30s like me. The sirens on otherwise empty NYC streets are unending & haunting. I’m tired. But really honored to be back in the ER in the morning.”

Item 2:

My last five shifts in the ER I have worked in triage – literally triaging hundreds of patients, and I can concur with this doc’s assessment. Almost everyone coming in has COVID-19. But the good news is that the overwhelming majority of people with this illness are going to survive. Of course, it’s an ER, so we are going to see the worst cases as well – but I want to dwell on this somewhat more positive thought for a moment.

I know how easy it is to slip into a panic over this. Yes, it’s a real pandemic. Yes, there is a high likelihood that most of the population of North America will end up with it at some point. But it’s not a death sentence. Sometime in the future, enough people will have come down with it that herd immunity will kick in, and it’s likely that by that time some type of vaccine or treatment protocol will be in place.

So take all precautions and try to be one of the ones who make it through without coming down with it. But most of us have been sick at some point in our lives, and we’re still here, aren’t we? BTW, the doc who tweeted that contracted EBOLA and survived it.

So please adhere to your local Department of Health’s recommended precautions, and allow me to recommend one of the best ways to alleviate anxiety.

Reach out and help someone else.

Who you really are tends to get revealed in a crisis, and people won’t forget what they see. You might be panicking and feel justified at the moment, but one day this will all be over and you’ll have to live with your actions.

Think about that.

Ok, I feel compelled to comment from the front lines of people treating COVID-19 patients (for anyone stumbling on this blog – I’m an ER nurse). This one has to do with science and not the state of ER’s attempting to handle this mess.

Epidemiology is predicated on analyzing objective data – in the case of the spread of COVID-19, we’re essentially talking about how many cases exist in the general population, and perhaps more importantly, what the mortality rate of the disease is.

And yet – from my perspective (and I work in an ER in the largest hospital in New York City), basically no one is tested. That is, unless you are being admitted to the hospital.

No one.

Just mull THAT over for a minute. Mind you, I’m no infectious disease expert, but how can you possibly track a disease you’re not even testing for?

Now, I have no idea what government agency is responsible for bungling this mess, and quite frankly, I don’t give a shit. ‘‘Twas ever thus in this country – to quote Billie Holiday: Them that’s got shall get, them that’s not shall lose.”

So don’t believe what you read in the papers or hear online – no one has a fucking clue how many people have contracted it. I know, because I work closely with quite a few brilliant ER docs, and I’m constantly grilling them for information on how we’re handling testing. They are all exasperated and quite forthcoming about their frustration.

Hopefully this will change, and when it does, I’ll report it here, if for no other purpose than to simply give me a timeline of where we are in this shitshow at this point in time.

Unsurprisingly, given the current state of America, it’s a steaming plate of incompetence.

Of epic proportions.

I’m seeing Multiple COVID-19 positive patients everyday in the ER, and most symptomatic patients aren’t even tested. We send them home for Christ sake, and I’m quite sure there’s no follow up by the DOH. Why would there be? If they never tested for COVID, of course they don’t show up in any pesky infectious disease statistics. Starting to get the picture where things are headed?

I can be triaging someone for afib, when they’ll drop “I’ve had this annoying cough for a week,” and because they’re being admitted to telemetry for their heart condition, the hospital will approve a COVID test. In point of fact, no one gets tested unless they’re being admitted.

To say that stress levels among staff already feels oppressive is to compare them to the passengers on the Titanic who said “Look at that lovely little floating piece of ice,” just before you know what happened. We all know how that ended.

Every shift I feel like I’m dodging bullets for 12 and a half hours and yet I know things haven’t even started yet. Did I mention the staff already out on quarantine because they were exposed without PPE? There’s a certain fatalism in the air among ER docs and nurses, a kind of grim realization that there’s a very good likelihood none of us are going to make it through this without getting infected.

And yet – this is what we do. Everyday. No matter how sleep-deprived or exhausted. This is what we signed up for – because (whether we want to admit it or not), most of us find great satisfaction in caring for people in need. Without that, no amount of money would make this particular job worthwhile.

But I guess my point here is there’s no shame in admitting you’re struggling. It’s part of what makes us human.

Struggling here boss.

Things are getting pretty tense, no? Well, if your anxiety is starting to get away from you, I’ve got a quick fix that’s guaranteed to make you feel better…

“Richard Pryor: Live in Concert” is streaming on Netflix, and to say it has held up as one of the great masterpiece‘s in the history of comedy would be a gross understatement. Watching it again last night, hoping for a relief from pandemic madness, I wasn’t disappointed.

I literally laughed (or at least smiled) for the full 90 minutes – and I’m a jaded comedy fan who had seen it multiple times before, although not in many years. For a comedy special filmed in 1979, I was a bit shocked at how well it aged – with perhaps one exception, it holds up as even in the context of today’s “cancel culture.” That’s how much vulnerable humanity Richard expressed through his comedy.

So return to a shaman of comedy for your dose of just the right medicine. In fact, bookmark it – we’re probably going to have to return for a few more doses before this thing’s over.

Don’t underestimate the following simple strategies to protect you and your loved ones…

1. Wash your hands.
2. Don’t touch your face.
3. Employ social distancing – stay at home as much as possible.
4. Alleviate stress however you can (stress impairs immune function).
5. Stay active and as fit as possible (but it’s probably best to stay out of the gym – see #3).
6. Get plenty of sleep.
7. Eat healthily and stay well-hydrated.
8. Don’t panic (see #4).
9. Set a reasonable example for others.
10. Live your life.

I’m personally on the fence about staying out of the gym since it’s kind of my sanctuary – but because my job as an inner-city ER nurse already puts me in direct contact with the infected, for the moment I’m trying to be prudent and stay away from other people.

It’s too late to stop this pandemic, but these are the current recommendations from infectious disease experts. Ignore them at your own peril. BTW – #9 & 10 are my own, because we are in this collectively and life goes on.

Enjoy it while you can.