Assistant Professor of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
“Early to mid-March was when we started to see COVID-19 patients in our Emergency Department. I started having symptoms on March 12, 13. My first symptom was a dry cough. After that I had fevers, chills, body aches, some headaches. I knew I had to stay home and get better, but I wanted to be on the front line. … I was able to return to work two weeks ago, right before the peak. It was a completely different department. Most patients in the ED had COVID-19. … It was very hard to see people come in critically ill. I’ve never seen anything like this in the 12 years I’ve been in emergency medicine. I’ve never seen anything like this where it is so novel and so widespread. … Now that I’ve been back for the past two weeks, a lot of the patients have been older. EMS brings them in and usually has instructions from the family, if there’s family available. … Sometimes EMS will tell us a patient is full code: DNR/DNI—do not resuscitate, do not intubate. Other times, even though they don’t necessarily have that form with them, people don’t want to be resuscitated should their heart stop. Sometimes they do. So we try to talk to the patient if they’re awake, alert, able to answer questions even though they’re very dyspneic. We ask them what they want, should the condition deteriorate. Sometimes they say, ‘Please talk to my family about this too because I can’t make this decision alone.’ … One patient really couldn’t make up her mind. She wanted to get to one of her granddaughter’s events in the spring, but she had been thinking recently that she didn’t want to be resuscitated. She felt guilty. We said, ‘You know, this is your decision. It sounds like your family loves you so much, but you need to make this decision for yourself.’ This happens on every shift, several times a shift. This is all very new for all of us. … I previously preferred 12-hour shifts. Now I can prefer eight hours. It’s just too emotionally and physically demanding to deal with 12 hours of the COVID craziness.”
As told to Janice Fisher
April 15, 2020
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