I have been an emergency physician for almost 20 years. I have worked through numerous disasters, and I'm used to the daily grind of heart attacks, gunshots, strokes, flu, traumas, and more. It's par for the course.
Yet nothing has made me feel the way I do about my job as this pandemic has—that knot-in-the-pit-of-your-stomach sensation while heading into work, comforted only by the empathetic faces of my colleagues who are going through the same thing. I am grateful for their presence, knowing they are literally and figuratively with me, that they understand and accept so profoundly the risks we take each day. I also hope that my friends and family forgive me for my lack of presence during this time—precisely when we need each other most—and that they realize that their words, their encouragement, and their small gestures that come my way daily are the fuel that gets me through. This is a story for all of us.
I met my patient, Mr. C, on my first real pandemic shift, when what we were seeing that day was what we had been preparing for all along. His presentation was classic, his x-ray findings, his low oxygen levels. We just knew. He was the nicest man I had met in a long time. Gasping for breath, he kept asking if we needed anything, and saying it would all be OK. He told us he was a teacher, but that he was learning so much from us. He told us how much he respected what we were doing. The opposite could not be truer.
We had to decide how long we would try to let him work through his low-oxygen state before needing to intubate him. His levels kept falling, and despite all our best efforts, it was time to put him on the ventilator. He told us he didn't feel great about it. “But, doc, I trust you, and I am putting myself in your hands,” he said.
That uneasy feeling in my stomach grew even queasier in that moment. But he, with his teacher's steady voice, kept me grounded, where I was supposed to be. I saw his eyes looking at me, the kindness in them, even as we pushed the medications to put him to sleep. To say this was not an easy intubation is an understatement. He nearly left us a few times during those first minutes, but he kept coming back. We fought hard to keep him with us. The patience and strength of my team that day were truly remarkable.
I handed him over to my friend and colleague, Beth Ginsburg, MD, and her team in the ICU. Her calming voice reassured me that they had it from there. For the next 12 days, I waited and watched his progress, knowing the statistics and how sick he was when he got to us. But the ICU did its magic, and just yesterday, my new friend Mr. C was extubated. I decided to go “meet” him again.
Mr. C was in the COVID-19 stepdown unit, recovering without family. Nobody was allowed to visit him. Even worse, his wife had been home alone in isolation too. My heart broke thinking of how that must have been for her. I donned my PPE, and cautiously went into his room. When he saw me, he stopped for a second. A moment of recognition.
I introduced myself. “I'm Dr. Akbarnia, Mr. C. I was the last person you saw in the ER. You told me you trusted us to get you to this side. Looks like you did just fine.”
He started to cry. “I remember your eyes,” he said. And then I started to cry. What he didn't know is that, at that moment, I realized that we do what we do exactly for people like him, for moments like these. His strength, his kindness, his calming words to me meant everything. At that moment, my heart (which had been beating more than 100 bpm since this pandemic began) finally slowed down.
I sat down, and we talked. I told him that while he is here, we are his family. He will always have a place in my heart. And whether he knows it or not, he will be my silent warrior and guide as I take care of every patient, COVID-19 or not. He will fuel me until the day I hang up my stethoscope.
This story and photo were posted with the patient's consent.
Share this article on Twitter and Facebook.
Access the links in EMN by reading this on our website, www.EM-News.com.
Comments? Write to us at [email protected].
Dr. Akbarniais an emergency physician at Advocate Condell Medical Center in Libertyville, IL. Follow her on Twitter@halleh13.