Notes from the Front Line

Hi everyone,

A few notes from the front line:

• Almost all COVID patients have hypertension, diabetes, hyperlipidemia, and/or obesity.
• Most patients are people of color
• The stories are similar: several days of worsening cough, fatigue, and shortness of breath, culminating in respiratory failure
• Our youngest patient is 29, the oldest 100.
• The ARDS is generally severe and responds to standard interventions: low tidal volume ventilation, proning, sedation, inhaled vasodilators, and neuromuscular blockade
• Good critical care is crucial: stay organized, round at least twice a day, complete the MICU check list, avoid over-sedation, and collaborate with the nurses and respiratory therapists
• We planned well: we have most of the equipment and staff we need
• Once you go into patients’ rooms a few times, it gets much less scary and the worrying goes away
• You get used to wearing masks.
• Reading glasses don’t fit under goggles
• Laughing and courage go hand in hand
• I witnessed countless moments of supreme humanity, like an intern sitting for over an hour with a dying patient and a resident staying long past her shift to comfort her grieving family
• Fellows and attendings from other departments are making key contributions
• You can get creative with head coverings
• We’re stuffed: Pizza from Pepe’s and Eli’s, chocolate and cookies from grateful patients.
• We have phenomenal nurses, respiratory therapists, APPs, PCAs, residents, fellows, and attendings
• Legendary nurses are back in the ICU, emerging from the PACU, billing, and administration
• Though families can’t be there, the patients aren’t alone; the doctors, nurses, and respiratory therapists treat patients like family
• Well-rested residents can rise to any challenge (thank you Chiefs for the spectacular schedule)
• Our mortality rate seems lower than reported (fingers crossed, but that’s what I’m seeing)
• Scrubs are fashionable and comfy
• The community lifts us
• The goal isn’t to be a hero. We do what we’ve trained to do. We support one another. We help our patients. We show up.

And now it’s off to join my team.

Mark