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