Pandemic19

TINA MARTIN: 2020, the year of the COVID-19 pandemic.

GINNY BRADY: I just finished a night shift.

It was a long one-- it ended with a terrible death.

POOJA AYSOLA: I can see my colleagues just really drained.

MARTIN: Video diaries from three doctors on the front lines.

BRADY: And I said, "We just extubated your dad and he's doing great."

You could just hear the relief on the other end of the phone.

MARTIN: "Pandemic19" on Local, U.S.A. ♪ ♪ (sirens wailing) (counter ticks) ♪ All right.

So, my name's Ginny Brady.

I am a pulmonary and critical care physician.

I was... (clears throat): Born and raised in New York City.

Been a lifelong avid Yankee fan.

I'm currently on this long stretch of working in the I.C.U., like, on a four- or five- weeks-straight stint, and it happens to have coincided with the emergence of coronavirus here in Boston.

Um, and... (clears throat): It's something that I think... Um... ...raises a lot of uncertainty and fear amongst people who are practicing, because... (sniffs): We just...

There are so many unknowns.

We don't know how bad it's going to be.

♪ It's March 20, about 1:00 a.m. up in Clearlake, California.

And it was another calm day today.

Our patient volumes have been very low, and it feels, it feels great.

Um, we are running a little bit low on PPE ourselves, and was unable to find an adult mask, but I've got this... pretty sweet kid's mask to wear.

Maybe not the best-fitted, but might get the job done.

♪ AYSOLA: Hi, guys, I'm Pooja.

I am an E.R.

physician and I work at a couple of community hospitals just outside Boston.

I'm also a full-time student right now.

I'm getting my MBA from M.I.T., and so what that really means is that I'm in classes Monday to Thursday, essentially during the week, and I work on the weekends.

And so... things have been pretty crazy the last few weeks.

And I'm fortunate that I have these breaks in between my shifts.

My next shift is tomorrow, and so it's really hard to know what to expect.

(clicking) We have a little container that looks like a small lunchbox.

(clears throat): And it has my name... my name on it.

And this is my N95 that I'm going to be using the entire... at least the entire week, maybe longer.

I was doing a lot of research today trying to find out if there were specific guidelines, and of course, because it's a pretty new virus, there aren't a whole lot of published guidelines available.

So it's... You do what you think is best.

And hopefully I did what's best for my patients.

Interestingly enough, I didn't test a single person today for COVID, even though about half the patients I saw definitely had it.

And that's because we're low on tests and none of them required admission or met, or met the criteria that we look for.

It's March 30, about midnight, and I just had my first death, likely from COVID.

Super sad story, it was a 65-year-old male who was walking and talking earlier tonight, but had been complaining of some shortness of breath recently.

With new visitor policies in the hospital, it's really, really difficult.

You have to go to family and say, "Your loved one has just died, but you cannot visit them right now."

I think that... as things ramp up, it's going to have a much different, much crazier... Events will change, and it's going to feel much different in the emergency room.

♪ (counter ticking) I think we sort, like, of compartmentalize and shut off the terribleness of it, and connect just enough, you know, to, to have empathy when, when talking to the families.

And I think, you know, if you really took every case and every death to heart, it'd be impossible to do the job that we do.

So I think that's, like, a coping mechanism, and I think it, there's an appropriate balance of being in touch with your emotions, but not too much that you're, you know, crying over every patient.

You can't do that.

Um...

But every once in a while, there's, like, a patient that'll touch you, and you don't know why.

Maybe you like the family, maybe the patient's hands reminded you of your dad, or, like, whatever it is.

And it does, like, all of a sudden connect at your core, and you feel this surge of emotion and this lump in your throat and the water in your eyes, and you're, like, "Uh-oh, I have to turn this off."

I hear New York might be getting a little bit better, that's what they're saying.

I see my mom all the time.

She lives in New York City, and I go down once a month to see her, and I haven't been able to see her, um...

It's always hard.

You're always scared you're gonna get everyone else sick.

My car broke down on Sunday, and I called AAA, and AAA says, you know, "Have you been in contact with somebody who you know has coronavirus?"

And I was, like, "Uh...

no."

Because I knew, I mean, if I say yes, they're not going to come help me with my car.

So it's Saturday, April 4.

Just finished a shift.

And volumes are still very low in the emergency room across the multiple sites that I work at in the Bay Area.

So another interesting development, I am going to try to go to New York City to see if I can get a locum's job.

I think that this time is emergency medicine's spotlight, um, and it'd be kind of a shame to not see what... what is going on in New York City, mm-hmm.

♪ (breeze blowing, leaves rustling) (car approaching) ♪ AYSOLA: Like I said earlier, I am feeling very fortunate that I am not full-time anymore.

I can see my colleagues just really drained, and everyone's very aggravated with the whole shift changes, because we are not working as much, and so we're not getting paid, and the patients need us there.

So the whole thing is just really crazy.

Nurses are really unhappy with the short staff providers, because sick patients are waiting for a really long time, even though we have enough people, theoretically, just... We're sending doctors home early and the whole thing is just crazy.

But they're trying to cut back on our hours, because I guess we're expensive, and they're not... You know, the hospital's not making any money off of the elective surgeries.

But I felt like today was busy, regardless.

So I'm glad to be done.

Anyways, I got an hour-ish drive ahead of me.

Thankfully, there is no traffic.

I guess that's one of the most positive things that I can think of in this entire situation.

♪ Hey there, how are you guys?

I just finished a shift-- I'm gonna take everything off.

I gotta have all this stuff on for... most of the night.

It was a long night.

I'm making some coffee right now.

Uh... Oh, God.

(sniffs): Uh, um...

So I just finished a night shift, and that was a long one.

It was a really long one.

Um... Let's see, uh...

Things that...

I don't know.

It ended with a terrible death.

So it's always like, just, oh, it's awful.

Every patient is, you know, blah-blah-blah-year-old, blah, blah, here with respiratory failure from coronavirus.

It just kind of can be a little bit monotonous.

Today, we had a patient come in who was intubated in the emergency room.

And I was putting in a central line in her neck, and a... a radial artery line in her wrist.

And while I was doing it, the nurse was going through her belongings and came across a sandwich in her bag, in her bag of belongings.

And, like, this woman walked into the emergency room, thought, "I might have to wait a while, so I should get a sandwich," and got a sandwich.

And now is on life support without family around her, because we're not allowing families in.

And all of a sudden, like, I looked at her and, like, saw her as a person instead of just a patient with coronavirus.

Monday, April 13.

It's around 9:30 at night, and I just got home.

Two weeks ago, I was kind of, like, bummed out that none of my patients had gotten better and that this is such a long haul to recovery.

And I looked back last night at those patients.

I think I signed up ten patients.

None of them have gotten better.

Some are still alive, but none of them have gotten better.

And it's just wild.

Just, like, scary.

(counter ticking) (seagulls cawing) CHANG: All right, so, I'm going to give a little bit longer of an update of where I am, how I got here, and what's been going on.

So I am currently working in a COVID unit.

It's in the Washington Heights neighborhood of Manhattan.

This unit was set up about two weeks ago.

It's set up in, not in the main hospital.

We're currently in the lobby of the hospital.

I'm not sure if the hospitals in California were doing quite as openly, but we were dressing family members up with, with N95 and PPE and allowing them to come and visit, which...

Which is incredibly necessary.

Um, I was, we all, we have iPads next to all of the beds, so patients can FaceTime if they don't have their own phones.

Um...

I definitely feel a little bit nervous at contracting COVID.

But, who knows, I might have been positive at some point in the past.

I might have been through it, I don't know, um...

I'm generally much more careful now, um...

I've been very good at putting on a mask and not touching it while it's on, and...

I think I, yeah, it's definitely when somebody touches their face.

I think I touched my face earlier in this video, but it's definitely-- I notice it.

I really wanted to see more and understand COVID.

It's a fascinating, fascinating illness.

And I've only been, in the past few days, getting to understand it a little bit.

Um... Understanding how it's changing our practice of medicine.

Um... - Hey, man.

- What's up?

What's up, man?

- Keeping a diary?

- This is... - Hello.

- Dr. Rose.

He is my esteemed colleague.

- Yeah-- eh... Not so esteemed.

- Very esteemed.

- Yeah.

(pigeons cooing) ♪ I have very, very exciting news to share.

Today, April 19, I extubated two patients.

Uh, which is awesome.

It's awesome.

I have been working like a dog, on service for weeks and weeks and weeks, and had not extubated a single patient.

(whispers): A single patient.

(aloud): And I extubated two today, which was thrilling.

And you, I call.

First ring, family member picks up.

"Is everything okay?"

I had already updated them, so they weren't expecting another phone call.

And I said, "We just extubated your dad and he's doing great."

And they're, like, genuine joy on the other end of the line.

(clears throat): And they're, like... "This is the best news I've heard in weeks!

Thank you, thank you!"

(stammering): "I can't thank you enough!"

Like, "This is unbelievable!"

And it was just...

Felt really good to deliver that news.

Um... And, you know, our patients are fighting for their lives and we're fighting for them.

But these family members are home fighting and praying and doing everything they can to will their loved ones better.

And you could just hear the relief on the other end of the phone.

Um, and that felt great.

(people cheering, pans clanging) Make some noise!

Whoo!

(clanging and cheering fades) (counter ticking) Hi, it's April 30, 2020, and I have my next shift tomorrow, on Friday.

But I just found out that it's my last shift at this hospital, which is the hospital that I've been working at for four years.

I just found out that they're cutting all of our shifts because there is not enough volume due to the pandemic, and they can't give me any more shifts for an indefinite amount of time.

I'm in a bit of a disbelief.

I'm really upset about it.

I'm just thankful that I have another hospital that I work at, although I'm sure I'm going to hear from them any minute that they're canceling my shifts, as well, next week.

I, I just can't believe it.

At a time when we have a... We're in the middle of the biggest health crisis for a generation, and me, as an E.R.

doctor, I'm suddenly left in a position where I don't have a job and I'm worried about my rent.

I mean, I'm, I guess I'm more fortunate than a lot of people in terms of my training, in terms of, you know, what I do.

But right now, I don't feel that way.

Maybe I have to move to a smaller place so that I could afford it.

I don't know when I'm going to get more shifts at this hospital again.

Maybe I can look for another job.

I did love this place.

Can't believe that tomorrow's going to be my last day.

It's heartbreaking.

But I guess it's rough times for everybody.

BRADY: I had a couple of deaths.

You know, I was off two days and two of my patients died.

Um... One was pretty young, she was in her 50s, um, and my resident called the son to come be with her.

So the mom was on maximum dose of this high-flow oxygen, and her son was waiting outside the room, peering through the window, uh...

Looking at, like, the last moments of his mom.

And, uh... She wanted to be with him.

So she asked if she could take the oxygen off and we explained that, you know, "If you take the oxygen off," uh... You know, she'll die-- "You'll die, but also it might feel uncomfortable."

And she chose to take it off, and her son went in, and... She passed away pretty immediately.

Um... And I, I guess it's good she didn't die alone.

Um, so in the past few days, I've got to walk around the hospital and visit some things.

And I visited the operating rooms, which have turned into intensive care units, and this is one of the craziest things that I've seen.

Each operating room contains three to four ventilated patients.

So an operating room generally is not meant for any more than one patient, and to see three to four patients in each one of them is pretty wild.

Also, in my two weeks here, we have only treated one Caucasian patient.

I think more than half of our population is Spanish-speaking.

Um...

I think that goes to speak how much of this disease burdens multigenerational households and the poorer populations in Manhattan and where we are, and burdens the people that cannot socially distance, burdens the people that are unable to work from home.

♪ AYSOLA: Hi, thanks for tuning in.

It's May 8, 2020.

To start off with, I'll say I had to file for unemployment yesterday.

I did that, which was just crazy.

I've never even considered that as being a possibility in my career as an emergency room physician.

That's the one thing we joke about.

We say "job security" when somebody does anything stupid, because theoretically, that's true.

It's just really interesting because I've devoted so much of my time to helping to educate patients into understanding when they need to come to the emergency room, when they don't.

And I pride myself on that.

I focus a lot...

I'm proud that I have retained a lot of that from my training in Canada.

And in one week, that has been turned upside down.

And now I'm realizing that I get paid by those people.

I get paid by the people who don't need to be in the emergency room.

I get paid by the people who have a sore throat for a month.

People who come in because they want a pregnancy test.

Those people pay me.

(counter ticking) BRADY: Hey, guys, today is Thursday, May 14.

I've had, like, a really rough few days, and I feel like I probably should've been recording during it, but it's still ongoing, so...

I don't know, I'm feeling really, really burnt out, uh, really tired.

Today is Monday, May 18.

Work was insane on Friday, I mean, it was absolutely nuts.

One, two, three, four.

Today is Thursday, June 11.

♪ CHANG: I think I've probably put in 80 hours a week for the past two weeks, and I'm no longer able to sleep until, like, 9:00 a.m.

I'm super-grateful that I love my job in emergency medicine and that I'm able to come out and help out where I'm able to.

And...

Grateful, just, my family is healthy, and... ♪ BRADY: June 17.

It is like night and day.

A patient who got really, really sick one night and felt like she was going to die, she did fine.

She was on the news today being filmed from home, talking about her experience and talking about the doctor who told her that she was going to be, you know, put into a coma, and put her daughter on the phone.

I was, like, "That's me!

She's talking about me!"

(laughs) But it felt really good to see somebody... You know, the wins.

We have so many, like, non-wins.

We've had so many deaths, so many awful deaths.

Sometimes it's easier to remember those people and kind of feel like, yeah, we went through this battle, this war, but, like, our survivors are so wounded and our losses are so great.

But then you see a woman like this on, you know, on the news, and she looks great.

She looks awesome, and you're, like, "Oh!

Okay, it's worth it.

It's worth it."

♪ (counter ticking) (ticking gets louder) (ticking stops, echo fades) ♪ ♪