By Sara Ahronheim
I am a front line health care worker. I am an Emergency Physician. I am also a mother to two glorious, growing, miraculous children and wife to a handsome triathlete stay at home dad. Additionally, I am one of three daughters to a pair of still practicing exceptional pediatricians in their late 70’s, and sister to two strong, beautiful women. I am also a severe asthmatic well controlled only by being on puffers and a medication called a biologic, which can compromise my immune system.
And now, I am one of the hundreds of thousands of physicians trying to stand between a monster of a virus, and the citizens of the worlds’ countries who are vulnerable to it’s fangs.
The people I work with are heroes; doctors, residents, nurses, orderlies, x ray technicians, unit agents, registration clerks, security guards, respiratory therapists and so many more. They come to work each and every day with fear in their hearts but passion in their souls, and devote themselves to caring for patients. In the background the defenses are being laid by remarkable people who have been working day and night preparing protocols, simulations and contingency plans for us all to fall back on when the enemy breaches the gates.
And that enemy is coming for us quickly.
Going to work in my hospital used to be enormously pleasant. We worked hard, all of us, because we had the highest volume of patients in the surrounding regions yet our flow was exceptional due to the intense devotion of our group. The social banter was always there, smiles and jokes happening all around. We were a family. We still are.
But coming into work these days is like entering a war zone. There are barriers that come up randomly and block movement, so that a covid patient can be transferred without risking contaminating others. There are signs on patient doors that say “STOP” “CODE C”; reminding that the patient within can pass the contagion to anyone that comes in unprotected. Pandemic carts sit open in each section of our department, with N95 masks, impermeable gowns, long gloves, hair covers, plastic stethoscopes, and the material to urgently resuscitate covid patients. The mood is different; eerie silence permeates the empty hallways and waiting rooms, and the lively conversations of before are muted.
Fear thickens the air, causing me to wade through curtains of anxiety each time I leave my car. I steel myself for what’s coming by closing the door to my heart as I close the door to my vehicle. By the time I reach the elevator I am ready to face the shift, though deep inside I am teetering.
When I don my armour and prepare to enter a room, it is a dance such as a surgeon does when she scrubs. Gown, and tie at neck and waist. N95 mask, two straps, make sure they don’t cross. Mold to face, breathe, breathe out and feel for air escaping. Face shield, then hair cover on top, tuck in the braid or ponytail and ensure no whisps creep out on the sides. Long gloves, pull up and straighten over the wrists of the gown. Plastic stethoscope in hand. Walk to the door, sign the sheet to show you’re entering the room. Breathe. Enter. Breathe. Speak with patient, examine as best you can. Time to doff. Make sure someone watches from outside that you don’t screw it up. Wash gloves, peel off gloves, wash hands. Peel off gown and discard. Wash hands. Exit room. Hair cover off, wash hands. Face shield off while leaning over, wash hands. Last and most dangerous; the mask. Lean over, pull bottom strap over head, hold down straight, take other strap off over head. Pull mask away from face slowly, drop in garbage. Wash hands. Wash again. Breathe. Breathe. Breathe. Walk away.
This dance is repeated many times each day now.
At the beginning, our team ran a simulation one day to see how such a scenario would go. We learned to don and doff. We got the hang of it.
Slowly, our board that shows the patients in the rooms began changing colours. It used to be full of pink, orange and purple squares, signaling new patients or patients leaving, etc. Suddenly a new colour began to creep in, and has now taken over most of the board. Poop brown, or puke coloured, fitting, signaling to anyone looking that the patient whom that square represents is being tested for covid. First there was one square. A couple of weeks ago. Then a few more. A few more. Suddenly most of the board turned shit coloured and it’s stayed that way.
We are also working in our ambulance garage, triaging rule out covid patients.
We are running simulations on how to intubate a covid patient while wearing our personal protective equipment, and how (if) to do CPR on these patients. We are learning to stop CPR. We are learning to change how we approach each case.
And here we are; officially in it.
The pandemic has made it’s way to us, and within a week or two we will be overrun.
The enemy will breach the gates, of that I am certain. It remains to be seen how our secondary defenses will hold; how our shields will protect us individually, how many of us will fall.
We know this is a war we may not entirely win. We will take heavy losses. But we are fighting it every day. We are fighting not only for survival of individual patients, but survival of our way of life. Our world has changed drastically in a matter of days to weeks, and may change much more in the near future. It is up to us to make sure that the world we knew is there waiting for us on the other side.
So the Emergency Physician superhero goes to work, but the Mother superhero comes back at the end of each shift. Mommy and Daddy don capes and fly to rescue our children from despair. We take them outside and bike, scooter, play frisbee. We do arts and crafts. We play board games. We home school them. Most of all we shower them with love and make sure they know that this world is going to be there when all is said and done. School will resume, one day. Friends will still be there, and can be chatted with over facetime or zoom until they can once again play side by side. Pools will one day re-open, tennis lessons will resume, piano will be played, horses will be ridden. Grandparents will be hugged, and kissed, and loved.
Life will continue.
Yet when I close my eyes at night the darkness grabs me by the throat. When I drive home from work the empty streets yank sorrow from my soul and it’s all I can do to see through walls of tears. Remembering childhood innocence and wishing my kids could play at the park feels like a punch in the gut.
And I am left reeling, shaking, gasping for air in a world that wants to steal my breath.
So I go to work, each day, both at home and in the Emergency Department. I risk my life. I work for you, for our future, for the future of our children, and the future of our world.