We watch Wuhan, New York, and Milan. Our colleagues record what they see as they care for patients. Overwhelmed. We do not know how to treat this new novel COVID infection. Is it aerosol or droplet?
We know it is coming.
Tents go up outside the emergency department.
People are scared.
Testing is scarce. Results take days to come back.
Scrambling for N95 masks, face shields, and PPE.
Stripping down soiled scrubs outside after a long shift. Did I catch it from a patient today? Will I bring COVID home to my family?
School closed. Social pods. Nobody wants the son of the doctor and nurse in their playgroup (except other health-care workers). Toddler temper tantrums. Social isolation.
We start to see cases. First one. Then three. Then five.
Patients are sick. Confused. Scared. “Happy hypoxic,” with critically low blood oxygen.
We put them on mechanical ventilators.
We set up an iPad so families can say goodbye. No visitors allowed.
We learn as we serve. Every day a new policy. Every day a new guideline. New research studies to review.
The neighbors start to bang pots and pans in our honor.
Heroes work here.
More cases. ICU is filling up. Will we run out of ventilators or staff?
We study our adversary. Read scientific journals. Learn best practice. Apply what others have learned.
We learn to reuse N95 masks. We store them in paper bags for next shift. We get acne on our chins and bruises on our noses from wearing tight-fitting respirators all day, every day.
We learn to do more with less.
We don and doff PPE routinely. We rely on each other. Check each other’s PPE before entering room. Good to go. Lift each other up.
We rally. We adapt. We overcome.
We work in tents. In the ER. In the ICU. Wherever we are asked to serve.
Staffing shortages. Colleagues out sick. Hiring freeze. Hours cut. Early retirements. Feeling fatigue, but we are strong.
Our sacrifice is on public display.
Banners outside the hospital. Signs in front of our homes.
Heroes work here.
Fatigue. Attrition. Moral injury. Winter is coming.
Burn out. Burned out. Do I have to go back to work again tonight? When will it end?
A rise in substance abuse, anxiety, depression. A whiskey to help me sleep.
The cost of homeschooling, moral burdens, and closed society adding up. Relationships under strain. Breakups. Divorce.
Politics. Political divides. Anger. Hostility. Friendships lost. Estranged family members.
Arguments at grocery store. Please wear a mask.
Accused of fabricating a pandemic hoax for financial gain.
Gaslighting. Being told that the patients we treat and the suffering we witness is fiction.
We continue to care for our patients. We continue to care for each other. We are proud. We are tired.
Heroes work here.
Vaccines! Are they safe? Are they effective? Will they work?
We are the first to roll up our sleeves.
We show courage. Again.
Must keep our community safe.
We volunteer at vaccine centers.
We go on the radio and conduct webinars. Masked and Mighty! Get vaccinated!
Winter surge. Almost out of ICU beds. Almost out of staff. So tired.
ICU overflow. So many critical patients. So much COVID.
No vacations. No gym. No faith-based gatherings. No holiday congregating. No celebrating or mourning together. No grandparents visiting.
We are tired and angry like everyone.
Getting busier. All that has been neglected resurfaces … mental illness, cancer, substance abuse, cardiovascular disease, diabetes, violence. The violence is the hardest to digest.
Together, we rise to the challenge. We adapt, pivot, and recalibrate. We are vaccinated.
We serve to the health and safety of our community.
There is hope. We will win. We are resilient.
Heroes work here.
Reopening. No more mask mandate.
The Delta variant is lurking. More contagious. Concerning. Especially for the unvaccinated.
We yearned for normal a year ago, and normal is here … crowded emergency departments, more 9-1-1 calls, full waiting rooms, takes months for clinic appointment.
Accumulated traumatic experiences, unhealthy behavior, day drinking, sedentary lifestyle, substance abuse, limited access to healthcare, lack of medical screening services, job loss, economic hardship, uncertainty. Our health metrics show it. Our community is weary and sick.
At our work, we are yelled at, spat at, threatened.
I am sorry you had to wait to be seen. Others more critically ill cut in line.
I am sorry you have been waiting for your medication. We have had a lot of ambulances arrive within the last 15 minutes.
I am sorry you lost your job and cannot afford your insulin and now need dialysis. Can I get you a warm blanket?
I am sorry you stopped your chemotherapy last year out of fear of catching COVID, and now the cancer has spread.
I am sorry your son overdosed on opiates. We will bring you back to see him as soon as we can.
I am sorry we could not meet your expectations.
I am sorry your health insurance will not cover your outpatient MRI. Please do not yell at our staff demanding it be done emergently.
I am sorry that you are struggling and self-medicating with alcohol, but please do not urinate on the floor.
I am sorry you are having an anxiety attack while you wait to be seen; we are cleaning a room for you now; please do not spit at our staff.
I am sorry you are having a bad reaction to methamphetamines; please do not punch our staff.
I am sorry it has been a horrible 18 months, but please be kind. We are doing our best.
I am sorry. We are sorry.
We don’t feel heroic anymore.
Like you, we are tired, stressed, exhausted.
Like you, we have missed graduations, birthdays, weddings, vacations, holidays, funerals. We crave live music, crowded theaters, travel, hugs from strangers, a pint with a friend, and the kinship of together.
During your darkest hour, we promise we will take excellent care you of you and your family. We will do it with professionalism, compassion, and grace.
Heroes still work here.
Thank you to our health-care workers, first responders, firefighters, EMTs, law enforcement, mental health providers, social workers, and public servants. It is an honor to serve our community alongside you.
Jason Prystowsky MD, MPH is a local community emergency physician. Any thoughts or opinions expressed in this article are his own.