An ER doc writes from the front lines of COVID-19
‘I froze as I felt the presence of this microscopic invader in my warm little world’
(The email below was written during the early part of the pandemic by Dr. Averil Ivsins to her mother, Merla Russell. This story outlines the feelings and thoughts of a busy ER doctor in a small hospital in British Columbia. It is republished with the author’s permission.)
The first few times I heard about it on the radio, it seemed far away.
The word, “virus” would come and go out of the media not infrequently, and especially, with fear and doom’s day predictions attached. I would feel safe and warm in my tiny North Vancouver bubble. There are green trees all the time, and the ocean, and my little hospital. I am a doctor there, and all the nurses are my friends and I can drive my little blue electric Golf there in three radio songs.
It seemed sharp and sudden when everything changed. When I look back on what day it was, I can’t seem to remember how long it’s been, or when the moment was that I realized that things were bad. Now when I go to work, I bring a plastic bag that I throw out, so I don’t have to bring my purse. I wear only a certain pair of shoes and don’t touch them as they sit by the front door reminding me the rest of the time of the fear, sweaty arm pits and fogged up face mask I have to try to deliver care through, while I work as an emergency doctor.
So far, the hardest part has been the waiting. I feel like we are standing on the beach, and all the water has been sucked out to sea, and we are waiting for the wave to overtake us. I am standing there, with all my coworkers, only I can’t see them. We were all covered up with hair covers, goggles, masks, gowns, gloves. We can’t touch our patients and we can’t even see each other. Walking around in our unrecognizable PPE, I have to look deeply through the semi fogged plastic to see who it is. We have plastic sheets for walls, and “Do No Enter” signs, radios, tents, and comprehensive infection protocols. We are standing on the beach and we hear the news out of New York, out of New Orleans, out of big American cities filled with affluence and technology, but apparently not enough breathing machines or masks to keep the care givers safe.
The first time I saw a patient who came from China, months ago, worried about the far away virus, I giggled a little when I saw the triage note on the computer tracking screen. I remember Googling the province where they had been in China, and taking my striped isolation gown off in the room in front of them and saying “See, you were nowhere near the place called Wuhan,” I reassured them with a gentle arm squeeze, and my kindest doctor voice and went about my regular day.
The first time I saw a patient who was known to have the virus, I put on that gown, the goggles, the mask, the head cover and the gloves. A friend offered to go in the room for me. “I don’t have kids,” he said. But as someone who always likes to consider herself “brave,” we went together. It felt different; different than any other patient room I had walked into. I froze as I felt the presence of this microscopic invader in my warm little world. I thought of my husband and daughter at home, my plastic pink shoes I go to and from work in. I thought of the moment before intubation, when the drugs are melting you into unconsciousness, and your breathing is so fast your chest aches, and your head feels like the atmosphere is blowing right through you, and you know the plastic tube will be jammed through your vocal cords, and the only sound you will hear are the ventilator beeps, and I thought: God, please, please, please; not me.
And then I looked up. And I saw there something from my every day warm bubble that snapped me back to reality — a patient. A patient with big human eyes, looking right at me. Who was scared, whose chest was heaving from the fluid invading his lungs, whose heart was racing, trying to keep up with its body’s metabolic demands; a human who needed me. And I thought this: “This I know how to do,” and I moved into action.