OVERWORKED. ‘I can handle the headache. I can handle the body ache.’ OVERWHELMED. ‘I can handle the shortness of breath.’ COVID-19 HEROES. ‘But not my family.’
Health care workers fighting the virus find little respite at home, dogged by fear of infection, the mental and physical toll of their work
In the overflowing intensive care unit at San Jose Valley Medical Center, Dr. Amit Gohil battles the coronavirus every day. He calls it the monster.
When he goes home each night, his wife and three young children are waiting with monster fears of their own.
“Hey Dad, are you going to die?” his 9-year-old son, Shaan, asks.
“No, I’m not going to die,” Gohil reassures him.
“Because COVID’S not going to get you, right?”
“No, it’s not,” he says.
“But it could,” the child says. “No. It won’t.”
How much truth can you tell your children? he wonders. It’s one more worry.
For medical professionals, from nursing assistants at elder-care homes to pulmonologists like Gohil at county hospitals, home during the pandemic isn’t always a place of refuge.
These overworked and often overwhelmed health care workers have become the superheroes who fight the evil virus for the good of humankind. Their powers lie in their expertise, their empathy and their endurance.
But COVID-19 warriors like Dr. Gohil have families who need them, too.
“It’s very difficult when we go home,” he said. “Everyone is suffering in different ways.”
At the height of the global pandemic now in its 11th month, many intensive care units across the Bay Area are reaching their breaking points, with critical COVID-19 patients being sent to makeshift units. Over the past two weeks, the average daily death toll across the Bay Area more than doubled to 54. Santa Clara County reached a bleak milestone this week as well: More than 1,000 coronavirus-linked deaths so far.
Behind every casualty is someone desperately trying to save them, and too often lately, losing the fight. It’s a burden many care professionals carry home, adding to the challenges they find there.
A kidney specialist at Regional Medical Center in East San Jose, whose longtime dialysis patients are dying in tremendous numbers, is grappling with guilt that she hasn’t been home enough for her sons. A certified nursing assistant haunted by the cries for help she can’t always answer at an overwhelmed skilled nursing facility comes home each night to her grandchildren racing to their bedrooms: “Grandma is here! Hide! Hide! Virus! Virus!” And a respiratory therapist at Valley Medical Center who holds the hands of her patients as they take their final breaths reassures her 8-year-old daughter that “mom helps them breathe so they can go home.”
Health care workers try to find solace in the fact that they are part of history, that trying to save people from this global pandemic is, in a way, the honor of their lifetimes.
But Dr. Padma Yarlagadda, the nephrologist who is often the last hope for COVID-19 patients with failing kidneys, feels little glory in the fight. She knows her patients well — many were regulars on dialysis she would see four times a month in the clinic until they contracted the virus and ended up in the ICU.
“They’re dying. I’ve never seen so many deaths,” she said Thursday. “It’s like one or two a day. we had a lot of deaths just this week.”
The heartbreak has been relentless at work, but it’s been brutal at home, too. She and her husband, cardiologist Surendra Gudapati at El Camino Hospital in Mountain View, have done their best to minimize the chance of exposing their two sons to the virus. The family hadn’t eaten together at the dinner table for months, not even on the holidays when the parents were on call. Her youngest, 18-year-old Surya who has been taking his college courses from home, announced he’s moving back to Washington University in St. Louis.
“Even when I’m home, you never spend much time with me. That’s why I want to go,” he told his parents this week. “I’m not complaining, but I’m just telling you.” Yarlagadda was crushed. “I don’t blame him,” she said. “He told the truth. But it breaks my heart.”
The fear becomes real
Marissa Barnum’s greatest fear was always that she would bring coronavirus home.
“I don’t want to be the one to kill my family,” she said.
Working as a nursing assistant at Burlingame Skilled Nursing in the midst of an outbreak that has claimed more than a dozen residents, she has heard the cries of the sick.
“They’re calling your name,” Barnum, 50, said. “Please help me, I can’t breathe.”
At home with her two grown daughters and three grandsons, she’s made it clear that “the virus is really scary.” That’s why the boys, ages 6, 7 and 8, know to wash their hands all the time — she hears them counting to 20 at the kitchen sink — and not open the door for strangers.
“They ask me, ‘Why are you going to work when there’s a lot of virus outside?’”
she said. “I told them if I’m not going back to work, we don’t have food, we cannot eat. We cannot pay the rent. I cannot pay for my car.”
Barnum was so worried about contracting and spreading the virus that when she pulled into her driveway at home each night, she changed into fresh clothes in the car and left her shoes at the door before she walked inside. Still, the boys would squeal and run for cover, she said.
Then it happened: She tested positive in late December. “It was a nightmare.”
Her 25-year-old daughter, Lyka, fell ill and so did 8-year-old Karlo — as well as her 28-year-old daughter, Shara, who is 5 months pregnant, and her son-inlaw, Jan Fernan, who joined them for Christmas dinner from their home in Fairfield.
“I always pray to God, heal my family,” she said.
She asked that she be the one to take the brunt of the illness. “I can handle the headache. I can handle the body ache. I can handle the shortness of breath. But not my family.”
Over the past two weeks, they have all recovered and Barnum has returned to work. But sometimes in the middle of the night, she hears her daughter or grandson coughing. She tiptoes in and listens for the pattern of their breaths.
In the ICU at Valley Med, keeping patients breathing is the job of respiratory therapist Kyra Mcauley. After 11 years in the business, her skills have never been in greater demand.
COVID-19 attacks the lungs and when patients end up here, Mcauley handles the intubations and regulates the oxygen levels. It’s delicate and exacting work.
“Everyone deserves a chance to go home to their family,” she said. “I’m doing the best I can to make that happen.”
That’s what she always tells her 8-year-old daughter, Harper.
But in the adult world, Mcauley, 33, knows that sometimes that’s not enough. She doesn’t tell her daughter about the moments of silence she shares with doctors and nurses at the end, when they hold the patient’s hand and wish them peace. To Mcauley, “it’s a beautiful side of the darkness.”
While she is working 12hour shifts, she leans on her husband, Mark, who cares for the children at home and helps with their online schooling. They’ve been married 14 years and he can tell in an instant when she’s lost a patient. When she walks in the door, he quickly directs the children
to sit quietly on the couch.
Without him, “I don’t think I’d be able to get through all of it,” she said. “I probably don’t give him enough compliments.”
Mcauley already has assured her daughter that she doesn’t need to worry about mommy getting sick. So Harper focuses instead on her mother’s patients.
“Does that person have a family? Does that person have kids?” Harper asks.
Everybody does, Mcauley tells her.
Relief at home
For the caregivers in the trenches, the promise of a vaccine helps them see victory in the end. But the rollout has been slow and they know the battle will go on for months, at least.
So the families at home, in an endurance race of their own, continue to try making life easier for those on the front lines. Critical care nurse Stephanie Mejia, 30, has been either working bedside or, as the ICU spills into an extra wing, as a charge nurse “playing musical beds in order to get a very sick patient in.”
It’s intense and exhausting. Her mother, Luz, and her fiance, Sammy Haile, see the strain. Every morning, her mother prepares her lunch and Haile lays out her color-coordinated scrubs, fills her water bottle and packs it all up in her car “so all I have to do is jump in.”
Not everyone has that luxury. For those who live alone, the COVID-19 lockdown is another oppressive force.
“The isolation for me gets a little exponential at times,” said Regional hospital registered nurse Liz Thurstone, who goes home to her calico cat, Zoey.
Her brother, Chris, is a physician in Colorado and tells her she should be proud of her work in the COVID-19 ward. Her 87-year-old mother, Phyllis, a retired physician, also tries to be encouraging.
“She always says — of course, this is in the Bible — ‘This too shall pass,’ ” Thurstone said. “When we’re in the quicksand of it, it doesn’t seem like it’s going to, but I try to keep my eye and my heart on that. Eventually, it will pass.”
The emotions that health care workers are reluctant to express at home are often shared at work. Dr. Gohil, whose 9-year-old engages in a nightly round of questions about whether the virus will kill his father, is heartened to see nurses and therapists and young trainees support each other. They’ve made tremendous strides with their COVID-19 patients and are proud they were early adopters of treatments that proved to be major breakthroughs in fighting the virus, including using steroids and turning patients to lie on their stomachs to help their lungs.
And while the 44-yearold pulmonologist sees his colleagues giving pep talks around the nurses station, he also sees them in tears in the corridors.
There used to be an “unwritten contract,” he said, that you work really hard at the hospital and when you get home you can, for the most part, escape it.
“But now you go home and the family is under stress as well,” he said. “They are wondering what the monster looks like. There’s fear.”
Somehow, though, after confronting this monster face to face every day, he finds a realm of sanctuary with his family.
With his 4-year-old daughter, Zoya, he watches the animated adventures of “Peppa Pig” and her farmyard friends that “take you miles away from COVID.”
With his wife, Neha, whom he met while studying in Edinburgh, he has been pulled into “Outlander,” the steamy series set in Scotland.
And with his two boys, including 10-year-old Akaal, he tunes into the catalog of Marvel movies, where they are mesmerized by superheroes vanquishing their foes. They’re currently in the world of Iron Man, who protects the world in his iron suit.
At home on his couch with his boys at his side, Gohil’s daily armor — his gloves and gown, his face mask and shield — are left behind. So is the monster.