Family medicine resident
This essay is part of our new series, Flattened By the Curve, which features the voices of doctors, nurses, healthcare workers, and others on the front lines against COVID-19. For information on how to submit, click here.
I’m in my last year of family medicine training. In normal times, my residency program cares for nineteen hospitalized patients, half a hospital floor, mostly patients from our outpatient clinics. We share our floor with palliative care, which means the nurses we work with know about dying. As residency progresses, we learn about dying too.
My first patient who died, died of AIDS complications. Many of our nurses came from the Caribbean Islands during the AIDS epidemic, when there were not enough U.S. nurses who would care for people with HIV. Many of them still work the night shift. Unlike the physicians I work with who are over 65 — and thus not reassigned to the hospital as part of the surge preparing for COVID — many of the nurses and attendants, regardless of age, are expected to continue coming to work. As residents, we trend younger. Except for those who are immunosuppressed, we all got deployed.
The palliative care doctors have been sent to the Emergency Room. Our residency program has taken responsibility for a total of six hospital teams, or, 73 patients. I work a very piecemeal schedule: a few nights, a few days, a day off. I live in Chinatown, on the last stop before Brooklyn. My hospital is the last stop of the same train in the Bronx, over an hour each way.
After my first string of nights at the start of COVID, my housemates told me they think it’s too unsafe for them if I come home. I couldn’t disagree. I moved into my uncle’s empty apartment. Hertz gave me a free rental while a friend worked to fix my rusty 1985 Benz. My mechanic has gone back to the Islands.
The work requires blinders. We don our dirty, reused personal protective equipment and focus on the most urgent next task. Tubes go in; tubes come out. All night long the overhead voice announces that hearts have stopped. I put my phone in a ziplock bag and Facetime my patients’ families. I build a stand for my phone when I can no longer stay to hear the many ways this person was loved. I have learned enough about death to help the dying come without suffering. I wrap my hair in a plastic bag. I brush my patients’ hair back from their faces. I find no beauty in the work.
When the computer system occasionally alerts me of a hospital admission of one of my primary care patients, before their status is changed to deceased, I go visit when my shift is over. I use my phone in its foggy ziplock to FaceTime the families. I ziplock my face shut.
I drive my rental back to Manhattan and cry into the steering wheel. A pandemic makes you feel small. A pandemic makes you feel nothing at all. The streets are strewn with flowers. The little green leaves are unfurling.
Nell Baldwin is a third year Family Medicine resident at a hospital in the Bronx, NY.