Critical Care Physician
University of Michigan
VA Ann Arbor Healthcare System
Ann Arbor, MI
This is part of our 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 am a physician-scientist. Under normal circumstances, I spend a large portion of my time doing research. But—as I’ve been reminded repeatedly in recent weeks — these are not normal times. Like many clinicians, I have been putting in extra hours at the hospital.
I am happy to be working clinically right now. Caring for patients provides purpose and distracts me from things I’d rather not think about, like when my children may be able to return to daycare and school.
The COVID surge hit Detroit fast, and my hospital’s leadership worked quickly to ramp up our ICU capacity and offload neighboring hospitals. We opened a new ICU, allowing us to house patients with COVID separately from patients without COVID.
It was surreal showing up for my first day in the new ICU. There were a few familiar faces. Nurses who worked in the ICU years ago were now back to help. There were also many unfamiliar faces — respiratory therapists redeployed from sleep clinic, nurses who had come from the floor. Charting was happening on paper as there was not enough time to train everyone in the ICU software. Families were notably absent.
As our old ICU filled with patients struck by COVID-related respiratory failure, patients without COVID were moved to the new ICU. This included one patient, Mr. M, who had already spent a month in the ICU. His wife had been a great source of support during his prolonged critical illness, but she was no longer able to visit. Per Michigan Governor Whitmer’s Executive Order, hospital visitors were allowed at end-of-life only, and we were fortunately not in that situation. FaceTime was fun at first, giving Mr. M a chance to see his wife, children, and dogs back home. But it became less appealing over time since Mr. M was on a ventilator and unable to speak.
The discomfort was palpable in the new ICU. “Hi, I’m Hallie,” I’d say as I met new staff. “I normally work in clinic,” was a common reply. “Thank you for being here,” I would say, signaling my support and camaraderie. As an ICU doctor, I’ve had to work more hours than usual, but I haven’t had to do anything new. I deeply respect all the clinicians who have taken on new roles during the COVID pandemic.
We are now six weeks into the new ICU. We know each other’s names and have settled into a rhythm. It is springtime, and the weather is beautiful. Mr. M is making progress, re-learning how to walk and breathe on his own, but is still stuck in the ICU.
A few days ago, the nurses and respiratory therapists decided to take him outside. It was a large undertaking. A physical therapist helped transfer him to a wheelchair, a respiratory therapist connected him to a travel ventilator, and two nurses packed portable suction, a monitor, and medications. The trip was a success. Mr. M took his first breath of fresh air in several months, and the ICU team was invigorated.
Two days later was Mr. M’s birthday. He hadn’t seen his wife in over a month. The resident physician caring for him decided to contact Incident Command, the newly established office overseeing our hospital’s emergency response, to see if they would allow his wife to visit. It had been a long time since he’d seen her, and the visit would mean a lot, he explained. The request was denied. If we let her visit, then we’d have to do the same for everyone.
“He did go outside the other day,” one person offered. “We could bring him outside again today.”
“And maybe his wife will just happen to drive by when we are outside.”
The resident physician called Mr. M’s wife to confirm the plan.
The nurses and respiratory therapists again packed up all the supplies and prepared to travel outside after rounds. At first Mr. M wasn’t sure he was up for the trip. He was feeling nauseated, but the nurses coaxed him into agreement.
The weather outside was serene. 70 degrees, sunny, with a gentle breeze. Hospital traffic was being routed through the Emergency Department entrance due to the pandemic, so we had the front entrance to ourselves.
Ten minutes passed. We waited.
Then, very slowly, a car approached the front entrance. Mr. M squinted in recognition, not sure whether to believe what he was seeing. The car stopped, and his wife stepped out. Even the masks couldn’t hide their smiles. We burst into song. “Happy Birthday to you…”
The party lasted only a short while, and we were soon back to the controlled setting of the ICU. Still, the look of surprise and joy on Mr. M’s face remains in my memory. For those few moments, we forgot the pandemic. We had a surprise birthday party.
Dr. Hallie Prescott is a critical care physician and researcher focused on improving recovery from sepsis. She is obliged to remind readers that the views expressed here are her own and do not necessarily represent those of the US Government or Department of Veterans Affairs.