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COVID-19 Diary: The Beginning, the Peak, and Life Anew

Mengyang Sun, MD, in surgical mask
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The Beginning

A COVID-19 screening clinic had been set up overnight and they needed volunteers to staff it.

We formed a great team
Running a super-efficient system
Swabbing over a hundred patients a day
Everyone was scared, but motivated
To rise to the occasion
To fulfil our responsibilities as health care workers

And then, one evening, the mandate came down
No more community testing
Overnight, we became a staff testing site
And we started swabbing friends and colleagues
Our EPIC inboxes flooded with positive results
This Anesthesiologist
That Nurse
My resident
Our clerk

My pregnant colleague and friend
Both of us scared out of our wits
We didn’t know what effect COVID-19 would have on a mid-trimester fetus
She tried to be brave
I broke down and cried
It’s hard to breathe and cry 
Simultaneously under an N95 mask
She told me to stop crying
The tears might weaken the seal on my mask
I wanted to hug her but didn’t
Adhering to social distancing

In those days, that was what I missed the most
Hugs
Hugs to give comfort
Hugs to show support
Hugs to convey happiness
Hugs to express love

The Peak of COVID-19

They urgently needed doctors on the COVID-19 wards. Our five regular medicine teams had expanded almost overnight to 10, and then 15. They had run out of internists to staff all these teams and were desperate enough to take anyone willing to volunteer. I was assigned to the pink team just in time for the peak of COVID-19, which happened to coincide closely with my birthday.

Today is my birthday.
Today I spent more than 12 hours working in the hospital.
Today I learned how to sign death certificates, never having had to sign one before, and proceeded to sign three.
Today, I learned how to order fentanyl and versed drips for my patient who will be intubated on the floor.
Today I talked to my patient's family about code status, never thinking I'd ever have to engage in this kind of conversation again after finishing my last gynecologic oncology rotation.

Today, I watched my patient gasping desperately for air, not getting enough despite all the supplemental oxygen we had her on, not comfortable despite all the morphine we were giving her. I sang her a song while holding her hand and brushing her hair, hoping to soothe her discomfort. Because that's all I had to offer her: a song, and a hand to hold.

They only ever taught us how to fight disease and help patients stay alive. Nobody ever taught us how to treat the pain and help patients die, peacefully, and with dignity. I'm an obstetrician–gynecologist. My job had always been to welcome life into this world, not usher it out at the end.

Today, I felt completely defeated.

Today is my birthday. 
Today, my wonderful work brother organized a pizza party for me on labor and delivery, which made me super happy, because I love parties and I love food, and I love my brother—best brother ever!
Today, I took time to celebrate with my friends and colleagues who have given me so much joy, support and encouragement over the last few years, months, weeks and days.
Today, I realized how many old friends I had, and how many new friends I've made since this pandemic started.
Today, I enjoyed a gorgeous cake baked by the mother of a wonderful friend who took the time to bake it, despite being a dental hygienist re-assigned to take care of sick patients on the inpatient COVID-19 floors.

Today, I felt incredibly loved and appreciated.

Today, I'm grateful to be healthy and alive, surrounded by amazing friends, colleagues, and family who are also healthy and alive, fighting the good fight, side by side.

Tomorrow is the most beautiful gift I never truly appreciated. Until today.

Losing Friends

I submitted a request to work in the ICU, which was speedily approved. We’ve all had friends and colleagues fall victim to COVID-19. I was no exception.

I watch him from outside his room. 
I scrutinize his vital signs. 
I look at all the drips he's on.
I do the math in my head, is he doing better? Is he getting worse?
I send him good vibes and warm thoughts through the closed door.
I shout words of encouragement every time the door opens.

I don't go in. Because they tell us not to waste PPE. 
I don't go in. Because I am completely helpless, useless, hopeless.
I don't go in. Because I don't want to see the expanding blisters on his legs.
I don't go in. Because I can't bear to see his fingers turning blue, then purple, then black.
I don't go in. Because I'm not strong enough to be there for him.
I don't go in. Because out here, I can almost convince myself there's still a chance.

I watch from outside his empty room.
I stare at the blank monitors.
I look at the IV pumps, turned off, gone dark, all silent.
I don't go in. Because it's too late now.

The Beginning of the End

The Emergency Department was eerily silent. Where were all the patients? Have we somehow managed to crawl through the deepest, darkest heart of the pandemic and emerge back into the light? But the ICUs were still filled with critically-ill COVID-19 patients. Then “Fight Song” by Rachel Platten played overhead. Another COVID-19 patient extubated.

We hear “Fight Song,” and it's bittersweet. 
Somewhere, sometime, somebody—extubated!
Some days, we find the energy.
We bask in the moment.
We sing, we dance, we clap.
We celebrate COVID-19’s defeat.

But in the back of our minds,
We wonder, wonder, wonder...
Will he be reintubated?
Will he actually survive?
Will he be one of our success stories?
Or will he still die?

We look around us, and what do we see?
Everywhere, everyone else,
All of them still intubated.
And what song shall we play for them?
The ones who lose the fight?
The ones who die?
Who so slowly, slowly, slowly fade away
To a gentle goodbye?

Perhaps just the sad song of weary souls
Shedding silent tears over the lives that COVID-19 stole.

Life Anew

I finally went back to my regular job, dealing with the birthing process, rather than the dying process.

Labor and Delivery
Where we welcome new life
With open arms
Where death
Ever so present everywhere else
Is but a faint memory

A baby is born
That first wail of life
So vibrant and strong
Piercing through the dense fog
Of forgotten joy and wonder

I take a deep breath
Behind my N95 mask
And I marvel anew at the miracle of life
I feel that serenity again
For the very first time
Since COVID-19 invaded our lives


Dr. Mengyang Sun is an Attending Physician in the Department of Obstetrics and Gynecology at NYC Health + Hospitals/Jacobi, Assistant Professor at Albert Einstein College of Medicine, and Jacobi Site Director of the Obstetrics and Gynecology Residency Program.

 

Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.

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