Lakshman is an ICU physician from Boston
“It’s just past 4:00 AM in the COVID ICU. If you were here, you might be surprised at how quiet it is and how few people you see. You might think it’s not so bad here. How could this be a crisis?
That is not an accurate reflection of what’s happening here. Our patients with COVID are in single rooms behind glass doors on ventilators. In the ED, you might hear people screaming, sobbing, laughing, but our COVID ICU patients aren’t doing any of that.
They just breathe. We help them. Quietly.
The ICU is all about meticulous control. We don’t thrive in chaos; in fact, our top priority is to suppress it.
Disorganization & critical illness don’t go well together. Instead, we watch, we control, we support. That’s how we save lives. Slowly. A nudge here, a tweak there.
Months ago, the ICU was full of life. Not all patients were on the vent. Some were in the halls working with physical therapy. Dozens of services from dietary to renal chatted at the nursing station. Families crowded rooms and joined rounds. It was ALIVE.
I miss it. We all do.
It’s all different now. There are no families, so the large rooms & wide hallways seem empty. The silence and emptiness is alarming. The waiting rooms that used to have family in them at all hours of the night have been turned into work rooms. Day and night, we limit staff exposure and conduct many consults virtually. We are all staying away from each other.
A frustrated colleague told me “I hate this damn virus!” Months ago I would have hugged her, but sympathy at six feet just isn’t the same.
Before, when a patient died, we were there for each other. We knew it hurt. You saw the pain painted on your friend’s face. Now, the mask is a barrier that keeps you out… and keeps me in. We disperse.
When you hear the analogies to a battle, know that this isn’t a war movie. It isn’t a rush of action or brave sacrifice or heroic last stands. But it is trauma. So much trauma – to lungs, to hearts. To families and communities. And yes, to us.
We are not bold heroes of war…but we are bearing witness. In silence.
No one screams on a breathing machine, but you hear it echo somewhere inside anyway. Stay home. The storm is real.”
See Lakshman’s tweet.