I have been an Emergency Medicine Physician for almost 20 years. I have worked through numerous disasters, and I’m used to the daily grind of heart attacks, gunshots, strokes, flu, traumas, and more. It’s par for the course in my field. Yet nothing has made me feel the way I do about my “job” as this pandemic has—that knot-in-the-pit–of-your-stomach sensation while heading into work, comforted only by the empathetic faces of my colleagues who are going through the same. I am grateful for their presence, knowing they are both literally and figuratively with me, that they understand and accept so profoundly the risks we take each day. I also hope that my friends and family forgive me for my lack of presence during this time—precisely when we need each other most—and that they realize that their words, their encouragement, and their small gestures that come my way daily are the fuel that gets me through each day. This is a story for all of us.
I met my patient, Mr. C., on my first real “pandemic” shift, when what we were seeing that day was what we had been preparing for. He was classic in his presentation, his X-ray findings, his low oxygen levels… we just knew. And he was the nicest man I had met in a long time. Gasping for breath, he kept asking if we needed anything, and that it would all be okay. He told us he was a teacher but that he was learning so much from us, and how much he respected what we were doing. The opposite could not be more true.
We had to decide how long we would try to let him work through this low oxygen state before needing to intubate him. His levels kept falling and despite all our best efforts it was time to put him on the ventilator. He told us he didn’t feel great about this, “but Doc, I trust you and am putting myself in your hands.” That uneasy feeling in my stomach grew even more in that moment. But he, with his teacher's steady voice, kept me grounded, where I was supposed to be. I saw his eyes looking at me, seeing the kindness in them, even as we pushed the medications to put him to sleep. To say this was an “easy” intubation is an understatement. It was not. He nearly left us a few times during those first minutes, but he kept coming back. We fought hard to keep him with us. The patience and strength of my team that day, truly remarkable.
I handed him over to my friend and colleague, Dr. G, and her team in the ICU, and her calming voice reassured me that they had it from here. And then for the next twelve days, I waited and watched his progress, knowing the statistics, and how sick he was when he got to us. They did their magic, and just yesterday my new friend Mr. C was extubated. I decided to go “meet” him again.
Mr C. was in the COVID stepdown unit, recovering, without family. Nobody was allowed to visit him; even worse, his wife had been home alone in isolation for the past fourteen days, too. My heart broke thinking of how that must have been for her. I cautiously went into his room, donned in my PPE, and when he saw me, he stopped for a second. A moment of recognition.
I introduced myself. “I’m Dr. Akbarnia, Mr. C. I was the last person you saw in the ER. You told me you trusted us to get you to this side. Looks like you did just fine.” He started to cry. He said, “I remember your eyes.” And I started to cry. What he didn’t know is that, at that moment, I realized that we do what we do exactly for people like him, for moments like these. His strength, his kindness, his calming words to me meant everything. At that moment, my heart (which had been beating over 100 bpm since this pandemic began) finally slowed down.
I sat down and we talked. I told him that while he is here, we are his family. He will always have a place in my heart. And whether he knows it or not, he will be my silent warrior and guide as I take care of every patient, COVID or not. He will fuel me until the day I hang up my stethoscope.
Written by Dr. Halleh Akbarnia MD, shared with permission by Dr. Akbarnia and patient