Back in the ER, day 1.

Everyone is trying to help. The hierarchy of healthcare has flattened in an attempt to flatten the curve. Senior surgeons getting oxygen or residents checking IV drips, everyone is doing whatever they can to address this virus head on. It is inspiring.

People are really sick. The respiratory distress and pneumonia causes patients to be confused. They need oxygen, which we give them, but this virus is affecting so many other parts of their body. The heart, the kidneys, overall circulation. It's devastating.

The more we learn more about this virus, the more I realize how lucky I was to stay at home and stay safe during my entire course. If you had that course, just take a moment and say thanks.

The ER is an ICU- full stop. When you walk in an ICU there are sounds and beeps that are so familiar. The ER had some of that before, but not to the same degree, until now.

There are ventilated patients everywhere. There are critically ill patients, near critically ill patients and everyone else is discharged. We are delivering care to all the patients who need it in the way that is centered on their needs, and not a scarcity of resources.

We are dealing with the overwhelming number of deceased people in NYC. While saving lives is our priority, respecting the deceased, and the process of saying goodbye, is something someone will have to figure out, I just don't know who.

I am very small cog in an enormous wheel that is keeping this city going. Over the past couple of years I had really decreased my presence in the ER, both in frequency and acuity, in order to do other things.

I am humbled to work along side those who have been there the whole time. Many of you don't see those working 4-5 shifts a week in the ED, but they deserve praise, not me. I know I live my life out loud, and sometimes I wonder if that overshadows other people.

About 3 hours into my shift I got a call that I had mounted a strong antibody response to COVID19 and was a candidate to donate plasma. The feeling of knowing I have appropriate antibodies to this virus is both liberating and inspires a mandate in me.

Immediately after I got off the phone I decided round on the awake patients in our ER and just look in their eyes and hold their hands. I am not sure it made a difference to the patients, but it definitely made a difference to me.

I worked one day in one ER in a city that fundamentally defines who I am.

There will be many more days, some good and some bad.

All know is that, for now, I am okay and ready to go back.

/fin