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The elevator doors slide open.
There’s already someone inside, one of the hospitalists. He moves over to one side as I enter, subconsciously distancing.
I look at him and smile, “Coming or going?”
He doesn’t answer right away.
Instead, he pauses, as if trying to remember. 1/
There’s already someone inside, one of the hospitalists. He moves over to one side as I enter, subconsciously distancing.
I look at him and smile, “Coming or going?”
He doesn’t answer right away.
Instead, he pauses, as if trying to remember. 1/
I know what he’s feeling.
There’s another shift taking place in the hospital’s atmosphere.
It’s affecting some of us more than others, but everyone is feeling it.
We are in the dying of the light.
“The dying hours,” says one of the intensivists.
Death has come to collect. 2/
There’s another shift taking place in the hospital’s atmosphere.
It’s affecting some of us more than others, but everyone is feeling it.
We are in the dying of the light.
“The dying hours,” says one of the intensivists.
Death has come to collect. 2/
Don’t get me wrong.
Death is always present in the hospital, the natural endpoint of all our journeys.
It’s just that right now, it’s accelerating.
More and more names disappear from my list, deceased or transferring to hospice, as more and more new names take their places. 3/
Death is always present in the hospital, the natural endpoint of all our journeys.
It’s just that right now, it’s accelerating.
More and more names disappear from my list, deceased or transferring to hospice, as more and more new names take their places. 3/
And it isn’t the kind of death we are used to.
By now everyone has heard, or read about, or seen, or (God forbid) experienced the goodbyes from a distance.
This particularly cruel price that COVID-19 insists on exacting.
It’s distanced, but it’s not, you see.
We are here. 4/
By now everyone has heard, or read about, or seen, or (God forbid) experienced the goodbyes from a distance.
This particularly cruel price that COVID-19 insists on exacting.
It’s distanced, but it’s not, you see.
We are here. 4/
I’m sitting in the ICU dictation room with the intensivist.
She looks to me, “You meet those new travel nurses from New York?”
I nod, “I’m glad they’re here.”
“You notice the way they handle the death? They’re numb.”
I nod, “They’ve seen the ending to this story before.” 5/
She looks to me, “You meet those new travel nurses from New York?”
I nod, “I’m glad they’re here.”
“You notice the way they handle the death? They’re numb.”
I nod, “They’ve seen the ending to this story before.” 5/
“It’s affecting some of us more than others. You have to go numb. You have to deaden that part of yourself, to function. Keep that distance.”
As she says “distance” the intensivist holds her hands apart.
I know what she’s talking about.
I’m doing it already.
Going numb. 6/
As she says “distance” the intensivist holds her hands apart.
I know what she’s talking about.
I’m doing it already.
Going numb. 6/
Walking through a COVID ICU, it used to be jarring.
Seeing one mechanically ventilated patient after another lying on their bellies, their faces turned away as if unwilling to form any connection that might remind them of how they once breathed freely.
Now, I’m used to it. 7/
Seeing one mechanically ventilated patient after another lying on their bellies, their faces turned away as if unwilling to form any connection that might remind them of how they once breathed freely.
Now, I’m used to it. 7/
Is some vital part of me dying off too? Withering and wasting away as I focus on distance, distance, distance.
Human beings weren’t made to pass by each other in ever-widening orbits.
Life is not lived at a distance.
And yet we must.
We must.
To have any chance at all. 8/
Human beings weren’t made to pass by each other in ever-widening orbits.
Life is not lived at a distance.
And yet we must.
We must.
To have any chance at all. 8/
People ask me how my day was. I used to try and think of a way to describe it.
Now I can’t even try.
I know the question is innocent, it shows that they care, it’s polite.
But it also shows that they have no idea.
Don’t make me relive these long days, these small hours. 9/
Now I can’t even try.
I know the question is innocent, it shows that they care, it’s polite.
But it also shows that they have no idea.
Don’t make me relive these long days, these small hours. 9/
It isn’t all death, of course.
My view is skewed as a consultant, I often see the sickest patients in the hospital.
People are getting better too, recovering.
But today it feels like those points of light are just flashes in an infinite darkness.
Fleeting, delicate hope. 10/
My view is skewed as a consultant, I often see the sickest patients in the hospital.
People are getting better too, recovering.
But today it feels like those points of light are just flashes in an infinite darkness.
Fleeting, delicate hope. 10/
One of the patients is put on ECMO and transferred out.
The intensivist invites me to observe. As if she senses that my soul needs something to hold on to.
It’s an incredible thing to see. Truly.
For a moment, enrapt, I forget the realities of my world. 11/
The intensivist invites me to observe. As if she senses that my soul needs something to hold on to.
It’s an incredible thing to see. Truly.
For a moment, enrapt, I forget the realities of my world. 11/
But it all comes crashing back down.
“Attention, Code Blue.”
Somewhere in the hospital, Death reminds us that whatever hope we hold on to will only slip through our fingers.
I want to go home, to the Before I can no longer return to.
I want to sleep.
No dreams.
Please. 12/
“Attention, Code Blue.”
Somewhere in the hospital, Death reminds us that whatever hope we hold on to will only slip through our fingers.
I want to go home, to the Before I can no longer return to.
I want to sleep.
No dreams.
Please. 12/
The last time I cried was July 10th.
Well... and tonight, July 17th.
Exactly one week apart, to the hour.
It happens in the shower.
As if the water might camouflage the tears, and make them indistinguishable from the rivulets running down my body.
Down the drain. 13/
Well... and tonight, July 17th.
Exactly one week apart, to the hour.
It happens in the shower.
As if the water might camouflage the tears, and make them indistinguishable from the rivulets running down my body.
Down the drain. 13/
The days are blurring together.
Everyone feels this, inside and outside the hospital.
I live my life one shift at a time. I exist in the reddened grooves my PPE etches into my skin.
Today is whatever day people say it is.
COVID doesn’t count the hours, and neither do I. 14/
Everyone feels this, inside and outside the hospital.
I live my life one shift at a time. I exist in the reddened grooves my PPE etches into my skin.
Today is whatever day people say it is.
COVID doesn’t count the hours, and neither do I. 14/
I finish my work for the day.
I’m exhausted.
The kind of exhaustion that makes your soul ache.
I get on the elevator as the doors slide open, and a nurse gets on with me.
“Hey Dr. T,” she smiles, “coming or going?”
I smile, and then pause for a moment, trying to remember.
I’m exhausted.
The kind of exhaustion that makes your soul ache.
I get on the elevator as the doors slide open, and a nurse gets on with me.
“Hey Dr. T,” she smiles, “coming or going?”
I smile, and then pause for a moment, trying to remember.
