Early this morning while on shift in the ER, a first year emergency medicine resident, just two months into her residency, came into the doctor’s work area and tapped a more senior emergency medicine resident on the shoulder. “Can I have a hug?” She asked. 1/16

“Of course” said the senior resident as she stood up and hugged her junior colleague. The first year resident was in tears. Her eye makeup was running down her face, blackening the inside of the surgical face mask she now had hanging around her neck. 2/16

The thought of masking and social distancing never even entered my mind. They walked around the corner to talk and I was quick to follow to see if I could be of any assistance. 3/16

Standing at a distance so as not to intrude I asked, “Is everything okay? I don’t want to interrupt if you would like some privacy.” “No, it’s fine,” said the junior resident, “I just had a really rough night.” “She’s on MICU,” said the senior resident. 4/16

Knowing we had 19 patients with COVID19 in our MICU, I asked, “How are the COVID patients doing?” “They’re really sick and they’re dying,” the junior resident responded. “We had a totally healthy patient in their 30’s die from COVID last night. It’s really hard,” she said. 5/16

“I’m so sorry,” I said. “I know how hard it is caring for critically ill COVID patients, and I know you all did your best.” The junior resident nodded in agreement but there remained a look of deep pain in her eyes. “I know,” she responded. 6/16

“Are you going to be okay? Do you want to speak with our resident psychologist?” I asked. “She is really good.” I went on. “No, I’ll be okay,” she responded. “I just need to get some sleep. It was just a really long night and I gotta be back tonight.” she said. 7/16

“I understand,” I said. “Feel free to reach out to me, if you need anything, whenever” I concluded. “Thanks, I will,” she responded. 8/16

I left the two residents to talk and walked back to where I had been sitting. As I sat down my mind took me back to a night In April, when I was volunteering in Queens, NYC caring for critically ill COVID19 patients. 9/16

Earlier that evening we had a patient on our team die. As is often seen in end stage COVID patients, his lungs had become stiff and noncompliant making it impossible to adequately remove CO2 from his body which made his blood very acidic. 10/16

There were no further changes we could make to the ventilator. We had tried everything, but the patient remained on maximum life support and he was not improving and we knew he had no chance of survival. 11/16

As patients family members are not allowed on the intensive care units, for fear of further spreading of the virus, the patient’s family had to say goodbye to their loved one in a way that can only be described as heartbreaking for all involved: over FaceTime. 12/16

I remember leaving the hospital that night with tears running down my face, holding back to keep my composure. 13/16

It was one of the hardest moments I’d faced as a physician, and it wasn’t the last time I’d take a family through that surreal and horrible process before returning home to California in early May. 14/16

This was the pain I recognized in the junior residents eyes. I knew exactly what she was going through, but the difference is I’ve been practicing emergency medicine for 8 years, she’s been doing it for 8 weeks. 15/16

This is the reality of the COVID19 pandemic for far too many patients, their loved ones & those who care for them. It is a dark reality, but it is the truth - and people need to be aware of the terrible reality of what is currently happening in hospitals across the nation. 16/16