When I see these reports of hospitals becoming full it reminds of my clinical time in Queens, New York. I get post traumatic stress when I remember how, in March, we first tried to separate the ER into “COVID & non-COVID” complaints. We had no idea what was to come. - a thread.

We soon learned this would not work, as the patients we examined and admitted for acute appendicitis later tested positive for #COVID19. It felt like every patient had it. That’s when fear really set in - we realized there was no sure way to safely isolate high risk patients.

Masks were low, and there certainly wasn’t the medical real estate to accommodate all of the patients who would need a “Negative Pressure Room.” Simple tasks (an acute asthma exacerbation) became difficult to manage.

We converted our hospital lobby into a triage center and other departments joined in the effort. We had opthomologists evaluating un-differentiated patients!

As time moved along - New York City responded in an incredible way. Non essential tasks were put on hold, masks were worn, social distancing was quickly acknowledged.

The Emergency Room soon calmed and I remember having high hopes — until I was asked to check on an admitted patient who was a family member of one of our ER staff members. Rules were so strict, it was incredibly difficult to move about the hospital, even for employees.

After my shift, I made a plan to take a trip upstairs. The co-worker asked if they could try and join me. They didn’t have the privilege of my MD badge but they asked if they could try. The patient was their grandparent - there was no way I wasn’t going to give them this chance.

In retrospect - I was completely unprepared for what I was about to see as we rode the elevator upstairs. I was happy my PPE concealed my shock. It was so busy no one even stopped to ask reasons why we were there.

The sounds of monitors beeping and alarming was so persistent, it was almost white noise. Patients were intubated and lined up so close to each other nurses had to physically move a patient to complete their tasks.

I realized this large room was organized into “patients intubated,” “patients on non-rebreathers (oxygen masks)” and “patients on nasal cannulas.” Escalating oxygen requirements.

The patients on non-rebreather masks could physically see their possible fate of intubation and the fear was palpable. We navigated this large room trying to find this family member. We found her, in the “oxygen mask” section.

“Grandma!” My co-worker said - this thought still gets me emotional as I am reminded of my own grandmothers vulnerability. She was so happy to see her grandchild. As they spoke to each other I was distracted by her monitor. She was using an oxygen mask, it was working. O2 Sat:90%

I quickly looked around for assistance - only to realize multiple patients were in the same situation. “We are permitting it,” a nurse said, as he saw my concern. These patients have capacity, many of them request to not be intubated at this time.

I thought “why would they?” If they can see the possible outcome in the next bed, I would probably request the same.

We said our goodbyes and I promised to come back and check on her, “see y’all later!” she said. That was the last time I would see her alive.

These deaths are not just numbers. They are matriarchs of families, they are essential workers, they are “young & healthy” family members with full lives ahead of them. And Many would like You to become numb to their loss. We can’t let that happen.