3 - Stories from a Pandemic: Virus
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What does the host say about the purpose of this COVID‑19 storytelling series?
Hi everyone, this is Emily and you're listening to The Nocturnus. I'm still here in San Francisco recording from home. California has been sheltering in place for a little over three weeks now. Some of us are finding a new normal, and some of us are still trying to find a foothold as we grapple with new routines, new childcare responsibilities, and the unpredictable behavior of this new disease. We've been learning about the virus's physical shape. It's genetic makeup, its epidemiology, its clinical presentation. And how its contagion affects everything from hospital workflows to visitation rules. For those of you who are tuning in for the first time, this is a special series of The Nocturnous, a medical storytelling show by Healthcare for Healthcare.
Well over a hundred of you have signed up to keep an audio diary about your experience working in the midst of this pandemic. And each week we feature selected clips from your diaries here on the show. Our goal is to serve as an outlet for truth telling, self-expression, and community among healthcare workers because we are hurting so much right now and facing unimaginable challenges. Listening to your voices certainly brings me a lot of comfort as I gear up to staff our hospital's covet service later this week. If you want to lend your voice to this project, Learn more at thenocturnist dot com And now? Allow me to introduce episode three. virus.
A week ago we had four positive covet patients. Six days later we have thirteen. Almost every single one of them are intubated. Paralyzed. About a third of them are prone to the right. Most of them are pressed. They do not behave the way that patients in acute respiratory failure behave. They Uh so labile and so unpredictable and so Different than any other patient I have ever seen in my almost 20 years of ICU experience. And I can't even begin to wrap my mind around it. Medicine as I know it right now is not working for these patients, and that terrifies me because I just feel like we're treading water and I don't know Had it. Get them out of it. And I feel like we're still not gaining any ground. I'm in a loss and I'm scared and
I don't know what the next six weeks are gonna look like. What I've noticed is that the Patients that we have
How does a MICU nurse in San Francisco describe the rapid rise of intubated COVID patients?
right now are predominantly male. Latino? Most of them are coming in as undiagnosed diabetics. Of the patients that we've had recover so far. Two of them have been They've been female. One was an eighty six year old woman. Who told me she had no time for this? Uh I think for whatever reason It looks like The women are doing better than the men. What we consistently see, however, is the patients coming into the emergency room, hypoxic, tachypnic, their chest x-rays and cts look terrible and consistent with what we've seen with everybody else. They come up to the unit, we look at them for a while, and then within, I would say, six hours, we intubate them. Take solace in the fact that we actually have had two patients
Actually leave the unit. And do well. So I'm hoping that that's that trajectory moving forward, but I'm not optimistic at this point. Today was not a good day. I'm an internal medicine resident in New York. Today is Saturday, March 28th. Today I managed my own mini ICU in the emergency department. I had two intubated patients that we had to intubate in the morning, but there were no ICU beds available for about three hours. And so we had our anesthetic. The other one had been intubated overnight, but because the you know everything was so busy in the E D, no one had been watching over her, so when I went to pre round on her from coming down from the floor, I saw her, like from across the room, reach over and pulled her tube out because she hadn't been adequately sedated.
So I literally ran over, thank God the anesthesia team was nearby. We re intubated her and uh got her properly sedated. But I kept walking from one side of the E D to the other, managing these two intubated patients, trying to get their sedation high enough to make sure that they uh were sedated enough and making sure that they had were on the right vent settings and just waiting, waiting for the ICU triage resident and the attending to come down and just check up on on these two patients and waiting for an ICU bed to become available.
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Chapters
8 chapters
1
What does the host say about the purpose of this COVID‑19 storytelling series?
0:01–3:09
2
How does a MICU nurse in San Francisco describe the rapid rise of intubated COVID patients?
3:09–6:32
3
What challenges does an internal‑medicine resident in New York face while managing a makeshift ICU in the ED?
6:32–9:53
4
How does an internal‑medicine resident in Montreal describe COVID‑19 labs, symptoms, and emotional fatigue?
9:53–12:46
5
What is an experimental mRNA vaccine trial participant’s experience and how does the trial work?
12:46–16:10
6
Why does a geriatrician argue that older adults are being left out of COVID‑19 research and policy?
16:10–19:33
7
How does a fourth‑year medical student in New York cope with cancelled rotations and social isolation?
19:33–23:13
8
What final reflections and messages do the producers share about community and hope?
23:13–27:18