“If We Survive This, What Will Be Left?”: Considering a Post-COVID World from the Front Lines in NYC

Emergency Physician
NY-Presbyterian/
Weill Cornell Hospital
New York, NY

This essay is part of our new series, Flattened By the Curve, which features the voices of doctors, nurses, healthcare workers, and others on the front lines against COVID-19. For information on how to submit, click here.

“If we survive this…” beings any conversation with my husband about the future. He is an intensive care physician and I am an emergency physician. We both know that one — or more likely both — of us will be infected with COVID.

Our jobs involve direct patient care, and right now, everyone in the hospital has COVID. Medicine has always involved some form of sacrifice, from seemingly endless years of graduate and post-graduate training, to high-interest student loans to hours of work in the hospital at the exclusion of anything else. Despite our predilection for sacrifice, the calculus for us has changed with COVID. I think everyone working in NYC knows colleagues who have become critically ill from COVID infection, and perhaps some who have died. We cannot assume we will survive this pandemic.

Besides worrying constantly about whether I am touching my face, or if my N95 has an adequate seal, I continually have to tell patients that we can’t test them for COVID-19. Only the sickest patients can get COVID testing. I have to tell patients that I hope they will get better, but please come back to the ER if they get worse. This conversation sucks, because I know I’m not doing the right thing for them.

Patients and their families scream at me, threaten to sue me, and refuse to leave the ER. I agree with them. I wish I could test them, but I can’t. It’s not up to me. I know that nearly 800 people are dying from COVID every day in this city. I know people are scared. I am scared too. I am working outside of my comfort zone. I am telling myself that the city is in disaster mode, so we can only hope to do our best for as many people as possible. Hospitals are full; we are discharging people who should be straightforward admissions.

Recently, our hospital has established telemedicine follow up for these “moderate risk patients” within 24 hours of discharge. This helps me worry a little bit less about all the people I would have liked to watch in the hospital. But I feel I am still not able to do the right thing for my patients, and it keeps me awake when I could be sleeping, wondering about who might not do well. Will I see them tomorrow, but this time they will need a breathing tube?

Working through this pandemic, healthcare workers have been pushed to the physical, mental, and emotional limits. The Boston Marathon bombings happened during my emergency medicine training in Boston; the patients I cared for during that disaster are etched into my brain, and I will always carry them with me.

But this is a different type of disaster: slow and relentless. COVID owns my conscious and subconscious mind. All my dreams are about COVID. Sometimes I wake up crying. Sometimes I fall asleep crying. My face is bruised from PPE, but I am also sure that my mind is bruised and battered. If my body survives COVID, it will surely claim other parts of myself, and I am not sure they can be resuscitated.

Radhika Sundararajan is an Emergency Physician, anthropologist, and global health researcher in New York City. Her research seeks to improve engagement with evidence-based health resources through culturally competent healthcare interventions. The opinions expressed here are her own.