There is Always One Patient That Will Get to You

Second-year ER Resident
New York

This is part of our 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.

I hadn’t cried over a patient in my medical career thus far, but there I was driving home, tears falling down my face. I had held it together as long as I could. They say that there is always one patient that will get to you, and I guess this was the one.

Over the past few weeks, I had seen the same thing: COVID, intubate, code, die. It was often the older patients, the ones I could stomach to have this fate. My patient that day was young, in his fifties. He tested positive for COVID with a breathing rate of 50 breaths per minute. Normal is 12 to 16 breaths per minute. His oxygen level was 80% even while on an oxygen mask. Normal is 100% on room air. He was sweating and scared; his dark brown hair was soaked and clinging to his forehead.

Yet, he cracked a couple jokes in between breaths. I imagine he was trying to calm himself down, in addition to making us laugh. A small gold crucifix bounced on his chest as he struggled to breathe. He seemed like a nice guy, someone who’d be fun to grab a drink with.

We intubated him immediately, and he stayed stable for the rest of my shift. He’s young, he’ll make it, I just know it, I thought. I had 10 minutes before my shift was over when I heard a call from his room. He’d lost his pulse. They had started compressions. We coded him, and he got ROSC — return of spontaneous circulation. His pulse was back, and now it was a half an hour past my shift’s scheduled end. I handed his care off to the overnight resident and sat down to call his wife and give her the update. She was quiet and soft and I tried to keep my voice even-toned, not too cheery, not too sad. Truthfully, I was scared for him. If he coded once, his prognosis wasn’t the best.

From what I’d seen thus far, he wouldn’t make it. I didn’t want him to die. He seemed like a nice guy. I cried on the drive home wondering if he’d be there tomorrow. He was not.

Melanie was born and raised in California and moved to New York for her Emergency Medicine residency. In her free time she enjoys cooking, running and playing with her tuxedo cat named Milosh.