As a newly minted neonatal-cardiac intensivist, I was all ready to take on the world. I mean, caring for the babies with congenital heart disease (CHD), congenital diaphragmatic hernias (CDH) and all other congenital anomalies and premature birth. I was excited and ready for service. It was my 27th year of "being a student." I had gone through the grind of medical school, residency training, fellowship training, and an additional ...

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Barriers. Barriers of yellow tape and plastic mark our makeshift rooms. Red zippers define the “ENTER” and “EXIT.” In the middle is a window of still clearer plastic, partially obscured by taped ECGs. Barriers are put up to keep us safe, but they can do so much more, if we let them. A tap on the plastic window has become the universal command of attention from the nurses, residents, and respiratory ...

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I am an ICU nurse. I love what I do; It's not just a career: It's who I am. No other job could offer me the intimate opportunity to support and guide a total stranger through the worst (and occasionally best) days of their life. Nowhere else would I leave feeling humbled by what I do every day. Nothing compares to that. Simply put: You don't find that sense of ...

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As I held the shaky, sweaty hand of my 52-year-old African American patient, lying in her ICU bed, trembling with fear, tears rolling down her eyes, she gathered enough strength to utter “I can’t breathe.” Her words felt like a punch in my gut, eliciting a visceral reaction, with flashes of George Floyd’s body pinned to the ground, running through my mind. The events of the last few weeks had given ...

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COVID-19 has upended the medical community. Nowhere more so than in the intensive care unit. Life as an intensivist with two young children and a working spouse is never dull. I liken it to tight-rope walking with a pole for balance. I wake up every morning and balance the clinical responsibilities, teaching, reviewing journals, learning, school assignments, lunches, after school activities, bedtimes, repeat, repeat, repeat.  The balance remains just ...

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An excerpt from It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation. On that night when the desperate call came to pick up the critically ill baby with MAS, I felt very fortunate that Dr. Cunningham was my supervisor. When I arrived at the hospital ...

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We worked tirelessly attempting to resuscitate this mother of five for almost an hour. Her husband was called, and he notified us that he would be there shortly. In the end, our heroic measures were simply not enough. It is fearful to imagine being told your wife and mother to your five children is no longer alive on Mother’s Day. The uncertainty of what killed her is a tough pill ...

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As the pandemic loomed, there was widespread concern about running out of crucial medical resources, such as mechanical ventilators. We watched as the crisis escalated in Italy and elsewhere, where hospitals seemed overwhelmed. We prepared for the surge. Hospitals, industry, and government clamored to secure both ventilators and other valuable resources such as personal protective equipment and medications. Health care professionals were recruited to New York City and other hard-hit areas. ...

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Before becoming a certified registered nurse anesthetist (CRNA), I was a surgical intensive care unit (SICU) nurse for decades. During that time, I often saw patients during their greatest time of need – trauma victims, transplant recipients, patients with brain tumors, ruptured aortas, and septic shock. I thought I had seen it all, but working in an improvised COVID-19 ICU has taught me to expect the unexpected, and has required ...

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Last weekend, my partner witnessed some of the pandemic’s collateral damage in an upsurge of violent deaths via car wrecks and shootings. A patient of mine, chief of the local SWAT team, had predicted as much: he gave people two weeks at home before they started acting out. I expected a similar weekend and was pleasantly surprised at how few calls I received by late Saturday night. But it doesn’t take ...

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The coronavirus pandemic has turned the world, and all of its citizens, around, never to be the same again. As an ICU and ventilator survivor, I focus on the drama of the patient’s room, and the reality of what is truly a tragic experience. Nineteen-ninety-eight seems like yesterday, and while it was 22 years ago, it is fresh in my mind. The vacation abroad that fall was a sunny respite from ...

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It’s been a whirlwind of emotions during the last few weeks. I started in the hospital when our cases were starting to creep up. The fear. The anguish. The uncertainty. The anger. The sadness. The crazy dreams. The donning. The doffing. The decontamination process. The week, I signed three death certificates (non-COVID), and I sent two patients to ICU (one COVID). Needless to say, I came home every night feeling sad and powerless, knowing this COVID-19 beast has us pretty ...

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Your town has more than enough ventilators if you know where to find them. Tens to hundreds of vents are sitting in almost every neighborhood in America, but are being utilized incorrectly.  Throughout the nation, there are facilities known as LTACs, which stands for long term acute care facility. These facilities are utilized for a broad array of patient care, but almost everyone falls into three categories: the first patient ...

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Moving so quickly. Round and round. Head turning, trying to keep track. 1, 2, 3, 4, 5 … faster and faster Losing count. My head spins. A doctor, Indian, like me. A friend, my age. A mother, could be my own. No time to grieve. I kept a list of your names. So I could continue to honor you, your memory, when life slowed down just enough so that my heart had time to process. The memory is clear. I was ...

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The media and policymakers have spent a lot of time focusing on the shortage of ventilators in the country. Elmhurst Hospital in Queens - one of the hardest-hit locations in the country, and where I work - received a donation of 40 desperately needed machines from Tesla a couple of weeks ago. There was a brief moment to rejoice before putting these to use. Healthcare workers and the ...

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It is all about the nurses and the respiratory therapists.  I watch countless brave actions every day in the ICU.  These are people who, in “normal” times,  spend nights, weekends, and holidays caring for the sickest of the sick. They are modestly paid, and often have little control over their schedules.  They balance a stream of demands from doctors, patients, families, and an insatiable electronic medical record that demands constant ...

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You always knew they didn’t care about you.  The administration, I mean.  But you knew that going into it.  It’s just four years that you have to endure until you can be respected, until you make the big bucks, until you’re treated like a human being.  Four years is not that long. But you knew this going into it. That they didn’t care.  You’re just a resident.  Now more than ever, ...

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I am the director of critical care for a hospital. Five days ago I tested positive for COVID-19. I can’t know for certain where exactly I contracted the virus. But when my hospital admitted its first COVID-positive patient, I stayed until 3 a.m. to set up the isolation ward and care for the patient until she was intubated and transferred to the ICU. I entered the isolation room wearing ...

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Our 23 bed ICU has been converted to COVID-19 patients. All of them. I want to tell myself this is science fiction, but it’s not. It’s real. And we are scared. As I enter the unit to start my night shift, we have a huddle of the off-going and oncoming nurses. We are committed to fighting this invisible monster. After a brief update of all of our patients, we bow our heads and say ...

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Tonight will be my first night shift in the medical ICU (MICU) since COVID began ravaging New York City. I was on the hospital floors as an internal medicine resident during the early period of the COVID-19 pandemic. Since then, my clinic block was canceled, and I was placed on sick call, though I didn't get called into any additional shifts. I felt uneasy in the days leading ...

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