It's taken me a long time to try to process what's happening around me enough to string coherent words together on a page. As my state, my county, my hospitals, my people are in the midst of what can only be described as a disaster, I had the realization today that what I'm witnessing now is the closest to what I experienced in Afghanistan that I've ever seen stateside. It's crept up on me, the stress...the fear...the realization that my people aren't drowning, they are already underwater and all I can do is stand on the shore and try to throw them a life raft.
It's like the frog who was placed into a pan of water and as the water began to boil, the frog didn't sense the danger...until it was too late. This euphemism may seem silly, but it perfectly illustrates a common aspect of human psychology...we tend to accept things if they come upon us slowly, steadily...until one day we are standing in boiling water with no way out.
America is the frog. Except in this story the entirety of healthcare has been screaming out warnings for months...pleading for help, for safety, for compliance...and it fell on deaf ears, or maybe not deaf ears...they heard us, but they didn't care. America as a whole simply wanted to bury their faces into their TikTok videos and ignore what was happening in every hospital in this country. But the water kept getting hotter...and the frog didn't notice, because the temperature crept up degree by degree...until one day the bubbles started to roll. At that point there wasn't anything left to be done...the die had been cast and the frog's fate was sealed.
I am one of those healthcare workers who has been screaming for help since March. Pleading with my family and friends to listen, fielding texts messages from well meaning people trying to decipher if this was truly a problem or not. My answer was always the same...it's a problem, but the numbers aren't what matter to me, what matters to me is how the hospitals look. How the ICUs look. If they aren't bogged down, then we are ok. We are no longer ok...not even close to ok. The water is boiling over.
I've tried to explain my perspective but people don't seem to get it. As an organ procurement coordinator I travel to every ICU in my county. I have a literal front row seat to the disaster as it has unfolded. Today, as I entered one of our local hospitals I was almost stopped in my tracks by the calamity around me. I was instantly reminded of the numerous mass casualties we ran in Kandahar. There weren't bloodied soldiers everywhere, but there were patients stacked into converted rooms, PPE clad nurses, respiratory techs, and doctors running around trying to put out fire after fire, and there was an overall sense of hopelessness...of loss...of defeat. As I received report from the bedside nurse taking care of the patient I was following we spoke a bit about what was happening. I've known this nurse for over a decade...worked alongside her many, many years. She told me that this was the worst thing she's ever experienced in her entire career...that she doesn't know how they are doing it. What was left unspoken was the knowledge that none of them know how long they can continue until the entire system collapses upon itself, bringing everyone down with it.
I left that hospital and traveled to another one nearby...and was immediately met with the same situation. These nurses, pushed to their brink, were trying their best to take care of three ICU patients at once (the CA state ratio for ICU patients is one nurse to two patients, almost every hospital in our county has been above this ratio for the last week). The nurse I spoke to was gracious, and thankful for the help she was getting from another nurse...a nurse from a less impacted floor who had been floated down to help her care for her assignment. Amidst it all she was simply thankful that her team was able to support each other.
These are not isolated incidents or stories. This is playing out in eleven counties around us. There simply isn't room. Even the morgues are full. I found out that there is a person at a local hospital who's job it is to rotate the bodies in and out of the freezer every two hours. Imagine being that person. Imagine that for a moment. That's where we are at right now. We watched New York go through this months ago and seemingly learned nothing as a society. It was simply a story we watched on TV, blaming the media for over hyping the situation. Well, I can assure you this isn't hype, it's fact.
It's been exceptionally difficult to sit on the sidelines and watch this all play out...now it's excruciating. That is not to say I don't believe in what I do with my whole heart...I completely love organ donation and have been so proud of the lives I've helped to save this last year while the world fell apart. But now, as my best friends on earth struggle more than they've ever struggled before, I'm torn. I sit here, looking through the proverbial glass, into a world I know better than the back of my hand, completely unable to help them. I walk beside them every day...through their halls...around their corridors...watching everything they are experiencing, absorbing their stress and pain...and feeling useless. To that end I've asked if I can go back...not permanently...and not to the detriment of my primary job of saving lives through organ donation, but I can't keep sitting here and not attempt to throw my skills into the mix. I know that my impact will be very small, but if I can help one nurse to have a slightly better shift...help one patient suffer a little less...then I'll have made a difference. My co worker aptly described this personality (her personality included) as the "people who run towards danger." She's right. We aren't the only ones in our organization who feel this way either. I guess that's what makes us all truly great...our never ending desire to make a difference, to save lives, to alleviate suffering, to step alongside another human and share the burden, make the load even just a little bit lighter. I am honored to work with such amazing, empathetic nurses.
The one small ray of hope in this entire drama has been the delivery of a vaccine. I cried as I saw a picture of one of my best friends being vaccinated. I didn't realize how much fear I had that she would get sick at some point...that she would infect her husband...that they wouldn't be ok. I've teared up as every friend I have in medicine (and it's a lot) has posted their vaccine selfies. I will cry actual tears when I receive mine and when my husband receives his. And when the day finally comes that my mom is able to get hers, I'll finally have a huge weight lifted from my shoulders from the fear that she would get COVID and possibly die.
But despite the vaccine this is long from over...and again I plead with the entirety of America to please listen to us. Listen to the people on the frontlines. It is bad out there. There is no more space and even fewer healthcare workers to help. And I truly fear it's only going to get worse after the holidays...hard decisions will need to be made and more lives will be lost simply because of the lack of resources. Disaster medicine is here. The war front is now on our doorstep. The front liners are now your last defense.
Stay home, wash your hands, stay healthy...and for the love of God wear a damn mask.