Life and Death Inside New York’s Busiest Emergency Room

Nurses in the Bronx are still fighting for protective gear, while coping with the loss of their colleagues.

Lillian Udell

I was home on self-isolation, having tested positive for Covid-19, when I first heard President Donald Trump likening the coronavirus pandemic to a war. I initially bristled at the idea of comparing a health care worker to a soldier. Then I returned to work in the busiest emergency department in New York City, and realized that the pronouncement was truer than I could have imagined.

Each shift, health care workers enter a battleground thick with the infectious toxicity that this virus had released all around us.

The layers of PPE, or personal protective equipment, were not only uncomfortable; they obscured our identities from each other. I no longer looked the way I had been seen, and could not always recognize my coworkers as I had immediately before. It seems like a small detail during a catastrophic time, but this difference can change dynamics drastically. Soon, however, I noticed individual traits of my colleagues with more clarity: their gaits, voices, and sometimes even footsteps came into sharper focus.

I experienced with more clarity than ever before the bonds between myself and the other nurses. Our experiences leading up to this time seemed to be practice for this pandemic: the big event.

In the ER, we are surrounded by patients who are struggling for hours on end, no progress made — patients who are so exhausted from trying to breathe that they consent to whatever treatment you have to offer. One of the most devastating things to witness is patients suffering and dying alone, with no loved ones allowed at bedside. This is a problem borne out of a solution; visitors are restricted from visiting their loved ones in the hospital in order to halt the spread of the disease.

Witnessing this catastrophe alone would have been unbearable. It’s devastating that despite working in the same capacity as a nurse, I felt more powerless in what I can do for a patient in the worst of times. But it’s something I had to learn to accept: The limits that exist are insurmountable within the structures we have in place in our hospitals and broader health care system. My fellow nurses have been exactly the kind of support for me that I wish my patients could have for themselves in these times. The candor they have shown while sharing their thoughts, anxieties, and fears has allowed me to abide such a terrifying experience.

When interviewed about his experience of the Vietnam War, Tim O’Brien once said, “I carry joyful memories, too, friends I made and the conversations at foxholes where, for a moment or two, the war would seem to vanish into camaraderie and friendship.” This virus has sickened and killed some of our family members, sickened and even killed some of us. Our “foxholes” have been at patients’ bedsides, in the break room, at our desks, where we might laugh with each other in order to find solace in our own shared vulnerability.

Emergency rooms throughout the Bronx have quieted some in the last week or two. From Jacobi to Montefiore to Lincoln, I have heard that the uptick in outside staffing and the decline of patient volume has contributed to a cautious optimism among nurses that there is indeed an end in sight to this catastrophe. We look forward to days not spent donning and doffing inadequate PPE, turning every conscious patient’s oxygen level up to the max, and feeling a heightened anxiety. But once the crowds stop cheering us at 7 p.m. each night, people are permitted to return to their “nonessential” roles in society, and some semblance of normalcy is revived, we will still be here.

Throughout this time, the bravery of health care workers hasn’t come from being fearless, but from facing fear collectively.

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