18 Months Later, the COVID-19 Memories Won’t Go Away

Over the course of the COVID-19 pandemic, I’ve had the privilege of taking care of patients in several different roles: as a frontline provider in COVID ICUs during NYC’s peak; as a neurology consultant for my emergency medicine, internal medicine, and critical care colleagues; and as an outpatient neurologist treating post-COVID brain fog and headaches.

The way COVID-19 vaccines have turned things around in New York is nothing short of miraculous, and I’m thankful for that every day. But, like so many other healthcare workers, I still struggle with the lingering effects of working through such a nightmare. Now that both my anxiety levels and COVID cases are creeping back up thanks to the highly transmissible Delta variant, I can’t help but be increasingly reminded of painful pandemic memories.

Here’s what goes on in my head on a typical day in the hospital nearly 18 months into this pandemic:

In the morning, I meet my team for rounds in the neurology stepdown unit. In March 2020, this unit converted to a COVID ICU overnight (literally). Today, when I run into one of the PAs I worked with in the converted COVID unit, I immediately have a flashback.

I’m sobbing wildly in the resident work room, unable to catch my breath to call a 34-year-old patient’s family and ask them to come in straightaway. All of his organs are failing, and I’m concerned he may pass away imminently. The kindhearted PA, overwhelmed with his own patients, stands guard outside the work room, trying to give me a few moments of privacy to collect myself.

No time to dwell on that memory now, we need to start rounding.

I receive a text while the team is reviewing images from a diagnostic angiogram. “Dr. Leah, we hope you are doing well. We think of you and your colleagues often.” It’s from the family of a Holocaust survivor who spent most of April 2020 intubated in this very COVID ICU. My initial thought is to wonder how his family got my personal phone number. Quickly, I remember that I once used my cell phone to FaceTime them.

The family, unable to visit in person, wants to pray over the dying patient, but I don’t have time to find them a hospital iPad. The ICU is so busy that nurses are lining up outside of his room to talk to me, and they all look worried. Scared, I hold up a gloved finger to signal to the nurses on the other side of the glass door that I will be out shortly. Then I whip my phone out and dial the family’s number. They ask me to pray with them.

Another text comes in as we scroll through images of a carotid dissection. This time, it’s from a cardiology fellow who is consulting on another one of our patients.

Later in the afternoon, I respond to a stroke code in the medical ICU. As soon as I arrive, my mind flashes to the last time I was in this particular patient room.

It’s February 2021, and I’m consulting on a 29-year-old COVID patient who was just found to have a hemorrhagic stroke. I walk into the room to find a profoundly despondent MICU team at his bedside. The intern and resident both let tears roll down their cheeks silently while the attending asks me a series of questions. How could this happen? And why? Will he ever wake up? What do we tell his parents to expect? I don’t have any answers to offer them. Several days later, an overhead page announces an emergency in that patient’s room and my stomach drops rapidly. I can’t breathe for a few seconds.

The recollection makes my stomach drop again and I’m jolted back to the present.

The rapid response team arrives to help with the stroke code. We assess the patient and take her to the CT scanner. Once the patient is on the table, we all scurry into the CT control room. One of the nurses on the rapid response team pulls me aside to ask if I was the doctor who squeezed her hand during her first COVID ICU shift -- it’s my first shift too.

One of our patients suddenly drops his oxygen saturation to less than 50%, despite being on a ventilator with maximum support settings. Two intensivists rush over to help us, but we struggle to get his oxygen saturation back up. After we flip the patient into a prone position, I notice that one of the nurses is visibly shaken. She tells me that she feels responsible. She’s terrified that it’s her fault the patient is getting sicker. I say that she did nothing wrong, that we’re still learning what to expect from these patients, that we’re all terrified too. She gestures to a photo of the patient and his three young children that’s taped to the door. He looks so different now -- proned, intubated, pale and grayish blue, with multiple lines and drips running. I take her gloved hand in mine and squeeze.

The scans are done and we see a small evolving stroke. We take the patient back to the MICU and discuss the results with their team.

We talk about the possible stroke mechanisms in this case, and we flesh out a plan for further testing and treatment. I feel satisfied that this patient is tucked in. Then I circle back to the nurse and tell her that it was me who squeezed her hand and that I remember that night very clearly.

“Me too,” she says. “I can’t stop remembering it.”

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Cite this: Leah Croll. 18 Months Later, the COVID-19 Memories Won’t Go Away - Medscape - Aug 12, 2021.