Get vaccinated! It’s COVID-19 – Monterey Herald

Imagine that you wake up one day with a runny nose and a fever. You go on for a day or two and keep feeling worse. You’re going to get tested and voila, you’ve tested positive for COVID-19. Health care providers give you an inhaler and steroids, send you home, and tell you to isolate yourself.

If you isolate yourself like you are supposed to, you no longer see your wife or children.

Steve Lisowski (Courtesy photo)

In the middle of the night, one night, you just can’t catch your breath. Your wife asks you through the door if you need an ambulance and you end up saying “yes” even though you don’t want to be taken to the hospital.

The ambulance team arrives with N95 masks. They put a pulse oximeter on your finger, which provides information about the amount of oxygen in your blood. Your oxygen saturation is 82%, 90 or more is considered normal.

Taken to hospital

You are taken to the hospital where you are isolated from the other patients. You call your wife and talk to her in short sentences because you are having trouble breathing. Maybe you FaceTime with it. You tell her that you love her and don’t worry.

You try to sleep but you have trouble. Periodically, a nurse tells you to lie on your stomach. You try, but it’s uncomfortable.

You get up to use the bathroom and can barely get there. Your oxygen saturation has now dropped to 78%. The respiratory therapist (RT) enters and changes your oxygen supply to what is called high flow nasal oxygen. The RT sticks the nasal cannula to your face. It is now blowing high levels of concentrated oxygen into your lungs. You call your wife and both joke about your appearance. She is worried and you tell her not to be, after all 96% of people survive COVID-19. You will be fine.

The day continues with you in front of the television and you start to struggle again. The nurse tells you to lie on your stomach. We can’t watch TV like that but hey. The alarm on the nearby monitor keeps ringing and it’s annoying.

It lasts a few days.

Gradual decline

You feel more and more short of breath. You miss your wife and children. Now there is nothing you can do without a nurse helping you. The monitor rings continuously. At this point, you can’t even tolerate standing without feeling weak and horribly short of breath.

One morning you have a cough and panic because you cannot breathe enough. The respiratory therapist arrives with a determined gaze and this time puts on a full oxygen mask. It’s like being a fighter pilot and it’s scary. You breathe better, but now you can’t eat because of this mask. You can only drink small sips of water every now and then. Your wife calls but she cannot understand you because of the mask. You do your best to communicate with her. The doctor comes in and tells you that due to your condition, he must transfer you to the intensive care unit. You text your wife not to worry and provide her with the new room number.

Two more days go by.

Intubation

One morning, an intensive care doctor (intensivist) walks in and says that because of your breathing, your muscles will tire. They should put a tube in your throat to help you breathe. He asks you if your heart should stop, would you like everything to be done to save your life. You say yes, but he says if your heart stops due to COVID-19, things are unlikely to get better. You tell him you want to live. He nods and closes his eyes for a moment, but just looks at you. He asks if you would like to be kept alive only by the machine. Eventually you realize that is not what you would like and they change the status of your code to Do Not Resuscitate.

You call your wife and tell her the news. She is crying and it looks like she hasn’t slept in days. Your oldest child is very worried and constantly interrupts your conversation. Your youngest child is playing in the background regardless of the situation. This is the last time you will see them.

Several people enter your hospital room. A bright light is on and the intensivist rises above you and tells you not to worry. They will give you medicine to make you fall asleep. You look around and everything turns black.

I don’t know if you are dreaming. I don’t know what it’s like to be paralyzed. And you can’t tell me if something is hurting you. I have to use my training to assess you. I don’t know what happens when you start to wake up when we try to lower your sedation a few days later and you look at me, your eyes go crazy and panicked, but not really seeing me. I’m trying to comfort you. You are in my hands and you are counting on me. I’ll do my best.
We are doing all we can.

What I do know is how worried your wife is every time she calls. I know how much she clings to every word I say to her when I update her on your condition. She hopes I will say something positive but I have seen this, I know I must be very neutral. I assure him that we are doing everything we can for you, but your chest x-rays just seem to get worse and worse. We treat your fever. We must keep increasing
your oxygen on the ventilator. A week goes by like this.

You’re still no better. We have set up video calls where your wife and maybe your oldest child can see you with all those tubes inside you. Do you know they are there? As they do their best to appear positive and remind you of how they are rooting for you and how life is at home, I can see how tired and crying your wife is. Finally, I must tell him that the time is up for this call. She nods, understanding, but I know she wants to stay longer. She wants to touch you again.

You’ve been in the hospital for a month.

The farewell

One day, a hospice doctor calls your wife. He explains that you are not improving and that it is unlikely that you will. He begins to talk about the harsh reality of the future.

I hear him talking to your wife in a low voice. He is compassionate and honest about your situation.

It’s a matter of acceptance now. The next day, the hospital allows your wife to come and see you. It’s a farewell.

I can only have him in the room for a few minutes. She strokes your hair and cries. She touches your arm. I look away. I have a job to do. I’m holding out for you and your wife. You both rely on me.

Everyone is very supportive of your wife as she leaves. She can’t decide whether to look back or just go. We understand how difficult it is. We know she is barely holding up. We have already seen it.

Did you feel her touch you? Did you hear her say goodbye? Part of me wants to think yes but a bigger part of me is hoping that you are not on all this, dreaming about fond memories of your family or the beautiful places you have seen. This is what I hope comes to your mind.

Faded away

Soon after, we give you some type of medicine and take the tube out of your lungs. You don’t stay long with us. Your thrilled lungs cannot oxygenate you. I watch your oxygen level drop quickly, then your heartbeat gets fast and irregular, then way too slow. The monitor is yelling at us to do something, but now we can’t do anything else for you. The time for intervention is over. The doctor listens to your heart to be able to speak to you. And just like that, you left.

We stay there for a minute, maybe two if we have time. It is never easy. Maybe some of us are doing a silent prayer. Maybe someone is stroking your chest or your hair, a finishing touch as you go where our spirits go. Another patient comes in and we have to deal with him. It is time to move on. We have more work to do. Maybe we can save this next patient.

To get vaccinated

We are doing our best to remember you in the coming weeks. We may not remember your name. We probably remember your room or what you might have looked like. We probably remember your wife. However, what we probably remember the most, we’re not talking about how much you’ve suffered, despite everything we’ve done.

Get vaccinated! This is COVID-19.

Steve Lisowski is a registered nurse at the Salinas Valley Memorial Healthcare System and currently works in the ICU and COVID-19 intensive care at Salinas Valley Memorial Hospital.

Photo by Richard Green. Illustration by James Herrera


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