A male doctor was on duty – I didn’t want him anywhere near me, but they said there was no one else, so I gritted my teeth and got on with it. And I was angry. I had It’s why my bedroom is covered with pictures, to remind myself they exist. In this tiered system, patients are scored for age, medical problems and the severity of their current respiratory status. In a way, that job was easy. Officially, it is posttraumatic stress disorder, borderline personality disorder and major depressive disorder. It was a fraction of a second. “I think I really need to ask help to a psychologist.”. I used to say I'd fallen over.' The med doesn’t stop it completely, like the rest of my meds. It’s a Sunday, a slow day usually, but still, there’s only one patient, who’s being tended to by a nursing assistant. Their apathy and egotism almost killed me.” She would dissociate, meaning she’d lose track of her who she was, her thoughts, feelings, sense of identity, essentially, she’d blackout mentally but still be functioning physically as one of her alters. I’m almost 90 years old. I put my hand on her hand. I push these thoughts away, immediately. I go through this daily. They call families and talk to them about procedures that patients might have to undergo if they want to escalate the interventions; these doctors help figure out where the limits should be drawn. “There is a kind of grief, a sense of simmering anger, that has taken up residence in the space that confusion and hopelessness used to occupy. Several days ago, only a few patients had Covid, but suddenly it seems we have become, like facilities in Italy, a Covid hospital. I need to know what might come, what decisions I might be confronted with. On Twitter, I see a photo of resident doctors at Massachusetts General Hospital, where I trained, holding up official documents explicitly designating who should make decisions for their care if they become critically ill. All of that was traumatic and it’s what caused the PTSD. Apparently, a patient who was waiting for an inpatient bed, whose family had decided against extreme resuscitative measures, had died, without us even knowing. “The person you were coding was six years younger than me.”. I really don’t feel like healthcare institutions are set up to protect women of color.” “You were brave,” people say when I tell the story of my surgery discharge and what I had to do to stand up for myself. That’s crazy! Despite everything I know so far, I think he will do OK because he looks so well. Before the pandemic, I would typically see a fair number of nonwhite patients. It was quite a surprise. I would save the ventilator for a future someone else. It doesn’t mean anything. You have to reorganize your mind; you have to reorganize your work; you have to reorganize your personnel and health care people.”, Marco Vergano, a co-author of the controversial Siaarti guidelines, had removed the criteria from the document because he wanted to give doctors flexibility — and because he knew the criticism would be overwhelming. They get care — the best that modern medicine has to offer — with life-prolonging machines and IV drips of all sorts of critical-care drugs. I am super attached to Karen and my doctor because of this. “If you keep thinking of this problem, you can never do this job.”. He had this wonderful smile.” He continues: “Then I saw that he was looking at me. “You go on, you forget you have a person, a human in front of you. I … It’s a lot of work. I have a complicated diagnosis. A co-worker is collaborating with others to 3-D-print face shields. In the E.R., I sanitize, glove, remove glove, sanitize again. My behavioral therapist suggested I write her a letter. Then I think back to my own resident’s question: What would happen if they need to be put on ventilators? I learn that another died a few days earlier. … ” I think of all the doctors who sent their patients home because they looked well or are young or don’t have medical problems, and they came back to the E.R. He had previously decided that he did not want extraordinary measures taken to save his life; he did not want to be on a breathing machine. We have started to hold regular Covid-focused meetings over Zoom. It’s all part of the borderline. A faint abrasion has already settled into the bridge of my nose. “I knew that he was not doing well,” Duca says. “From colleagues to journalists to bioethicists — we are in firing lines these days,” Bertolini adds. I can hear their 1-year-old daughter in the background. This will end, I tell myself. And it doesn’t seem fair to me to minimize what I go through by saying things like you said. My promise to them has always been that when they come through those E.R. It took time to adjust to that idea I would never hold another baby (of my own) in my arms. His wife, an otolaryngologist, has also been recruited to the effort: She is now working in a Covid unit in a neighboring hospital. Will I, too, feel that way soon? I bring one to work, to test patients’ oxygen levels, to see how much they drop when they walk. I take anti-anxiety medication and antidepressants. While most of the specialists have been unflinchingly generous, offering extra hands in the E.R. It’s so hot. I believe it will be fairly obvious that in most of the cases where we don’t push forward with extreme medical interventions, we would not have been able to save the patients anyway. Emails come through from hospital leadership and the city’s health department telling us to be “appropriate” and conserve our N95 masks. The evening before I’m due to return to the hospital, a colleague messages our group to say that a 49-year-old Covid patient of hers, who was waiting in the E.R. I’m told we will give them to patients soon, so they can monitor themselves — and maybe to-go oxygen containers as well, if they’re needed. “I ask myself if I’m more useful if I go outside my home, take paper and alcohol and disinfect the doorknobs of my neighbors instead of going to work as a doctor,” he says.