At the Humber River Hospital ICU in Toronto, there is a man on a ventilator who is really struggling.
When he arrived, his breathing was so difficult that there were only a few minutes to decide that he should be intubated.
This is the time when you will want and need the ones you love nearby.
But it is a hospital with no family members, no flowers or balloons, and the absences cry “crisis.”
He is Dr. Tasleem Nimjee’s patient, and the isolation of it breaks his heart. The same goes for the stage a few floors below in the emergency room.
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A man arrived by ambulance from a nursing home. He did not answer.
Partly because the number of tests is so low in Ontario, wait staff were unsure if it was positive for COVID-19. So they had to assume it was. That meant meticulously putting on all PPE (personal protective equipment) they could. Performing CPR on someone who may have the virus is incredibly risky.
Nimjee describes the fear of working with COVID-19 patients.
“It’s not calm when we come in to do these procedures; even we, who are trained, our hearts get carried away, “she said.
“What we don’t want is to have you do it on a case-by-case basis, that’s when everyone is most at risk.” This is when you are most likely to infect yourself. “
The family couldn’t be there
Nimjee adapted and joined the team doing everything he could for the man in the emergency room.
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He did not survive. And that’s where an already excruciatingly difficult job got tough.
She had to connect with the man’s family, who couldn’t be there with or for him.
“This is the hardest part,” she said. “When this family member begs you to do everything you can, and when this family member cannot be here, when this family member did not come with this person in the ambulance with his close to be part of this trip. ”
Conversations that would normally take place in person, smoothly, are now done by phone, the empathic voices of health workers muffled by PPE.
“We know it hurts”
And so a call from Nimjee to those who can’t be with the people who matter now – know this:
“We do everything we can for the people you love. And it hurts us that you can’t be here with them. And we want to honor that by doing what we can in your absence. And we know it hurts. “
This sadness is as often a refrain as the fear you hear in the emergency room. In the past, rescue PPE was kept in the open air along the walls of the corridor. Now it is treated like a narcotic: counted, measured and rationed. Staff have no idea if they will have enough. And if they don’t know which patients have the virus, they must burn through the equipment at a careful but prolific rate.
The thoughts that there won’t be enough one day, or that they will make a mistake and fall ill, haunt these thoughts in the middle of the night.
“So many of us have trouble sleeping,” said Nimjee. “I have never had trouble sleeping before. “
The fact that she has time to go to the emergency room to stop and talk is a peculiarity right now.
You may have seen pictures of crowded hallways in emergency rooms in Italy or New York. You may imagine the barking COVID cough that resonates in these corridors. This is not what you see at Humber River Hospital. Admissions are increasing, but gradually; they do not seem to be increasing.
You can choose to see this as a very good sign. Or you may fear that this is only part of the story, that the reality is that people deteriorate at home and sometimes die away from hospitals. Until the test numbers increase dramatically, it may be difficult to know how bad it is or how bad it will be.
Amid criticism over its low number of tests, Ontario announced last week a “renewed test strategy”, outlining its plan to increase the testing capacity of COVID-19 to 16,000 tests per day. here on May 6.
“Hope takes root”
Right now, there are spasms of calm in the emergency room. And it’s strange. There are empty berries here.
There may be fewer car accidents or injuries that send people to the emergency room. Maybe some people are wondering if they should go. Whatever the reason, it leaves staff with a heavy feeling of expectation and worry about who will go through the next door.
Do they have endurance for the long term?
“Good question,” said Nimjee, pausing before being very clear that there is no choice but to say yes and say it.
“Human beings are pretty remarkable creatures, and we are nothing if we do not have hope, we are nothing if we are not in a hurry …. and the stamina that comes from places we never expected it to come from. ”
While Nimjee and his colleagues were speaking, their conversations were punctuated by construction noises: plexiglass barriers were installed in the nursing stations. It’s just another layer of protection against their patients, or maybe the paramedics, or anyone, really, who comes to the ER.
A new day brings a new precaution. And maybe new waves of panic. With all the respect that Canadians have for health care workers now, a day in the emergency room shows that they deserve even more.