Dr. Qanta Ahmed: Coronavirus – A tribute to patients and their families from an ICU in New York

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Respiratory therapist couple keeps ventilators running in NYC

Respiratory therapists Bryan Zabala and Jennifer Cubero, who have two kids at home and one on the way, open up on 'Fox & Friends' on helping COVID-19 patients.

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It was my first morning assuming care for the critically ill COVID-19 patients at New York University-Winthrop, part of the NYU Langone health system. I was reviewing my patients’ computer records. Across the room, my colleague was doing the same.

As I made plans for each patient and marked annotations, my colleague, also an attending pulmonologist and critical care specialist, picked up the receiver and began dialing to update families anxiously awaiting news of their loved ones.

I listened to his careful, measured tone, and the brevity of his kind words, conveying so much. He made similar calls to three families in succession. When he finished the last phone call, I was devastated knowing that all three families were losing their loved ones that day.

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My colleague and I shared a glance at the immense sadness of it all, the sorrow writ large on his face.

New York is the epicenter for coronavirus cases in the United States, with more than 100,000 cases in the state and more than 3,000 in New York City alone. Globally, there are more than 1 million cases and more than 70,000 deaths.

Out of necessity and a desire to be of service, I stepped back into the critical care unit after a decade-long absence. I couldn’t stand by while my colleagues who practice critical care medicine full-time were becoming exhausted and as the American public needs so much critical care. I was happy to be able to help even though I was afraid.

These families, these quiet Americans, are the unsung heroes of this calamity.

I was fearful that I would not remember everything I needed to remember. I was worried about failing my patients. But within hours of meeting the first few patients on my morning rounds in the intensive care unit, all my training came back. If anything was not immediate, a friendly colleague readily showed me.

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The incredible teamwork that makes for great medicine could keep me and my patients safe. I treated my patients with traditional practices I learned over a 30-year career, but also with the latest nuances and innovations shared by my younger colleagues.

Junior staff doctors who finished medical school a year or two earlier, interns and residents all supported me and brought into sharp relief how much the most seasoned and credentialed senior doctors are in need of these willing and extremely enthusiastic young health care providers.

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I was grateful for my house staff, 29 years after I was an intern myself. And in this strange week, I was working with three of my colleagues who had trained with me decades earlier.

As we compared notes on our patients and management, we gave silent thanks for our mentors and professors who had trained us in the very same building a generation ago.

I still carry my triple board certification, but my boards are meaningless without the amazing teamwork good medicine demands along with a foundation of knowledge rooted in excellent education from generous teachers.

I am in awe of how our collective intelligence got us through an intense week at a historic time. And still more needs to be done, with recent predictions that more than 5,000 New Yorkers will need to be in ICUs.

We were fully protected in various levels of personal protective equipment, even as some cities and states suffer shortfalls and report dire need. We were mindful of each other; if a gown was not on correctly, or a doctor, nurse or therapist forgot a certain item, we were quick to correct.

I witnessed the amazing strengths of the electronic medical record system in this pandemic crisis, offering the ability to be agile to scale at a time of disaster and an incredible asset as I made many decisions about desperately sick patients.

I could read the ventilator settings at the bedside from the safety of a computer in another room. I could order minute by minute changes without approaching the environment where infection risk is very high.

I witnessed firsthand the ingenuity of colleagues converting non-invasive ventilators into intensive care unit tools, elsewhere my colleagues are already using 3D printed components to convert devices into life support machines and sharing that data with us, and I worked with surgeons providing the maximum support to the sickest patients on ECMO machines.

A boost was how patients’ families offered gratitude and support by telephone.

As I later made similar anguished phone calls just like the one I first watched my colleague make, it was the quiet dignity and enormous trust families around New York offered that gave me hope.

Families who would never know my face, never know me in person, families I could never meet and console with a hand on their shoulder, families with whom I could never shed a tear in person, offered me the greatest encouragement.

They spoke of God, announced aloud their prayers both for me and all the medical teams working on their loved ones. These were the Americans who told me what my patients did in their day to day lives. One was New York Police Department detective; one an accountant at a car dealership; one an office worker at a doctor’s office.

Their families helped me build an even deeper connection to the critically ill person I was examining through all my layers of protective equipment.

These were the same patients who gave me consent to put them on life support, who were calmly waiting for us to sedate them as initiated the artificial breathing machines -- one of the most dangerous and precarious times in the course of treatment for the coronavirus patient.

These families, these quiet Americans, are the unsung heroes of this calamity.

As this one hospital surged toward 150 percent of its usual capacity, state and federal leaders offered support with resources big and small. Local communities offered meals that arrive around the clock.

Yes, the crisis will deepen before it flattens. But many of us in the medical field have confidence knowing that New York Gov. Andrew Cuomo and President Trump are collaborating on best practices to save lives and prevent the spread of the pandemic.

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We are thankful for them.

This nation will come through this unprecedented pandemic stronger. When COVID-19 is vanquished, Americans will emerge battered and humbled, but ultimately victorious.

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