Tony Scott - Along Came COVID - Love and Loss in the 2020 Pandemic

“We can manage. They are,” Ann said.

Haley said, “No, they aren’t. They are trying to figure out where to put all those critically ill patients.”

Peggy wanted to stir the pot. “ICU occupancy is about ninety percent all the time. No hospital can afford to have empty ICU beds on a continuous basis. So, there isn’t much space available for something like this. We might have to stop doing elective surgeries that require ICU beds to accommodate the epidemic, then resume when things settle down.”

“That would throw a wrench in the works for patients who need heart surgery or big cancer surgery. How do we deal with that?” It was Ricky. “We figure out which ones can wait, like surgery for weight loss and joint replacements, but there are a whole lot of people who need intensive care when they need it.”

“You wouldn’t be able to delay transplants,” Haley said. “When you have the donor, you have the donor. And auto accidents.”

“Out here, we won’t have as much transmission because of our low population density,” Ricky said. “You’ll see.”

“Shut up, Ricky.” She put her phone to her ear and listened. “Yes.” She ended the call. “Our patient in ICU is positive for coronavirus. That’s our first pregnant patient.”

“OK,” Peggy said, “it’s going to get real now.”

After rounds had ended, Faith and Josh suited up and entered the coronavirus patient’s room. “Good morning Reyenne,” Faith greeted her.

“Good morning,” the wheezy subject answered. Her eyes were sunken, she was straining to breath.

“This is Josh, one of the other doctors here. His last name is Menkowicz, but Josh is easier.”

Josh looked at the pulse ox reading, ninety-three percent. He looked at the blood pressure, slightly elevated. He noted the elevation of respiratory rate. “Have you been coughing?”

“Yes, I just had a fit of coughing. Sometimes I cough so hard I throw up.”

“We understand,” Faith said. “Do you have some family here?”

“No. They were told to stay away. We talked for a few minutes by Facetime, but I fell asleep.”

“Your coronavirus test is positive.”

“They told me.”

“You know we’ll take the best care of you we know how,” Faith said.

“I know.” She paused to take a few breaths. “Am I going to die?”

“Not if we can help it,” Faith said. “We will do everything we can to prevent that.”

“What about my baby?”

“We don’t know everything there is to know about this virus, so we are playing it by ear, but we have not heard that it is bad for the baby. Just for you.” Faith, in gloves, held Reyenne’s hand.

“Why won’t they let my mom come in?” she whined.

“We don’t want her to get infected. We need to contain this as best we can. Neither your family nor other patients in this hospital need this disease.”

“I hate that, though,” Reyenne said. “I wish someone could sit with me.”

“I understand,” Faith said. “I would feel the same way. But for now, we need to be careful.”

“Please come back and see me,” Reyenne said.

“I will,” Faith promised.

The two wandered out of the room as the patient started to doze. In the hall, “Reyenne really doesn’t look good to me,” Josh said.

“Nor to me,” Faith said. “What disturbs me the most is how fast she is getting worse.”

“I wonder what that means,” Josh said. “I wish we knew more about this disease. What the prognostic signs are, which medicines work, which medicines don’t work, what lab tests should we watch.”

“I agree.”

They wandered toward the elevators on their way back to the Labor and Delivery charting station. On arriving, Ann was at the desk.

“Reyenne looks terrible,” Josh said. “I wish there was more we could do for her.”

“Me too,” Ann said. “What did you tell her?”

Faith’s voice quivered, “We told her we would take care of her the best we could.”

“That’s enough. That works.”

When work had calmed down, Faith and Josh went back to talk to Reyenne. “Do you have a husband?”

“Not anymore. He left when we found out I was pregnant. He didn’t believe the baby was his. He said some doctor told him he couldn’t ever have children.”

“I’m sorry. Are you excited about the baby?”

“I was. Then my husband left. That hurt me, but now I’m slowly getting excited about it again.”

“Have you thought about whether you want a boy or a girl?”

“Dr Ann thinks it’s a girl and showed me on the ultrasound. I already have two boys. I want to dress her up and take her out. I like to sew, so it would be fun to make her things to wear.” Her voice was thin and tinny, her eyes moved slowly to Faith and then Josh. “My mom says it is just as fun to make clothes for a boy, dress him up and take him out, but I like pink and lace and fluff.” She closed her eyes long enough that Josh thought she might have fallen asleep. When she opened them, “Do you have children, Dr Faith?”

“No. Someday I would like to.” More information was not appropriate.

The patient drifted off again, but Faith sat and held her hand. “Go do what you need to do, Josh. I’m going to sit here for a while.”

Josh took the hint and wandered away, thinking he may have seen the patient alive for the last time. If she died, it would be the first patient to die that he had taken care of in his life. While he knew the day would come, as it does for any physician, it made his spirit churn. He thought about what Faith must be thinking.

After rounds the next morning, Reyenne was on a ventilator when Josh and Faith arrived at her ICU bay. This time, her pulse ox looked better, but she still had sunken eyes, and her skin was sallow. Josh looked at Faith. “I’ve never seen anyone die.”

“Jeez, Josh!”

“Well. What does it look like?”

“I don’t know. Maybe this.”

Together, they scanned the chart in the bedside computer. The patient had received regular doses of Tylenol for fever, had her oxygen setting on the ventilator adjusted several times, and had received her steroids. She had an arterial line in her wrist so that blood gas specimens could easily be taken, and blood pressure and heart rate could be continuously monitored. She had a fever.

“I don’t like this at all,” Faith whispered. “What do we do? Just stand here and watch her die?”

Josh wasn’t calm. “We don’t have anything else to offer her. We don’t know what works, anyway. Come on, Reyenne, it’s up to you now, girl.”

The two wandered away. They were both quiet at afternoon rounds and quiet in the apartment when they got home. Faith talked to Natalie briefly. “This patient we have looks really bad,” she told her sister. “Josh and I talked about what it looks like when someone is going to die.” There was a pause. “No, I just wanted to talk.” Another pause passed with nothing audible from Nat. “I’ll talk to you later. Tell Mom I called.”

“Just think, what if this were Natalie or Marla,” Josh said. “What if it were one of our parents. We would want to visit, we would want to hold their hand, and we would want to talk to them all the time.”

“If she dies, she leaves two other children behind. Who is going to take care of them? Where do they go? What will they think when they grow up?”

“Wow. I didn’t think of her other two children. Two boys. Two brothers with no mom.”

Faith didn’t say anything. Finally, she reached over, kissed Josh and said, “I’m exhausted. I have to go to bed.”

Josh sat and stared at his laptop for a long time, ingesting none of the information in front of him. Giving up on learning anything, he headed for the bedroom. He sat on the edge of the bed and watched Faith sleep for a long enough to contemplate her as a mother and savoring the idea that a little person would soon share this bed. That night, he held her especially tightly, as though she could slither away if he weren’t careful.