I pressed the dome of my N95 solidly onto my face and stretched the tight yellow straps over my head. Next came the face shield—hurriedly 3D printed at a local university when demand had far outpaced the supply—which was hung vigilantly in front of my mask and glasses. I was now ready to enter the unit, bedecked in the smothering equipment that would not leave my body for hours to come.
For the months prior to a few days before my first shift, our institution had restrictions in place on medical students’ responsibilities regarding COVID positive patients. At first, this reflected the severe PPE shortages that threatened the whole nation, but as time wore on it was maintained by inertia and some vague mumblings about ‘risk management’ on the part of medical school administration. In the past weeks, the number of cases in my community exploded, and with it, the local hospitals expanded to meet the demand. At the hospital with which my medical school was affiliated, the “COVID rooms” gave way to “COVID Floors” and in the past 3 weeks the “COVID Floors” subsumed the hospital towers they occupied, until it became more convenient to identify where the isolated non-COVID floors were located. With the exponential increase of COVID-positive patients came the need for more bodies and more help on the wards. Thus, my medical school reversed its earlier decision and established a rotation for M4 volunteers
It was in one of these hospital towers converted to an isolation ward that I began my COVID rotation. I applied my mask in what was once a patients’ room but now served as a staging area for donning PPE. I stepped from the room into the bustle of a busy hospital floor—nurses rushing from computers, deftly slipping into their gowns and gloves and entering the rooms to tend to patients. The swishing of plastic gowns was ubiquitous, and every hour a saccharine voice would announce on the hospital intercom that “For the safety of all, everyone must wear a mask at all times.”
I took a deep breath, which lingered within my N95, and began to seek out my patients for my first day on the COVID ward. The process of entering each new room was carefully scripted by infection control. Each precaution—gown, gloves, and hand hygiene—I had done thousands of times before, but somehow, in the uniqueness of the setting, I fumbled haplessly through each step. Finally, after much difficulty, I was able to enter the room and greet each patient. As the most junior member of the team, the attending had been careful to give me the least critical patients but even so, with every new patient, my casual, “How ya doin’?” was invariably answered with, “Terrible,” rasped over the ever-present hiss of oxygen.
After I had seen my patients and pended my orders, rounds proceeded with eerie normalcy that was interrupted only by the tedium of donning and doffing PPE at every door. Rounds occupied most of the morning, but once they were done, I was able to finally remove my N95—which by that point felt like it had melted onto my skin. Despite having to immediately apply a procedure mask, the freedom to breathe cool air was rapturous, and for a moment I stood alone in the cleanroom, eyes closed and breathing. I thought of my patients’ ravenous need for oxygen, and in my mind’s eye, I multiplied those gasps across the dozens of rooms that spanned almost the entirety of the hospital and took one more indulgent breath.
It will be a long month.
