The Brink

The inevitable is coming.

C, E, and I sit in the cafeteria. We're on ambulatory this week, and the clinics have begun to transition to telephone visits. They didn't really need us residents in Oncology clinic this morning. Only the patients on active chemotherapy regimens came in today; the rest were told to stay home. The attending told us to come back at eleven to see if there were any patients we could help see.

C went to medical school in New York. His classmate in NYC who's rotating on ICU is telling him that there's 200 patients in their hospital who tested positive, 200 more pending test results. The situation with PPEs has gotten so bad over there that the residents are being told to wash their masks for reuse. The admin here won't tell us outright, but the rumor floating around is that there are 4 active cases currently hospitalized in our hospital with 50+ tests pending.

I went to medical school in New Orleans. The ghost of Hurricane Katrina was ever-looming, with the medical school in the shadow of the abandoned Charity Hospital next door. We had attendings who were there when the waters flooded the hospital, when the ventilators lost power and patients had to be manually bagged until they were too far gone. I confess, there were times when I would imagine what would happen if I were the one having to make the uncomfortable judgment calls of having to triage lives. Since moving back to California for residency, the possibility of a major earthquake in Los Angeles had led to similar morbid imaginings.

With a viral pandemic knocking at the door, it's a little odd how unchanged my daily routine has been. I wake at the same hour and make the same commute to the hospital, albeit with considerably reduced traffic. I was waiting outside an onigiri shop for take-out the other day, and this guy also waiting for his order was telling me, "Man, isn't it weird working from home and not being able to go out to bars after work?" Life goes on.

I try not to read the news for too long. Inevitably I end up reading about idiots somewhere in the world, whether it's the Spring Breakers flocking the beaches in Florida or the churches packing their pews because they think this is a hoax or the hoarders filling their shopping carts with an ungodly number of milk gallons, and then I start to rage-stroke and have to close my phone.

An earthquake announces its presence with immediate havoc and destruction. Not this eerie calm that has snaked into the city, while the rest of us in this hospital wait on the brink of the inevitable. We know we're probably going to catch the virus. Most of us will probably be fine. But there's always the chance that some of us will end up like the cases you read about in the news. There was a NY Times profile about two 29-year-old female healthcare workers in China who got COVID-19. Only of them survived. One was a nurse, the other was a gastroenterologist. The latter went into cardiac arrest and multiorgan failure before dying.

For me, catching COVID-19 isn't what's causing that pit of dread, so much as that anticipation of what will happen when our hospital becomes overwhelmed.