Thread by @rn_critcare

My pt *Tim was admitted with Covid. A relatively healthy guy. Exercises more than I do if you don't count the steps I put in at work.

It's rare that Covid patients are already intubated before coming to the ICU, which can be both a blessing and a curse... ICU + covid =

Not a great combo.
But it does give us a chance to get to know our patients.

Tim was doing ok with self proning, he watched his oxygen levels and flipped himself over for "tummy time" to get them up again when they were low.

He's been here for weeks so he knows the drill.

I try hard to connect with my patients on some level, either through food, family or music. It helps them relate to me and reminds them that I am human too. I think it's paramount to building trust.

Tonight we talk about food. It's a safe starting topic.

I ask him what his favourite food is. He says he loves everything, his mom taught him to appreciate all variety of food. He wasn't allowed to say he didn't like it before he tried it. I tell him that's how I raised my kids too!
He is upset that his appetite is poor lately.

He says it's so much work just trying to breathe, he can't concentrate on eating too. He agrees to at least try to drink some ensure for the nutrition & protein.

I ask him if he could go to any takeout place what would he get.

Broccoli soup from the deli across the street.

Seems simple to me but the way he talks about the cheddar cream base with the perfect blend of spices and fresh broccoli I can tell he's thought about this a great deal.

He says it was the last thing he ate before he lost his sense of smell and taste. Before Covid.

I leave him to rest but reassure him I'll be back to check on him.

Overnight as I'm sneaking around his room he calls out, "Mom? Mom!"
I turn the low lights on to show him it's me. He is sweaty & flushed. Check his temp and he has a high fever.

"I'm sorry to wake you Tim"

"No it's ok, I think I was awake anyway. I was having a bad dream."

Anything you want to talk about?

Everytime I sleep I dream about death. My mother's death and then my own. I was there when she died & she's trying to come back to get me...

That must be so awful for you, I can't imagine the fear you have right now. If it helps, you are doing better & we are hopeful that you won't need to be intubated.
He turns onto his side, his way of letting me know that he doesn't want to talk any more. He reaches for the remote

BREAKING NEWS: The projected death toll for covid is splashed across his screen.
No wonder he is having nightmares I think to myself. Out loud I gently suggest we turn the tv off and he readily agrees.
The shift ends without incident, something we are both grateful for.

My days off are spent in the usual manner: restless sleep, articles texted from well-meaning loved ones, countless emails with daily updates from the hospital.

There is no escape from it.

I wonder if I can morph into a slug, I think to myself after my 3rd glass of wine...

I text a co-worker to check in on Tim the day before my return to work.
"He looks good" is the reply I get. This perks me up a great deal. As I'm driving home from getting groceries I pass by the deli & remember Tim's favourite soup. Next thing you know I'm ordering it...

Driving to work the next morning with his soup tucked safely away in my bag I start to wonder if this is even appropriate. Maybe I'll say it's today's hospital special. Maybe I'll just say I got it to test his senses. Maybe I'll just eat it for myself.

I go to his room & there is already a team in there. I try to remember who they are, I feel like they were there for our last head trauma. Neuro. Damn. Why are they here?

"Poor guy. We are seeing so much of this with Covid. This stroke was extensive..."

I want to throw up.

I quickly leave his bedside and find my assignment for the day. My coworkers are chatty & laughing about a funny meme. I join in & laugh too, ignoring the pit in my stomach. I push myself to be present with my patient for the morning and try not to think about Tim.

I finally sneak away to lunch & open the bag with the soup. I almost throw it out but decide not to waste it.

Just as I'm sitting down to eat my coworker comes in and says, "Oh does that taste as good as it smells?"

I choke back a scoop to hide a sob threatening to burst.

I can't do anything about the stroke. I can't do anything about covid. I can't do anything about the public perception of Covid.

But what I do now, is about once every few weeks, I order my favourite soup & let my senses take in all the deliciousness it has to offer.

Someone once told me the senses are the ministers of the soul. I'm not sure about that but I do know that on these solitary lunch dates I try to reset, refuel & refocus. It's funny how soup can do that. Or maybe it's the lesson from Tim, one of my first of many covid patients

Tim "survived" covid & even his stroke. He can't talk, walk or feed himself. He will be forever changed with lifelong deficits.
But because he's alive he goes into the 99% survival rate category. I'm not sure what his opinion on that would be.

I am sure we both hate Covid.