I noticed him the other day, as I made a left turn at the light.
He wasn’t there a week ago.
He must be new.
Nobody I recognize, but then again, his face is blurry and indistinct.
I look at him now, and I drive past. 1/
Arriving at the hospital, I park my car.
More ghosts here, even in the parking lot.
Some of them stand beside empty cars and look into them wistfully, as if wishing for keys to unlock their escape.
I recognize some of these ghosts.
I look at them now, and I walk past. 2/
The hospital is busier than I can remember it being… ever.
The ER looks like a war zone, hallways filled, ambulances lining up outside.
“Don’t they know we’re on diversion?”
“Who knows man, they came here anyways.”
I grit my teeth and make sure my N95 is tight. 3/
The COVID wards are being reopened, again.
This time, however, it’s different. There’s no sense of imminent danger like there was before.
The feeling of fear has been replaced by a grim inevitability.
Return to work, fast as you can.
You are expendable.
You always were. 4/
It makes me think of World War I and trench warfare.
We keep digging these trenches to nowhere and convincing ourselves everything’s okay, only to hear the whistle again and be given the order to charge.
And so we charge into No Man’s Land, side by side.
Surge by surge. 5/
I get off the elevator at the ICU.
Nowhere in the hospital are there more ghosts than here.
They pace the hallways.
Angry, at the way they died. Disbelieving. Disoriented at how fast it happened. Feeling cheated.
They all want something more.
More than this. 6/
COVID patients are short of breath, again. I’m looking at the same damn chest x-rays, again.
They tell me this is a milder variant.
What does that mean? “Milder?”
Can you please sit down and explain it to the ghost outside that room over there?
That it was only “mild”? 7/
Oh I get it. I understand the stats, and the low likelihood of serious illness.
I get all of that.
I just don’t see it.
I see another full hospital.
I. Am. So. Sick. Of. This.
All that remains of me is raw exposed nerves, and deadened scar tissue, in equal measure. 8/
I don’t understand why some events leave such a collective mark on our psyche, while others we’re supposed to just let slip away.
800,000 people dead and counting.
We aren’t equipped to grieve on that scale. But we can, we should, acknowledge it instead of pushing past. 9/
That’s all so many of these ghosts want.
Acknowledgment.
One of my last patients of the day is also my sickest.
This is a pattern I have seen many times before: lungs too ravaged to salvage, multi-organ failure, kidneys struggling to maintain their beloved homeostasis. 10/
As I look at them through the glass door of their room, the plastic protective isolation sheets make their face blurry and indistinct.
I confer with the intensivist and the cardiologist.
We all agree, there’s not much left to offer, besides comfort.
The end is inevitable. 11/
I write my note and leave before the family arrives. Normally I would stick around for this conversation, but today I leave it to the intensivist.
There is a gravity in the presence of death and dying that exerts a palpable force.
I can only be exposed to it for so long. 12/
As I walk along the ICU hallway, I notice that the ghosts are gone.
They tend to clear out when Death makes its way through, stopping outside its assigned room.
In a detached part of my mind I can hear the sobbing of a family in the consultation room.
Weeping in unison. 13/
Back in the elevator, I close my eyes and breathe deeply.
Almost everyone I see these days tells me I look tired.
Time off helps, but it’s a temporary salve. My writing helps, again, only temporary.
Gotta get to the root of it all.
Where the ghosts live.
I can’t today. 14/
At the end of the day I head back to the parking lot.
As I walk, I remember a conversation I had earlier in the day.
“Did you know in some languages the words for “tomorrow” and for “yesterday” are the same?”
Time is a circle.
We only perceive the direction of its flow. 15/
A time will come, after COVID, when our society will need us to rely on each other to do the right thing again.
There’s a ghost on the corner of 3rd and Broadway
I noticed him the other day, as I turned at the light.
He wasn’t there a week ago.
He won’t be gone tomorrow.
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“They just told me I have cancer. It’s everywhere in my body. And you say you’re a kidney doctor? What the hell are you doing here?”
His voice is gruff, and as he looks at me, I feel the weight of his gaze.
For a moment I hesitate, then ask.
“Mind if I sit down?” 1/
“What do I care, you’re gonna be gone in ten seconds anyways. Nobody sticks around, tell that chickenshit doctor who hasn’t seen me in three days that I know he’s gonna bill me anyways.”
I don’t speak. Not now.
He continues, “Sit down, tell me how bad my kidneys are.” 2/
The harsh truth is that my day would be easier if I didn’t sit down.
If I just stood at his bedside and spoke fast, did a perfunctory physical exam, and moved on.
The system incentivizes me to see more people, faster. And the faster I’m done, the faster I can go home. 3/
They say your first overnight call shift is the worst.
It gets better from there.
Every day you’re learning a little more.
I’m headed into the hospital on a snowy evening. Supposed to be some sort of record storm tonight. Thick clouds rolling in all day.
Overcast skies. 1/
I’m going to be the night-float intern. It’s my first overnight shift.
My heart is racing with adrenaline. A semi-queasy feeling, laced with excitement.
I enter the house-staff lounge to get sign out from the day teams.
They give me updates and tasks.
Then say goodbye. 2/
I will never see them again.
I don’t know that yet.
The shift begins as the clock strikes 7PM. Together with my fellow interns and residents, I start heading to the floors to begin my night-float rounds.