Heart of EM, COVID-19, Wellness

Heart of EM: I Answered

I answered the phone.

I had many reasons to do this, I’m sure.

I was waiting for a consultant to call back.

The clerk had answered and asked any doctor to pick up the line.

The constant ringing of the phone had been driving me to distraction.

None of these are correct. All of these are correct.

The ED is busy. It's never NOT busy, but today it is filled to the brim with people who can't breathe. People on oxygen via tanks or the wall or our own makeshift breathing devices. People whose oxygen is running out. People whose time is running out.

The room is mine, I know them all. The fear is mine, I don't know enough.

Somewhere, someone in this room is running out of oxygen. I check, and check and recheck to make sure there is enough. Won't there be enough?

Most of these people should be in the ICU, but if you think the ED is full, you should see the ICU.

So, I answered the phone.

The voice on the other end of the line is afraid. His mother is in the ED, you see. She was admitted and he needs an update. He has been calling other lines but they have been busy or rang without an answer.

But I answered the phone.

I tell him that she has been admitted and so she is not my patient. The ED is a strange place where strangers you don't know become yours. You see them, you treat them, you care for them. They are yours.

So, she isn't mine. But as the senior resident in the room, they are all mine. I have checked on her many times. I know her oxygen requirements. I know she wasn't doing well on a face mask, and that I put her on our own makeshift mask to give more, to help more, because we are out of bipap machines that come from a store. So a mask and a valve and some tape are her shepherds through this illness.

I read the chart and give him an update. It is the only information I have. The voice on the other end of the line tells me he works in an ICU. He knows the monster we fight. He knows it is cruel. The voice tells me he knows what her "increasing oxygen demand" means. He knows she may need a tube to breathe. It's his mother, you understand. He wants, no, needs, to see her. Please.

He tells me he loves her and his voice cracks. He tells me he wants a chance to say goodbye. I want to tell him it will be okay. She is doing better on our mask. But he has read our play. He knows my lines as well as I do.

My shift ends in an hour. I have too many patients, too many of whom are unstable. I don't give my number to unknown voices at the end of a line. But my heart  flashes to my father, to my mother. If they were in a hospital alone and scared, I would take it apart brick by brick to get to them.

This is not my responsibility. This is not my load to carry. But I answered the phone.

I give him my name. I take his number. I will call him, you see. As soon as my shift ends. I will video call him and let him see. Let him know. The tears and gratitude that meet this promise are too much for a phone call.

So I tend to the room. To the patients who are mine and to the ones who are not. When the work is done… well, not done - for it is never done - but no longer on my shoulders, I slip away to make a call.

He can barely see me. The mask, the gown, the glasses, the armor that separates me. The armor that saves me.

I warn him that she is tired, but awake. She is aware, but may not hear him over the mask, keeping death at bay.

He holds well when he sees her. She smiles through the mask and gives him a thumbs up. I don't speak the language but the heart knows what "I love you" and "I miss you" sounds like in any tongue. He is praying, I realize, and I shouldn't be there. This is a private moment with more emotion than can be shared. My presence is unnecessary. My presence is required.

Because I answered the phone.

He prays and he cries. And I ask his God and mine to spare her. To make her the one miracle in a room that needs it.

He isn't holding as well now. The tears flow fat and thick down his face as he says what may well be his last words to his mother. I know not how to end this call. How to tell him his time is up, so I stay there with the phone until he says he's done.

He tells me, thank you, and that he is grateful. He calls me beautiful, heroic words that do not fit with what I did. All I did. I had only answered the phone.

I wish him well. I tell him that I will keep checking on her. I will remember her name and remember his pain.

My shift ends, and I go home. I awake later in the day to find she has the tube now. I pray again to my God and his and any other that may be listening, because somehow she became mine and we are always selfish with what is ours.

The ED is busy and no one can breathe, until one day, not enough days later, I see the note in her chart. The darkest words each new doctor learns to mumble. Time of death.

The memory isn't mine, I rage, and I shouldn't have to carry it. But as a mentor long ago taught me, sometimes a doctor's greatest gift is the ability to bear witness.

So I wipe the tears I did not cry for the patient who wasn't mine... and I answer the phone again.

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