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Life Inside An Emergency Room During The Coronavirus Crisis

LULU GARCIA-NAVARRO, HOST:

Dr. Stephen Anderson runs the emergency department at MultiCare Auburn Medical Center just outside of Seattle. He's treated some of the first patients to get sick from coronavirus in the United States. He's also now coordinating COVID-19 responses throughout the country. We asked Dr. Anderson to document his experience for our Outbreak Diaries project. He says in 35 years of practicing medicine, he's never seen this much anxiety.

STEPHEN ANDERSON: March 18 - driving home from work at night - it's been a long day. And I am emotionally exhausted - going home to an empty house because my wife is in a different part of the state. I kind of feel like a pariah with my family and friends who really want to wish me well but want to stay as far away from me as they can because - let's face it - I'm interacting with everybody they're worried about.

Friday morning, the 20 - since my shift yesterday, I came back in to find the emergency department full. Everyone in the ICU at the moment is on a ventilator. Not only did everything change as far as the severity in my hospital went today, somebody forgot to inform everyone today, please don't go to the emergency department to get a routine test for COVID or because you've had two days of a cough and maybe a low-grade fever. Those people need to self-isolate at home, take care of themselves and call their doctors if they're concerned. But when you come to the emergency department - number one, if you don't have COVID, you're probably going to get exposed to it at a hospital now. Number two, if you do have COVID, you're going to expose other people who are very ill to it.

March 21 on Saturday evening - as I walked in the department, they screamed that there was a patient arriving from a cardiac arrest and that they needed me right away. I walked into the room, as the entire team that mobilizes for post-cardiac arrests do all the time. They were very efficient about organizing. And I looked around and realized only half the people had on COVID protective gear because that's not what they were thinking. It's a great team. We just screamed, no. Everybody in this room, we don't know what this cardiac arrest was caused by. I want everybody in COVID gear. And when we did their resuscitation chest X-ray, sure enough, they had the classic signs of ground-glass appearance in multiple spots on their chest X-ray, which is literally classic for COVID. And as I went out to talk to the family - found out that he had felt well enough to come home from the nursing home four days earlier. I have no hopes for this prognosis.

March 26 - we admitted someone to the intensive care unit today who wasn't going to survive. But we had an intensive care unit bed - and getting them up there just offers the family together for the necessary things that go into grieving. But in the United States today, because this is a pandemic, hospitals are limiting one visitor at a time per day. And so the COVID patients in the United States, which are dying at a rapider rate right now than anywhere else in the world, are dying alone. And I can tell you that, as a physician, some of the most rewarding moments I've had in my career are not necessarily the great save that I brought people back from the edge of death but when I helped people, when it was inevitable, to make that final journey with their families and loved ones around them. And the fact that that kind of grieving can't go on at the moment is even more tragic for patients, for families, for the nurses, for the doctors and those that care for them. Unfortunately, it's not over. We're still going up. And so I'm still going back to work tomorrow.

GARCIA-NAVARRO: That was Dr. Stephen Anderson, ER doctor at MultiCare Auburn Medical Center in Auburn, Washington. Transcript provided by NPR, Copyright NPR.

Lulu Garcia-Navarro is the host of Weekend Edition Sunday and one of the hosts of NPR's morning news podcast Up First. She is infamous in the IT department of NPR for losing laptops to bullets, hurricanes, and bomb blasts.

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