(This is my fictional perspective as a patient in the ICU)
The awareness arises in surges. Sometimes, it afflicts me like a lightning bolt, and at other times caresses like a gentle nudge. I prefer unconsciousness to awareness. Awareness frightens me. It confuses me.
Where are my kids, where is my husband, why I am not at work?
My memories are filled with fear, sorrow, yearning, weariness and then nothing….
I remember not feeling well. It had started with a sore throat; fatigue pummeled my body, and an unrelenting fever wracked my bones with shaking chills. I lay in bed, petrified, awaiting the results of the nasal swab that would confirm my diagnosis of COVID-19. I had tried to ride it out for over a week, in isolation, locked away in my room, as my family left food outside my door. We face-timed, when I had the energy, although we were in the same house. We were lucky that we had perfected this routine prior to my falling ill.
I had been so vigilant. I was an intensive care doctor, during a global pandemic. A pandemic that had caught us unprepared, ill-equipped, without adequate tools to protect ourselves, as we tried to help others in need.
I had channeled my fears into planning and keeping my family safe. I had self-isolated in my room, decontaminating at the door, keeping a safe distance from my kids. We had a couch in my room that the kids could use, when I came home from work, tell me about their day, spend time with me; we named it the ‘companion chair’. I had not hugged them in months. My husband slept in the guest room. I had my meals in a designated corner in the house that no one else was allowed to approach. That routine was comforting, it made me feel proactive. What could be more important that protecting my family?
It turned out that protecting myself was more important. And I had tried my best. I had access to N-95 masks, in limited supply. We got one mask per day. I held onto paper baggies with used masks, just in case we ran out. I hoarded them my locker at work, my office, my car trunk, my garage. I was mindful when donning and doffing. My hand hygiene had taken on a life of its own since my life literally depended on it. I had intubated many patients with COVID-19. It had been nerve-wracking to watch their saturations plummet into the teens and twenties for uncomfortably long periods of times, as we waited for the ventilator breaths to rescue them. I coded patients and watched many succumb, as the virus was aerosolized in rooms where I tried not to breathe too long or deeply. But breathing was synonymous with living and live I must. For my family.
I was forty-three years old. I was a decade under my belt, into my chosen profession, comfortable with nearly anything that came my way. I even took the pandemic in stride. I made the necessary adjustments in my personal and professional life. I was used to sacrificing, my needs, sleep, bathroom breaks, food, holidays, vacations, time with family. The pandemic just intensified the sacrifices.
I had driven myself to the hospital when my saturations started dipping into the eighties. Driving myself was probably not a good idea, but I could not expose my husband. He had to remain healthy for our kids’ sake. My colleague had arranged for my direct admission, and I was whisked away into an isolation room. The oxygen canula felt like a lifeline, air flowing into my lungs, replenishing my cells, energizing my body. I thought I would be OK. But the virus had other plans. The monitors in the room kept beeping incessantly, and within four hours I was hungering for air again. The nasal canula was changed out for a mask, then high flow oxygen. I sat bolt upright, holding onto my knees. This posture helped my breathing muscles get some relief. My heart pounded in my ears and sweat beads formed on my upper lip. I knew I had to prone, but the mere motion of trying to lay on my stomach was too much exertion. I started to crumble, the world became dark, and I felt like I was drowning. I heard the nurse scream at me, ‘Dr Khan, wake up, take a deep breath’, I tried to follow her directions, but the breaths did not follow, and my consciousness started to fade. I had a vague memory of the CODE-BLUE call overhead, of being pulled and shoved, of many hands on my body, and then it went blank.
When I came too, I was in the same room, my eyes focused on the monitor and then the ceiling. I tried to sit up, without success. I attempted to move my hands and feet, but felt a tug, was I restrained? I tried to lift my head and felt the plastic in my mouth, an uncomfortable gag reflex confirmed the intubation. I saw my heart rate on the monitor, 110, 120, 130, 140. I felt the beads of sweat on my forehead, my chest felt like it was in a vice, my lungs burned like the time I had inhaled water in the swimming pool, I coughed and gagged intolerably, gasping for breath, for air, for life. Then there was nothingness…. relief.
‘Mom, I hope you feel better… Mom CAN YOU HEAR ME!….we are starting a new unit at school, Kevin is my partner ….’ And then nothing. When I woke up again, I heard the comforting voice again, ‘Mom I got to present today, Ms O’ Hara really liked my story…’ I resisted the urge to sleep, I pulled myself out of the nothingness, I wanted to hear his story. My son was an introvert and he had been the presenter at school, I was so proud, I wanted to tell him, to show him my pride. Consciousness came in small waves and buoyed me up long enough to open my eyes. I saw my sons face, on an iPad screen, were we face-timing? I tried to smile but bit on plastic instead, I tried to move my hands but felt them restrained, and then the panic set in and I started moving my hands as vigorously as I could, the monitor started beeping incessantly and there was nothingness…..again….
I felt a touch on my shoulder, a soothing voice, calling my name. There was a familiarity there…. I opened my eyes and saw her, my friend, my colleague, donned in her protective helmet and gown. I tried to sit up but had no strength. Her calming voice told me to relax. I listened as she explained my predicament. I had been in the hospital for two weeks, on the ventilator, but was making progress. My oxygen level had stabilized, and they were waking me up to see if I could breathe on my own. I felt the vice grip my chest, my breaths became rapid and shallow and terror and panic set in…. the monitor started beeping, and I flailed my head from side to side…..’NO’ ….I screamed but there was no sound, and then there was nothingness….
My eyes flickered open as the hand on my shoulder gently stroked me into wakefulness. My colleague was explaining that I was waking up and needed to relax and breathe with the ventilator. I comprehended what she trying to tell me. I was on high alert. I understood the stakes. I was on a spontaneous breathing trial and had to demonstrate that I could breathe on my own. I put all my effort and concentration into the task at hand. My breaths felt shallow, my chest felt heavy, the plastic tube in my mouth induced a gag reflex every now and again, but I maintained my focus. She told me she would come back to check on me in an hour. The monitor did not beep. I kept concentrating on each breath, as I waited. When she returned as promised, she took my hands out of restraints and I gripped her hand with a death grip. My eyes conveyed my desperation. Her eyes smiled back at me and told me to hang on just a while longer, she was going to extubate me. I felt tears on my cheeks and my head started bobbing up and down like a boggle head … I was ready.
Extubation is not elegant. There is saliva and gagging and grossness. But it is over in a few minutes. I was liberated from the ventilator, just like that, and my body felt like it had run a marathon. My breaths were shallow, I was too tired to take deep breaths. I felt the nasal canula in my nose, and the air was refreshing and cool. I dozed off…. I was alive….and that was all the effort I could muster for today….
(self published @Medium)