The waves came and dissipated. We weathered the first four waves. It was tough, we lost many, but not unexpectedly. In the first wave, we were caught completely unawares, unprepared, like a deer frozen in headlights. We got through the mayhem. And we regrouped, another three times. We learned from each wave. Our protocols and therapies improved. We felt like we had something to offer. We witnessed that some patients improved and went home. I saw a few of these patients, who were so sick in the intensive care unit, come back in clinic months later, for lingering respiratory symptoms. But at least they were alive, at home with family, that was something.

This fifth wave has been the hardest to weather. Hope had come in its best form, as multiple vaccines with proven track records. The benefits far outweighed the risks. The data kept piling up, yet vaccine skepticism grew at the same pace. 

This fifth wave was preventable in its entirety. Unlike the previous waves where the average age of patients in the intensive care units was in the seventies, I can remember only two patients in that decade of life in the last wave. Why was that? Was it because most people in their seventies and eighties had died in the first few waves? No that wasn’t it.The average age of patients in the fifth wave was forty. Which translates to a fair number of patients their twenties, thirties, forties, fifties, and a handful in their sixties, and just two in their seventies.  What did they all have in common? As you may have guessed, it was their unvaxed status. Most of my patients were unvaxed young men in their forties. Many were younger than me. many had young families. Some had babies on the way. Their rooms were decorated by cards, pictures, posters of kids, wives, friends, parents. I even saw a handful of unvaxed pregnant moms in their third trimester who lost their baby or their own life, or both. 

The story was the same. A young man would come to the intensive care unit after battling worsening respiratory symptoms at home for a week, need supplemental oxygen for a few days then BIPAP (which was positive pressure through a tight-fitting mask), then their lungs would collapse and they would end up on a ventilator with tubes their chest. We airlifted a lucky few to outside hospital’s with ECMO capability (heart lung bypass machines) to give them their best chance. None survived. The ventilator was a death sentence. Their young age gave them no advantage. The story was so monotonous and uniform, that I made it a point to either allow their family to come in to visit (with full PPE), just before putting them on ventilators, if time allowed because I knew this would the last visit , or have a facetime call if time was critical.

I hope the families remember this small gift that I consciously tried to give them. I could not save their loved one, but I hoped for them to have their chance to say goodbye. I hung out in the room as these visits went down, ready to step in to intubate. It was always the same, tears, regret, false hope. I found these visits especially taxing. It would have been easier for me emotionally to just intubate and get it over and done with. The next phone call from myself would invariably be the one allowing another visit to witness the last breaths, or resuscitative efforts. 

It is a heavy burden to pronounce so many dead. To make so many calls to loved one. To hear so much despair, sadness, and loss. It is my job and one which I consider a privilege. I would much rather bypass this part of my job. I implore you to please get vaccinated.  My intensive care unit does not need any more young deaths. 

(self published in Medium)