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Opinion The strange new quiet in New York emergency rooms

Emergency medical technicians and a patient at Elmhurst Hospital Center's emergency room on April 7 in New York. (Kathy Willens/AP)
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Craig Spencer is director of global health in emergency medicine at New York Presbyterian/Columbia University Medical Center.

When you walk into the emergency room now, there is silence.

It’s not just fewer patients. Fewer monitors. Fewer dying. There is an actual emptiness.

The space seems the same. So do the colleagues you see. And all the patients look like they did before this pandemic upended our lives.

But there’s an unshakable unease. Something isn’t right. Something is missing. We don’t talk about it much. Maybe we are all trying to forget?

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There’s Plexiglas up now to keep us protected. We wander around in masks, goggles and gowns.

Even if the patients look the same, though, they aren’t. So many still sick, struggling with the long-term complications of covid-19.

And even if the people look the same, they aren’t. Because some of our colleagues and friends are missing. It’s only when the tidal wave recedes that we can get close enough to assess the damage.

In the past few weeks, many colleagues around the city have tested positive for antibodies to the novel coronavirus. This means they had been infected, almost certainly on the covid-19 front lines. Many didn’t experience any symptoms. They were lucky.

Others weren’t.

A few weeks ago, in the middle of a busy shift, you get a call. The voice on the other end is pressured. Frantic. One of our doctors is coming in. Short of breath.

When you see him at triage, he can hardly stand. His respirations are labored. Your heart races. You’re almost never scared. You treated war wounded during civil conflict in East Africa. You treated Ebola in West Africa, where most of your patients died.

But now, seeing your colleague desperately hungry for air, you panic inside. He’s one of us.

Get him in a chair. Get him back. Get him on a monitor, now. You know what to do. You pray it works.

You’ve done this before, so many times. But this is different. Put him on oxygen. Stand by. Stay calm. Deep breaths, both of you.

Eventually his breathing slows. His oxygen saturation slowly rises. It’s going to be okay. Bullet dodged. A friend and colleague saved. You exhale.

Two days later, a colleagues dies. He had been in the intensive care unit for weeks. Covid-19. On a ventilator helping him breathe. Infected like so many nurses who’ve been on the front lines. And then one day, life leaves him.

When you started here years ago, he was one of the first to take you around. Show you how things worked. Together you cared for hundreds of patients. Now he’s gone.

Then another tragedy hits. Your colleague, your friend. She dies by suicide.

A few years ago, you told her to change her travel plans. Go to Montenegro, it’s cheaper than Croatia. You argued about whether Aperol was any good. You heard about all of her snowboarding trips.

She survived covid-19. When she came back, you had walked around the emergency room together, lamenting your inability to do more in the face of the virus. What we saw and experienced was too much.

Her death hurts you now. It will hurt you forever.

At every step of this pandemic, we’ve been in crisis. Not enough tests. Not enough providers. Not enough PPE.

Now our crisis is silent. But it lives in each of us. It empties us out. It makes us hollow.

We can measure the number of tests we’ve done. We can follow the trends of patients intubated in the intensive care unit. We can chart the number of deaths per day to know when we can start working back toward normal.

But there’s no way to measure the impact and toll this has had on our front-line providers. How much we cry. How much it hurts to see your friends struggle to breathe. Struggle to deal with the terrible reality.

The Opinions section is looking for more stories like this one. Write to us with how the virus has affected you.

The curve will flatten. The cases will decline. And maybe one day, covid-19 will be an afterthought. But long after that, this trauma will define a generation of health-care workers.

Most of us made it. The best among us didn’t. May they forever rest in peace. For the sacrifice they made. For all of us.

Read more:

Craig Spencer: How long will we doctors last?

Craig Spencer: A day in the life of a New York emergency room doctor

Craig Spencer: When the coughing stops and the sense of helplessness begins

Michael L. Barnett: After the pandemic, visiting the doctor will never be the same. And that’s fine.

Sophie A. Greenberg: As a doctor, I am willing to do whatever it takes to defeat this virus. Why isn’t Trump?

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