Taylor Nichols is a Vituity emergency physician practicing outside Sacramento. He completed a fellowship in emergency medicine health policy and advocacy at UC Davis Health in June.
He came in by ambulance short of breath. Already started on oxygen by the paramedics. Still, he was clearly laboring just to breathe. He looked sick. Uncomfortable. Scared. As we got him over to the gurney and wrestled his shirt off to switch to a hospital gown, there was one thing that we all noticed: the Nazi tattoos.
The swastika stood out boldly on his chest. SS tattoos and other Nazi insignia ran down his arms. He was solidly built. Older. His methamphetamine use over the years had taken its usual toll, and his teeth were all but gone.
“Don’t let me die, doc,” he said breathlessly as the respiratory therapist switched him over to our mask and CPAP machine. I reassured him that we were all going to work hard to take care of him and keep him alive.
All of us being a team that included a Jewish physician, a Black nurse and an Asian respiratory therapist. We all saw. The symbols of hate on his body outwardly and proudly announced his views. We all knew what he thought of us. How he valued our lives.
But our job was to value his. So here we were, working as a team to make sure we gave him the best possible chance to survive. All while wearing masks, gowns, face shields and gloves. This moment perfectly captured what we are going through as health-care workers as this pandemic accelerates.
We exist in cycles of fear and isolation. Fear of getting sick on the front lines. Fear of bringing the virus home and exposing our families. Fear of losing our colleagues. Fear of the developing surge of patients and not having what we need to take care of them.
Isolation because we don’t want to be responsible for spreading the virus, knowing that we are surrounded by it every day. Isolation because no one else can truly understand this feeling, these fears, the toll of this work. But we soldier on.
Far too much of society has proved unwilling to listen to the science or to our pleas. We are begging for people to take this virus seriously, to stay home, to wear a mask, to be the break in the chain of transmission.
Instead, people have called the pandemic a hoax. They have called us liars and corrupt, told us we are being too political by worrying about patients dying and by trying to save lives. They have suggested we are trying to profit from the pandemic. They have stopped caring about our lives, our families, our fears.
Back in the ER, our patient was already on high respiratory support and still laboring to breathe, so I asked him whether he would want to be intubated. I knew it was all but inevitable, and I wanted to get his answer before the hypoxia made him more confused.
He said that if a breathing tube was the only way he could survive, he wanted us to do everything we could. So we would. We were out of other options by this point, so we prepared.
I’ve faced this countless times since medical school. Not the intubation — that has become routine at this point for me and my team. The swastikas. The racist patients. Every time I encounter this situation, I feel a bit shaken. And, every time, I’ve been able to smoothly and quickly move through those emotions.
I went into this job wanting to save lives. “They came here needing a doctor, and Taylor, you’re a doctor” is a mantra I’ve repeated to myself when I feel as though my empathic core is waning.
As I stepped out of the room to gear up for a high-risk procedure, I checked my PPE. I had my N95, face shield, gown, gloves. Was I safe? Was my team safe? I pause to make sure I have all my equipment and backups if needed.
I run through the plan with the nurse and respiratory therapist. I pause. I see the SS tattoo and wonder about what he might think of having a Jewish physician take care of him now — or how much he would care about saving my life if our roles were reversed.
And for the first time in my career, I recognize that I hesitate, ambivalent. The pandemic has worn on me; my mantra of caring for all isn’t having the same impact in the moment. I realize that maybe I’m not okay.
After the patient was intubated and stabilized, I never saw him again. But he taught me a lesson that I know is a shared experience among health-care workers: This pandemic is simultaneously testing and strengthening the depths of our compassion.
We hold each other up to ensure we can continue to give you our best care. Our doors will always be open, no matter who you are, so you can seek care when you need it.