FEATURE
MICU REFLECTIONS DURING THE PEAK OF COVID-19
AUTHOR Justin Chu, MD
Acute hypoxic respiratory failure:
wherever I am in my training or
career, these words will forever
take me back to, so far, the most
memorable time in my generation’s
history. I was an intern assigned to
the MICU during the peak of the
COVID-19 global pandemic. Like any other
rotation during my internal medicine & pediatrics residency, I
learned about myself and gained valuable clinical skills I hope to
carry with me in the future. However, this particular month was
special. The blossoming flowers of early April had succumbed to
the eeriness of COVID-19.
Being in the hospital when the rest of the world was on lockdown
isolation was peculiar. Hospital employees, health care providers,
janitorial staff and I – we all carried ourselves with a greater sense
of pride and responsibility. The “call to medicine” that aspiring
pre-med students write about came to life that month. Nonetheless,
there was an unmistakable air of trepidation, an anxious trembling
in the atmosphere.
COVID-19 taught me a myriad of lessons from management of
acute respiratory distress syndrome to taking the utmost precautions
when performing procedures. Working up close and personal with
COVID-19 showed me how there’s more to its potency than particles.
I witnessed firsthand the powerful emotional blows it strikes on
patients, their families and health care professionals. Throughout
that MICU month, we struggled with sadness, fear and hope, in
cycles, over and over and over.
Sadness: COVID-19 has attacked and taken an ever-mounting
toll on human life, all across the globe. Although dying is very
much natural, to see it this rapid, this ruthless, weighed heavily on
my heart. Having countless goals-of-care discussions with family
members over the phone was exhausting. As the numbers accumulated,
despite having gained experience, the conversations never got
easier. I understood but struggled with the patient’s inability to have
family support because of necessary infection control. Knowing that
patients died without the comfort of their loved ones at their bedside
was extremely disheartening, especially when they had requested
to see them during their final moments of consciousness. Death is
no stranger to the MICU, but death from COVID-19 that month
was: unfortunately they’re becoming more and more acquainted.
Fear: Witnessing the rapid decline this beast of a virus inflicted
on patients tied my stomach in knots. A majority of the time, when
we could predict decompensation and were using every ounce of
our medical knowledge, we failed to halt its unstoppable force. We
felt utterly helpless, over and over. It’s as if we’d been handcuffed
and forced to watch people die. The novelty of this virus, the lack of
controlled trial data, fueled our fears. I marveled over the various
34 LOUISVILLE MEDICINE