into the Guam Memorial Hospital premises always brings along a cloud of foreboding . The hospital staff prepares to receive the patient , whose uncertain fate triggers a collective fear and anxiety .

“( Patients ) keep coming in . They need help and attention and there is always a concern that we don ’ t have a bed so we need to find a bed for that patient ,” said Lilian Perez-Posadas , GMH administrator .

The oft-maligned government hospital has been crammed with Covid and non-Covid patients since the second wave rolled in by the early part of July . Behind the masks of bravery , GMH employees lug a sense of trepidation given their constant exposure to the coronavirus . As of mid-September , the number of GMH employees who have been stricken with Covid-19 has gone up to 55 .

In the past three months , GMH has been on death watch on a daily basis . On certain days , two deaths occur less than an hour apart . As of the last week of September , Guam ’ s Covid-19 death toll was hitting close to 50 while the tally of confirmed cases had gone over 2,200 . Numbing statistics continued to come out of the labs .

“ We feel beaten sometimes ,” Posadas said . “ We are human beings . It ’ s sad . It ’ s painful . It ’ s difficult . We feel for the patients as much as we feel for their families .”

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But the staff does not have the luxury to pause . “ We have to get up . If we get numb we can ’ t take actions . We have to keep fighting ,” Posadas said . “ We know there ’ s light at the end of the tunnel .”

No matter the condition of a patient , Posadas said , “ we don ’ t give up . We give it all .”

A registered nurse , Posadas has been in the health care field for 43 years . She received an associate degree from the University of Guam ’ s School of Nursing and Allied Health in 1975 and was first hired as a licensed practical nurse at GMH in 1976 .

She earned a bachelor of science in nursing at UOG in 1989 , and master of nursing from Washington State University ’ s Intercollegiate College for Nursing Education in 1993 . She worked at GMH for 29 years until her retirement in 2006 . She came back 10 years later as a member of the GMH Board of Trustees . She served on the board from July 2016 to December 2018 , while working as a registered nurse at United Airlines .

In January 2019 , Gov . Lou Leon Guerrero appointed Posadas to lead GMH , which is typically a battlefield for clashing politicians .

Now , GMH is the war zone for Covid-19 . And as the chief of the frontline army , Posadas said she is confronted by the “ most challenging experience ” in her career as she tries to navigate an unchartered territory .

“ For one , Covid-19 is a new disease ,” she said . “ There are lots of unknowns , lots of uncertainties . So even though we planned and prepared for it , when something comes up , it causes anxiety , fears and concerns .”

Even prior to the pandemic , GMH has been grappling with limited resources , a predicament that has been exacerbated by the pandemic . As it hits surge capacity , GMH is forced to resort to makeshift solutions .

“ Because of the uncertainties , we are constantly moving beds around to make sure that we can accommodate patients . We are constantly training people to make sure they follow the CDC infection control guidance ,” Posadas said . “ We always have to shift lanes when we deal with compounding issues that are occurring all the time .”

In a topsy-turvy situation , disagreements among the staff are inevitable , she said . “ We are human beings . We have meltdowns . We argue . We disagree , but at the end of the day , we have to regroup and agree on a solution to a problem ,” she said . “ We just have to treat each other with respect . It ’ s not about the argument , it ’ s about finding the best solution .”

Amid the stress and tears , the staff occasionally steals moments to take a deep breath . “ We pray hard . We also have humor in between . You got to have humor . It ’ s tough but there are moments when you need those positive chemicals

to get out because this is a long-drawn battle .”

Posadas said she works 12 to 16 hours a day . “ My brain sleeps for two hours but it is awake because many things have to be done . As long as I get two to four hours of sleep at night , I ’ m good to go the next day ,” she said .

Despite the pains , Posadas said , the job can be gratifying . “ We feel rewarded when the patient pulls through and get reunited with their family . Those are our biggest rewarding moments .”

Having to deal with public criticisms is the most dispiriting aspect of the job , Posadas said .

This is nothing new . For decades , GMH has been a subject of scrutiny , a magnet for scandals and prone to conspiracy theories .

“ There are comments in the community that we are taking this opportunity to let the patients die so we can get more federal funds . That is such a warped mentality . We are here to save lives , not to let people die just to get federal funds ,” she said .

“ In every society , there are always negative critics , who find faults in everything but they are not offering help . This does not help the staff who sacrifice their own lives . Criticisms don ’ t help them .”

What the tired and sleep-deprived staff needs , Posadas said , are “ support and encouragement .”