I recall very vividly responding to my first potential COVID-19 call. My partner and I at the Teaneck (NJ) Volunteer Ambulance Corps were dispatched to a bus stop on a busy street where we found a young man doubled over in pain. As I approached our patient, he held out his hand telling me not to get too close; he had just returned from abroad and was in close contact with someone who was sick. Although barely anything was known about the novel coronavirus at the time, it was obvious to me that universal precautions were necessary. The wind made it nearly impossible for me to don my Tyvek suit, and the N95 mask was stifling. We brought our patient into the ambulance, my partner opened the windows, and I completed my patient assessment.
When we arrived at the hospital, we were instructed to wait in the back of the ambulance for further instruction. I sat and waited, every second increasing my chance of potential exposure. The several minutes until we were cleared to enter the hospital were among the most terrifying of my life. I found solace only in comforting my patient. We transferred patient care, decontaminated the ambulance, and returned to headquarters.
As the situation worsened in Teaneck, my family decided to move to upstate New York to my parents’ home. My parents insisted that I join them and I agreed on the condition that I could return for my weekly shift. But as we learned more about the virus and the potential harm that could befall my family if I contracted COVID-19, we decided I would remain upstate, safely and with my family – indefinitely.
Over the next week, I watched as our weekly roster thinned with the departure of many of our more at-risk members. I received page after page requesting members to our headquarters or to the scene for COVID-19 patients. When I read that field hospitals were being established in Central Park, I decided that I could no longer justify being away, comfortable and secure with my family, while being qualified and trained to help with emergency medical response. Quickly, the idea of returning to Teaneck consumed my every thought. I planned to remain upstate through the upcoming holiday and then return to help. As the holiday approached, however, I decided that I could no longer remain away from my hometown and returned home a few days before the holiday.
When I returned, I began to take calls immediately. Family friends who had heard that I was back in Teaneck to volunteer began asking how they could help. They ordered and cooked food for me, and offered their assistance in case I needed anything. In a most touching gesture, my closest friend delivered a care package for me for my first weekend home alone. It included home-cooked meals, a letter, and water bottles with personalized labels affixed; the labels bore a picture of me in dress uniform with “you are a hero” in big letters. I won’t pretend for a moment that I wasn’t teary-eyed while going through the package.
I noticed upon my return that our town had radically changed. The streets were empty but for a few cars. Our local hospital had been transformed to mitigate the risk of spreading the virus. The new wing of the emergency department dedicated to COVID-19 patients was full, and a tent had been erected in the ambulance bay. All of our members were directed to wear masks and other protective gear as necessary on all calls.
In the darkest days of the pandemic in Teaneck, I was taking calls nearly every day, with my off-hours being dedicated to finishing my college courses. At the time, I had already been on several hundred calls, but this period was unique. Our crews were being sent out extraordinarily frequently, not only on COVID-19 calls, but also on other medical calls. The frequent dispatches paired with the extra time it took to decontaminate ambulances led to numerous requests for additional ambulances. At a certain point, our staffing was down about fifty percent while our call volume was approximately double its typical amount. I recall the immense pride that I took in our organization at the time; while many other volunteer squads were shutting down, we were at our best, running from call to call, treating critical patient after critical patient. I was part of something truly unique.
Never in my life had I seen so much suffering in such a short amount of time. At a certain point, it felt as if there was little I could do for these patients; our treatments, such as oxygen therapy, did offer some relief, but not as much as I had seen with previous patients. As a result, there was no shortage of heart wrenching moments. On one of my first calls after returning to Teaneck, an elderly woman was experiencing pain and not acting like herself. My assessment revealed discoloration and guarding, which made me concerned that there were internal injuries that I could not find or treat myself. I encouraged the patient’s daughter to allow us to transport her mother to the hospital.
Of course, as a result of the virus, she was apprehensive of the thought of her elderly mother spending time in a hospital. This concern would soon become ubiquitous –
“Am I better off staying home?” And for the first time ever, it came down to EMS personnel helping to make those decisions. We had to take into account the patient’s overall expected outcome, the possibility of overwhelming our local hospitals, and the relatively poor recovery rate of people exhibiting symptoms at the beginning of the pandemic. However, the most difficult part of this call came when the patient’s daughter asked me: “What would you do for your own mother?” For a moment, time froze. My job is to administer high-quality care to my patients without my subjective feelings of right and wrong influencing their decisions. It took me a few moments to gather my thoughts. Eventually I decided that, given the circumstances, if I were to be in her situation, I would have my mother assessed at a hospital. She agreed, and we transported her mother. To this day, I still think about that call; I hope this was the right decision for the patient and that it led to a positive outcome.
On a Saturday not too long after this, I responded with a crew to a patient who was experiencing symptoms of COVID-19. After a full assessment, he opted against being transported to the hospital and signed a release. Only a few hours later, on Saturday evening, I responded back to that same house for a patient in cardiac arrest. When I arrived, I found the same man with whom I had been speaking that day, lying on the floor unresponsive. The paramedics were already on scene making resuscitative efforts. Since I was to be the primary EMT for this patient, I was the only member of the crew to have donned my gown prior to our arrival on scene. This meant that I would be the one performing chest compressions. Until that night, I had not known what it was to see someone who was seemingly relatively healthy and later perform CPR on them. There was a more human component to him, and that made it all the more difficult to think about, especially after his pronouncement. But there was little time to process my feelings in between calls.
My most difficult call as an EMT came soon after. Just before the weekend, another member and myself were off-duty spending time at our headquarters. I was being interviewed by a journalist interested in how the frontlines were handling the chaos when the emergency phone rang. The call was for a patient with difficulty breathing. I suited up in full PPE and headed into the house with a radio. I could tell right away that my patient was in trouble. She was sitting in a chair, sweating and fighting for every breath. She said that she was having difficulty breathing and was experiencing chest pain. She was COVID-19 positive and had been released from the hospital only a few days earlier. I did my best to reassure her and started oxygen therapy right away. I called out to my partner to grab a carrying device to get her to the ambulance. The paramedics arrived soon after and helped us to transport her while her family watched from the lawn in front of her house. I gave a verbal report to one of the paramedics and made it clear that we required their assistance. Only a few minutes later, while the paramedics were performing their workup, the patient took one last deep breath and then suddenly went unresponsive. I was looking into her eyes when it happened. The paramedics looked at the EKG. It showed asystole; no heart activity.
Our crew initiated resuscitative efforts and I was sent to trail our ambulance in the paramedics’ response vehicle. Upon our arrival at the hospital, the patient was still in cardiac arrest. Without time to put on another gown, I ran to help treat the patient. I took over giving chest compressions, and took the patient in to be seen by the emergency department staff. The paramedics transferred care while I continued with compressions until the staff took over. I remain genuinely heartbroken for what that patient had to endure; I cannot imagine what it is like to literally have your breath taken from you. I have thought a lot about her family’s suffering as well.
When we arrived back at headquarters, I concluded my interview with the journalist from a safe distance. I changed out of my contaminated clothes and went home. I spent the first twenty minutes alone lying on the floor, absolutely speechless.
The tough calls were relentless, and not all of them were COVID-related. Only a few days later, we were dispatched to a call in which a young pregnant woman was experiencing abdominal pain and was in and out of consciousness. We performed our assessment and prepared for transport. En route to the hospital, she became completely unresponsive. I searched for a pulse and had never been happier to feel one. Fortunately, by the time we got to the hospital, she was fully conscious. I transferred patient care to the hospital staff and hoped she and her baby would be healthy.
Living alone and isolated from others made it more difficult to work through the challenges I faced during the pandemic. I spent a lot of time speaking with one colleague in particular about his experience, which did a lot to help. However, returning to an empty house every night certainly took its toll, as did my inability to spend time with those closest to me without a mask and with at least six feet separating us. The one silver lining in being alone was my ability to play the piano at all hours of the night, which greatly eased my anxiety.
While I wanted to be taking calls all day, the academic rigor of my college coursework prohibited me from doing so. I have always wanted to be a physician, so the completion of these courses with high marks was a necessity. But I felt selfish for studying organic chemistry while I could have been out genuinely helping people. This frustration led to a balancing act, in which I would take calls whenever possible and find coverage when I needed to devote more time to my classes.
Out of the darkness of the COVID-19 crisis, a deep sense of camaraderie emerged among our membership. Many of my fellow volunteers whom I had previously viewed as colleagues became my closest friends, some even like family. We spent countless hours together at headquarters between calls. My mentor, with whom I still hold a weekly shift, has become a close confidante. The calls to which we responded together during the most difficult days of the pandemic have forged a truly special bond between us, which I expect to survive the test of time. I feel privileged to have been able to serve my community in its time of need with these extraordinary people. And I look forward to continuing to serve my community alongside them for many years to come.