Finding light in the darkness

I often think back to my first day in the COVID ICU. Vivid flashes play through my mind like a bad sci-fi movie – nurses in their PAPR hoods looking like astronauts, room after room with lifeless bodies face down and red hazard bags filled with PPE lining the halls. The feelings of dread, fear and awe lodged in my throat as I wondered what strange planet I had just wandered onto, astronaut suits aside.

Now, as I start my seventh week in the COVID ICU, I am amazed at what has now become routine. Patients who are not on a ventilator are an aberrancy, and talking to patients now feels foreign. I used to be met with utter confusion by nurses based on my specialty, but I am now a fixture in the ICU. What started as a two-week deployment has stretched to seven weeks, with what feels like no end in sight. It is almost hard to remember a time before this started. Plastics consults, home call and physical exams seem like distant memories. COVID-19 has pervaded almost every aspect of my life, both in the waking and sleeping, as I switch back and forth from days to nights and nights to days. Even in my dreams I find myself back in the ICU, coding a patient or donning PPE (or forgetting to don PPE in my nightmares). I come home from the hospital and feel as if I'm returning to Earth; I carry out my now ritualistic decontamination process before I feel "safe" in my apartment. I try to run outside almost daily, grateful for time without a mask on, grateful for fresh air and the ability of my lungs to function normally. Without our routines, many of us do not function – and all of this has become routine out of necessity to stay sane.

Nevertheless, my time in the COVID ICU has not been all bad. Anyone who knows me knows that I am an avid Harry Potter fan, and Dumbledore's words have never been truer: "Happiness can be found in the darkest of times, if one only remembers to turn on the light."

Yes, these are dark times, but they have been punctuated with so many moments of light. I have seen incredible teamwork across specialties and professions. Nurses, doctors, RTs, housekeeping, our prone team and many others have come together as a in a way I never saw before. The nurses and RTs who go in and out of rooms countless times without fear or complaint continue to amaze me on a daily basis. We have been showered with free food and gifts from local restaurants and members of the community. I developed immensely close friendships with residents from across specialties that I otherwise would have never met, bonded together by our shared experience. I have been lucky enough to see some patients recover, to "meet" them for the first time and talk with them after they come off the ventilator, and happily wave goodbye as they leave our ICU. I have been thanked profusely by family members – even when their loved ones are dying – and am repeatedly humbled by their gratitude when it feels like we have so little to offer. These are the things that I never want to take for granted or to allow to become routine.

One of my co-residents joked about being "forged in the fire of the COVID ICU." As dramatic as this sounds, it is true. I know that we will all come out of this as stronger clinicians, ready to take on whatever challenges may come our way for the remainder of our careers. This will end, one day, but these memories will last for our lifetimes.

Dr. Smith is a plastic surgery resident at UMass Medical School.