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| How a Respiratory Therapist, Working ‘Code to Code,’ Spends His Sundays | How a Respiratory Therapist, Working ‘Code to Code,’ Spends His Sundays |
| (8 days later) | |
| Before the coronavirus, respiratory therapists mostly worked in the shadows. But now what they do — help people breathe — has thrust them into the spotlight. | Before the coronavirus, respiratory therapists mostly worked in the shadows. But now what they do — help people breathe — has thrust them into the spotlight. |
| “Breathing is the most important life function,” said David Van De Carr, a respiratory therapist at Mount Sinai Morningside, in Manhattan. “This disease is very much focused on that.” | “Breathing is the most important life function,” said David Van De Carr, a respiratory therapist at Mount Sinai Morningside, in Manhattan. “This disease is very much focused on that.” |
| When he’s not working 13-hour shifts, Mr. Van De Carr, 56, a former general contractor/carpenter, lives in Jackson Heights, Queens, with his wife, Beth Nathanson, who works for a civil rights organization, and their cat, Shmookie Boots. | When he’s not working 13-hour shifts, Mr. Van De Carr, 56, a former general contractor/carpenter, lives in Jackson Heights, Queens, with his wife, Beth Nathanson, who works for a civil rights organization, and their cat, Shmookie Boots. |
| “I’m proud of our hospital system,” Mr. Van De Carr said. “It’s diverse and multicultural, just like New York.” | “I’m proud of our hospital system,” Mr. Van De Carr said. “It’s diverse and multicultural, just like New York.” |
| SHOWER PRAYER I’ve been waking up earlier, about 4:45. I don’t sleep very well. I have one cup of coffee. In the shower, I say a morning prayer. I ask God to be relieved of the bondage of self so that I may better serve others. | SHOWER PRAYER I’ve been waking up earlier, about 4:45. I don’t sleep very well. I have one cup of coffee. In the shower, I say a morning prayer. I ask God to be relieved of the bondage of self so that I may better serve others. |
| I always have my scrubs folded up neatly on the living room side table (I have eight to 10 pairs). I set them out the night before. Also my shoes, the backpack. I try to leave very early so I can get to the hospital an hour before my shift starts. | I always have my scrubs folded up neatly on the living room side table (I have eight to 10 pairs). I set them out the night before. Also my shoes, the backpack. I try to leave very early so I can get to the hospital an hour before my shift starts. |
| DWINDLING OPTIONS Normally on the drive to work I’ll call the restaurant across the street from the hospital, Strokos, and put in an order to pick up. But recently there was no answer. When I got to work I saw they were closed. So I sat in my car and ate the sandwich my wife made me for lunch. But my mouth was so dry from fear that I had trouble swallowing. | DWINDLING OPTIONS Normally on the drive to work I’ll call the restaurant across the street from the hospital, Strokos, and put in an order to pick up. But recently there was no answer. When I got to work I saw they were closed. So I sat in my car and ate the sandwich my wife made me for lunch. But my mouth was so dry from fear that I had trouble swallowing. |
| THE LOW DOWN I go into work early. Maybe to decompress. To change. Lately I’ve been wearing a disposable scrub jacket. When I go into a Covid room, I double glove and I put on a disposable surgical gown. I wear an N95. Over that I wear a regular surgical mask. I also wear a surgical cap and a face shield that’s just a clear plastic thing with an elastic headband. | THE LOW DOWN I go into work early. Maybe to decompress. To change. Lately I’ve been wearing a disposable scrub jacket. When I go into a Covid room, I double glove and I put on a disposable surgical gown. I wear an N95. Over that I wear a regular surgical mask. I also wear a surgical cap and a face shield that’s just a clear plastic thing with an elastic headband. |
| I get a report from the night shift therapist. We have a big board with all the patients, and what kind of machine they’re on, and what the settings are. That is updated daily. I make my patient list, what their settings are. Where they are. I copy it all down on paper. I use this paper all day long. | I get a report from the night shift therapist. We have a big board with all the patients, and what kind of machine they’re on, and what the settings are. That is updated daily. I make my patient list, what their settings are. Where they are. I copy it all down on paper. I use this paper all day long. |
| Sometimes I’ll clean vents. We have an equipment tech now. He’s been coming in five days a week, sometimes on the weekend, the turnover is so great. There’s also a tank room, nitrogen, carbon dioxide, that’s piped into the operating room. Previously it was our responsibility to change the tanks. Now Carl, the equipment tech, does that. He’s really been stepping up. | Sometimes I’ll clean vents. We have an equipment tech now. He’s been coming in five days a week, sometimes on the weekend, the turnover is so great. There’s also a tank room, nitrogen, carbon dioxide, that’s piped into the operating room. Previously it was our responsibility to change the tanks. Now Carl, the equipment tech, does that. He’s really been stepping up. |
| My shift is officially from 7 a.m. to 8 p.m. I do my rounds in the I.C.U. We do what are called vent checks. Recording the settings on the ventilator, what the patient is doing, including breaths a minute at a certain volume of air and at a certain oxygen level. I do an assessment of the patients. Essentially all of them are Covid. | My shift is officially from 7 a.m. to 8 p.m. I do my rounds in the I.C.U. We do what are called vent checks. Recording the settings on the ventilator, what the patient is doing, including breaths a minute at a certain volume of air and at a certain oxygen level. I do an assessment of the patients. Essentially all of them are Covid. |
| ON THE JOB Typical patients in the I.C.U. are sedated and on a ventilator. In extreme cases, we’ve been proning patients, which is flipping them over onto their stomachs and ventilating them that way. It takes six people to do this, as someone has to secure the airway. Proning relieves pressure on the lungs. It enables the patient to breathe easier. | ON THE JOB Typical patients in the I.C.U. are sedated and on a ventilator. In extreme cases, we’ve been proning patients, which is flipping them over onto their stomachs and ventilating them that way. It takes six people to do this, as someone has to secure the airway. Proning relieves pressure on the lungs. It enables the patient to breathe easier. |
| No matter what kind of state the patient is in, I’ll come in and introduce myself. I’ll ask them how they’re feeling. I know it’s kind of weird to introduce myself to a sedated patient, but I’ll still do it. I’ll say, ‘Mr. or Ms. So and So, I’m David from respiratory, and I’m here to check up on you.’ Each thing that I do, I’ll tell them what it is. ‘I’m going to listen to your breathing, I’m going to measure your pulse.’ | No matter what kind of state the patient is in, I’ll come in and introduce myself. I’ll ask them how they’re feeling. I know it’s kind of weird to introduce myself to a sedated patient, but I’ll still do it. I’ll say, ‘Mr. or Ms. So and So, I’m David from respiratory, and I’m here to check up on you.’ Each thing that I do, I’ll tell them what it is. ‘I’m going to listen to your breathing, I’m going to measure your pulse.’ |
| With a ventilated patient, I’ll make a note of where the tube is. We don’t want it to be in the same space for too long, as they could develop an ulcer. There’s a clip where you can move the tube from side to side in the mouth. I’ll record their heart rate, their blood pressure, I’ll listen to their breathing. I’ll put a catheter down the tube, it makes them cough, hopefully, secretions into the tube, and I’ll suction them out. | With a ventilated patient, I’ll make a note of where the tube is. We don’t want it to be in the same space for too long, as they could develop an ulcer. There’s a clip where you can move the tube from side to side in the mouth. I’ll record their heart rate, their blood pressure, I’ll listen to their breathing. I’ll put a catheter down the tube, it makes them cough, hopefully, secretions into the tube, and I’ll suction them out. |
| MIDDAY MIRACLE Right now we’re inundated with calls. Calls from the floors, calls from doctors. But last Sunday was remarkable. A colleague bought us lunch, a big Italian spread, and we were all able to take a meal break. Thankfully there were no calls. It was an act of God. A lot of us did some crying. I was the only guy, surrounded by four women. I don’t really have an appetite, I’m so keyed up all the time. But I was actually hungry. We got to take off our masks, and do something normal. Commune. | MIDDAY MIRACLE Right now we’re inundated with calls. Calls from the floors, calls from doctors. But last Sunday was remarkable. A colleague bought us lunch, a big Italian spread, and we were all able to take a meal break. Thankfully there were no calls. It was an act of God. A lot of us did some crying. I was the only guy, surrounded by four women. I don’t really have an appetite, I’m so keyed up all the time. But I was actually hungry. We got to take off our masks, and do something normal. Commune. |
| CODE TO CODE In the afternoon, there are multiple codes, people being intubated. There was a person who declined really rapidly on the floor across from the I.C.U., and we coordinated with each other. ‘Do You need a ventilator? Do you need a holder?’ | CODE TO CODE In the afternoon, there are multiple codes, people being intubated. There was a person who declined really rapidly on the floor across from the I.C.U., and we coordinated with each other. ‘Do You need a ventilator? Do you need a holder?’ |
| The rest of the day is just this incredible inundation. Some days you just feel like you’re trying to put out fires. We don’t have the luxury of treating people like we did before, when we had a fraction of the patients we have now. We’re responding from code to code. | The rest of the day is just this incredible inundation. Some days you just feel like you’re trying to put out fires. We don’t have the luxury of treating people like we did before, when we had a fraction of the patients we have now. We’re responding from code to code. |
| ‘I LOVE YOU’ What gets to me these days is the kindness of other people. I get hugs from transporters and nurses. We say ‘I love you’ a lot more now. My director and I will have a conversation, and end it with ‘I love you.’ | ‘I LOVE YOU’ What gets to me these days is the kindness of other people. I get hugs from transporters and nurses. We say ‘I love you’ a lot more now. My director and I will have a conversation, and end it with ‘I love you.’ |
| Updated August 24, 2020 | |
| It’s overwhelming, the tragedy of it all. The coming together of people, risking their lives all day long. And that’s everyone. The people cleaning the room. Cleaning the bathrooms. I’ve had people ask me ‘Why don’t you just take off?’ and I can’t. It’s my. It’s more than a job, it’s my duty. | It’s overwhelming, the tragedy of it all. The coming together of people, risking their lives all day long. And that’s everyone. The people cleaning the room. Cleaning the bathrooms. I’ve had people ask me ‘Why don’t you just take off?’ and I can’t. It’s my. It’s more than a job, it’s my duty. |
| SHIFT CHANGE The night shift person comes in at 7 p.m. Sometimes it’s 6:59 and they’re like, “Oh I need you to come down — we’re proning a patient.” Good God let me get through this last half an hour, but inevitably, it happens. I try to give an accurate report. We’re so exhausted by then. | SHIFT CHANGE The night shift person comes in at 7 p.m. Sometimes it’s 6:59 and they’re like, “Oh I need you to come down — we’re proning a patient.” Good God let me get through this last half an hour, but inevitably, it happens. I try to give an accurate report. We’re so exhausted by then. |
| I dispose of my mask. We’re recycling N95s and face shields so there are bins all over the hospital. Before I leave, I wipe my pen, my paper, my stethoscope. I obsessively clean my hands. I take the scrub jacket off and hang it in my locker. Change into my sneakers. | I dispose of my mask. We’re recycling N95s and face shields so there are bins all over the hospital. Before I leave, I wipe my pen, my paper, my stethoscope. I obsessively clean my hands. I take the scrub jacket off and hang it in my locker. Change into my sneakers. |
| REFUGE When I get home, I take my shoes off, empty my pockets, put my jacket and backpack down on a particular chair. I wipe my phone down, and I put my scrubs in a trash bag. I get in the shower. I bring my glasses in the shower and scrub those. I might say another prayer. And then I put on my pajamas. | REFUGE When I get home, I take my shoes off, empty my pockets, put my jacket and backpack down on a particular chair. I wipe my phone down, and I put my scrubs in a trash bag. I get in the shower. I bring my glasses in the shower and scrub those. I might say another prayer. And then I put on my pajamas. |
| A lot of times Beth will rub my feet for a while on the couch. That’s a beautiful, beautiful, thing. Generally we don’t have dinner together after a shift. Sometimes I’ll have a piece of toast. | A lot of times Beth will rub my feet for a while on the couch. That’s a beautiful, beautiful, thing. Generally we don’t have dinner together after a shift. Sometimes I’ll have a piece of toast. |
| The things that brought me joy before don’t bring me joy now. Beth is a huge fan of 19th-century costume dramas like “Little Women” and “Sense and Sensibility.” We watched that the other day. That she’s so into them helps me be into it. We seek out lighthearted romantic comedies; stuff that’s not so dark. We watched “Sleepless in Seattle” the other night. | The things that brought me joy before don’t bring me joy now. Beth is a huge fan of 19th-century costume dramas like “Little Women” and “Sense and Sensibility.” We watched that the other day. That she’s so into them helps me be into it. We seek out lighthearted romantic comedies; stuff that’s not so dark. We watched “Sleepless in Seattle” the other night. |
| WORRIES I try to go to sleep by 10. I take my sleep aids, melatonin and Benadryl. When I get into bed, I worry about the next day. What’s going to happen? Am I going to get it? Do I already have it? I don’t know. I take my temperature. I have a pulse oximeter at home to measure my oxygen levels. I have these aches and pains and I don’t know what they are. The other night my chest was hurting before I went to sleep. I was like ‘Oh my god what is this.’ I went to sleep, saying ‘OK, body, I’m gonna give you some rest, and let’s heal that.’ | WORRIES I try to go to sleep by 10. I take my sleep aids, melatonin and Benadryl. When I get into bed, I worry about the next day. What’s going to happen? Am I going to get it? Do I already have it? I don’t know. I take my temperature. I have a pulse oximeter at home to measure my oxygen levels. I have these aches and pains and I don’t know what they are. The other night my chest was hurting before I went to sleep. I was like ‘Oh my god what is this.’ I went to sleep, saying ‘OK, body, I’m gonna give you some rest, and let’s heal that.’ |
| The next morning I woke up and the pain was gone. | The next morning I woke up and the pain was gone. |