From One Dying Breath to The Next

If I tried, Thanksgiving 2020 would not be forgotten.

The patient's family had to say goodbye through a screen while he was dying. The man didn't see anything. He was not aware of what was happening around him. I put my hand on his. He appeared to be smiling. He died.

My role as a respiratory therapist has changed. I couldn't be the faceless and sometimes unseen person in the room anymore. It was no longer possible for me to maintain that level of distance or unfamiliarity. The patients didn't have a close relationship with each other, so I had to do that task. The consequences were that I would have to feel each loss as if it were my own.

Before COVID, I was a respiratory therapist. I could handle the decision to remove the life support of patients if I distanced myself from the situation. The family of the patient would usually sit in the room with their loved one. They would remember the good times and the bad. After I knocked on the door, I walked over to the bed and removed the tube from the patient's throat. I moved on to the next patient to survive the day.

After fighting a constantly changing virus, I think hospitals can do a better job of preparing for the future. There needs to be a better focus on minimum supplies. Mass casualty drills make sure personnel are prepared to deal with more patients than they have. Hospitals need to be more transparent with the public. The general public saw the empty rooms when I ran from room to room to get ventilators after people died.

The past two and half years with COVID have been very similar to my time as a combat medic in the Army. Those lessons can be shared.

I was a freshman in Puerto Rico and walked through the lobby between classes when the Twin Towers fell. If I acted now, I could help put more good things into the pages of history than bad, since I realized that history was being written every day. When I joined the Army as a combat medic in 2003 I knew I would take a life if I had to save a patient or protect my country.

In 2004, I traveled to Iraq. There were things you had to experience to understand life and loss. I was a medic with an aid bag. I had to make sure that what was in that bag would last even if there were more casualties. A medic needs to use the least amount of supplies. I didn't know how important the lessons of 2004.

I came back from combat in December of 2005 with a mind full of loss and nightmares, and a combat Badge for being engaged by the enemy. It was weird that something that would follow me for the rest of my life could be summed up in a single sentence.

I began to have respiratory issues in 2010. The Army medically retired me because of asthma. I became an EMT in San Antonio and felt that it wasn't enough, so I decided that the respiratory condition that hampered me could be the reason I returned to fighting. A respiratory therapist is someone who works with respiratory problems. I tried to put the war behind me, but as we all know, an enemy more dangerous than any we encounter in combat was about to come.

Hospitals and the media tried to keep us informed as the disease spread. I quickly realized that we may have some trouble ahead after listening to the news and studying. The description of the virus wasn't worrying. How different the information was was concerning. We had a new virus that could kill and we had to face it head on.

Respiratory therapists were guaranteed exposure. I was afraid of something. I knew I was at high risk of death and severe illness due to my history of asthma. When my hospital needed volunteers to staff a new COVID unit, I volunteered.

I wore an N-95 mask, two pairs of gloves, a gown and shoes for 12 hours. I would shower at home. There was a bucket near the door. I put my clothes into the washer when I got home. I would use a UV light box to destroy my equipment. I wanted to get enough people informed, distanced and protected so that we wouldn't overwhelm the hospital until we got a vaccine. We battled a full hospital for almost a year because this wasn't the case.

We have more and more doubts today. The virus gets less chances to evolve if we can prevent people from getting it. Natural immunity as well as vaccine-mediated immunity will be defeated if the virus is spread.

Our job has changed because of a lack of public knowledge. We don't know if people will try to avoid exposure to a virus. The virus will have a lot of opportunities to change over the course of time. We must now expect variant, an increase in severity, hospitalization and death, and stock hospitals with equipment and personnel that will ensure we can handle large numbers of patients.

I thought I would never see that scenario again, where supplies are less than casualties, and we need to decide who has the best chance of survival. Is this going on right now? Thank goodness, it's still alive and well.

We don't have a lot of patients today. We have enough supplies to last us until the day we die. We were hoping that the vaccine would do the job. We still feel uneasy when we see the rooms filled with "airborne precautions" symbols on the door. Is this the last one? Is we prepared?

The views expressed by the author or authors are not necessarily those ofScientific American.