Women in Neurocritical Care Corner: Perspectives from the Frontlines
By Diana Greene-Chandos, MD, FNCS
I recently watched a segment from a critical care physician on national news, where she described writing a “goodbye” letter to her children while struggling to catch her breath due to hypoxia from COVID-19. I, like many, were moved to tears by the rawness of the interview and the mere consideration that I and many of my colleagues around the world, could potentially be in the same boat.
Many medical professionals have lost their lives or have become gravely ill — to think that it couldn’t hit our wonderful NCS family would be defying odds. As such, I decided to dedicate this article to every member in the Neurocritical Care Society. While some are experiencing this pandemic in extreme scenarios and have watched their neuro ICUs turn into COVID units or MICUs, others are diligently preparing for the surge in their hospitals and helping those colleagues across the country with kind messages and food. This article explores our heartfelt perspectives collected from conversations and social media posts from multiple NCS members tackling this viral beast from their different roles in healthcare.
On New Routines
Everyone is in scrubs and do not see each other’s smiles through masks. We have each developed our own personal and elaborate decontamination process to keep the virus out of our homes. Many of us never imagined spraying Lysol on everything we own, undressing in our garages or keeping our children away when we return home until we have fully showered. We have coveted items like bleach wipes, hand sanitizer, hydrogen peroxide, UV gadgets and any PPE we can get our hands on.
Some get an extra 30 minutes of sleep because there is no makeup or hairstyling. People are figuring out how to cut their own hair or making family do it. We sanitize our hands like our lives depend on it; in fact, our lives can depend on it. Families with children are having raw moments like having their children ask, “Mommy, would you please play with me before you go to work, in case you don’t come back?” Those with older children are helping navigate the stresses of online classwork and serving as surrogate teachers. Some parents in NCS are making wonderful lessons plans and sharing projects on social media. Others with young adult children are making certain they all know the location of wills, deeds and important phone numbers. Some parents have opted or needed to live away from their family, and FaceTime and Zoom have become their lifelines. One NCS member said it takes about five weeks to feel adjusted to these new ways, but we all have tackled it and adjusted in such impressive ways.
On Being the New “Heros”
Many of us have shared the same sentiment that we have always been in the business of saving lives, but never with such numbers and such a potentially rapidly deadly disease without a clear clinical script. The additional support from friends, family, strangers, our medical societies, media and each other has been part of the fuel that has fed each of us. Perhaps it needs to be emphasized that never have the different medical disciplines within our specialty needed each other more. We celebrate our successes and give “high elbows.” We exchange knowing glances through our face shields, letting one another know that this just took a turn, and we may not be able to overcome. If we weren’t bonded before, we certainly are now.
On the Lack of Bedside Families
One item that has been an emotional sword is watching people say goodbye to spouses, parents, children and siblings through FaceTime. This isn’t just for COVID, but COVID has been different because their families cannot be bedside in this pandemic. Colleagues have reported crying in the breakrooms and bathrooms. They have taken to telling patients, “We are your family now.” People who might not typically be the one holding a hand at bedside can’t and won’t leave the bedside, so that no one passes alone. It will undoubtedly affect us in ways we will not see clearly until things settle, and we will need the support of one another in NCS in unprecedented ways.
On Science and Sharing Information
As a global medical community, intensive care and emergency medicine have been sharing information in quick and creative ways. International WhatsApp groups, international Facebook groups, multi-hospital planning groups and rapid approval of COVID-based grants, IRBs and journal articles have shown us what a tremendous force we can be when we focus together.
On Supporting One Another
The support we’ve given to one another through donating money to purchase food for neuro-ICUs in the hot zones and sending kind messages has shown all of us that we are truly in this together. I’ve been told of nurses sewing caps with buttons to keep our hair tucked and ears without skin breakdown for entire units. Another unit took a break on Easter Sunday to hold an Easter egg hunt in the clean areas of the unit since so many were away from families. Another unit made a TikTok dancing video about staying home that went viral and made it on the national news. Our NCS leaders and the society have made educational products free and readily available as well as giving us a break on dues for a month. There are examples in every unit around this country. I hope we hang on to this spirit from here forward. We need that to heal.
There has been much said about politics, needed changes in medicine, lack of PPE and the recovery. All of us are likely in various stages of grief, and these topics weigh more heavily than others at times. There is anger and significant fear. We are vulnerable and tired. We feel that some of this could have been prevented, and that we are being asked to work in unsafe ways. It takes a toll on everyone caring for patients and working in hospitals. We, however, all understand each other because we must get up and keep moving — if not us, then whom? We rise to leadership if it is lacking where we are. We plan. We use our creativity. We read and prepare. These moments define us. That’s not to say that we shouldn’t fight for our rights as medical workers and for our patients; we should, and I’m certain we will when we have the time to give it its due attention.
To every warrior in NCS, we in the Women in Neurocritical Care section see you and are so incredibly proud to be amongst you. There is comfort in knowing each of you is a text, email, Facebook post or phone call away for much needed support in this viral war.