Lonely Farewells
On The Front Line Of Coronavirus by Nick Judin
July 22 - August 4, 2020 • jfp.ms
Dr. Andy Wilhelm and RN Ashley Moore’s medical intensive-care unit is strained to capacity with coronavirus patients.
ers who spoke to the Jackson Free Press, it is the cadence of their lives, the increasingly rapid drumbeat forcing the countless decisions they make in any given day. “It’s more hours of work. It’s less time for patients. It’s less time talking with families. It’s knowing that when you spend less time with the person that you may not be taking as good care of them as you would’ve otherwise,” Wilhelm said. “Nursing is all about time management,” said nurse Alex Marten, a pseudonym, whose ICU at a different Mississippi hospital is more than half COVID-19 patients. “It doesn’t necessarily require a lot of strength, or dexterity, but you have to manage 20 to 30 tasks at a time, all day. It’s like spinning plates.” And even the smallest mistake could cost a patient dearly, or expose the caregiver to the disease itself. “These people are critically ill. Coronavirus patients are exceedingly complicated and exceptionally sick,” Wilhelm said. “More sick than the typical non-coronavirus patients.” “And with them, the details matter,” Moore added. Details, endless details, emerging from the grinding torture to which the coronavirus exposes the human body. To call it a respiratory disease is darkly comic in light of the litany of damages Wilhelm lists: renal failure, strokes, clots, muscular degeneration, a vast and deadly constellation
of cardiac diseases. All require precise and dedicated care beyond the consistent respiratory symptoms, which are horribly lethal on their own. Moore and Wilhelm’s unit serves coronavirus disease patients without coronavirus itself. The virus has already torn its way through their system, leaving them free of the cause and suffering from the symptoms. “Once the virus is gone, they’re left on dialysis—or they’re left on the ventilator because their lungs are too scarred to breathe adequately anymore,” Wilhelm said.
That lingering damage is just another reason the rapid spread of the virus so threatens the state’s health-care system. Wilhelm describes the cyclical nature of treatment and recovering. “You’re having the same conversation over and over again with patients: We don’t know if you’re going to live or not. ‘Am I getting better?’ Not really. Or maybe a little bit. Or you’re still the same, three weeks in. … When you have to have that conversation every day...,” Wilhelm pauses, searching for the words. “It’s difficult.” UMMC Communications
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‘Exceptionally Sick’ For many Mississippians, coronavirus metrics are numbers on a screen. Plateaus become spikes, triple digits become quadruples. All-important data reduce the human catastrophe of the virus to a daily drip of vaguely threatening news. For Moore, Wilhelm and the many other health-care work-
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shley Moore is saying goodbye. She does not offer a traditional farewell, neither the last rites of a priest nor the comforting touch of family. “I’m gonna stay here with you the whole time to support you. I’m gonna make sure you’re comfortable,” she says to a breathless COVID-19 patient. She places the ventilator on her patient, soothing the best that she can, treating the myriad complications of an organ system in terminal decline—but for many, little she can do helps, and nothing works. “Hours later, days later, a week later ... they pass away,” Moore says in a later interview. The isolation, more than anything else, haunts her. “They didn’t get to talk to their children before they passed, or their loved ones. You are the last person they talked to.” She said goodbye to a victim of coronavirus once again only days before her interview. For her, it was the 11th time. For Mississippi, it was one of more than a thousand lonely deaths just like it. Moore is nurse manager at the University of Mississippi’s Medical Intensive Care Unit, a unit entirely devoted to severely ill coronavirus patients. She spoke to the Jackson Free Press alongside Dr. Andy Wilhelm, medical director for the same unit. Both talked candidly about their fatigue and their resolve, and the urgency needed from all Mississippians as the virus rampages through the hospital system, leaving UMMC and many other hospitals across the state packed full of critically sick and dying patients. “The hardest part for us is knowing that we’re operating at full capacity. And we know that there are a lot more people that are going to need critical care services over the next few weeks to months. We’re already going full speed. But we’re going to have to run faster,” Wilhelm said.
Catie Carrigan is a nurse at the University of Mississippi Medical Center’s Emergency Department, now inundated with COVID-19 admissions.
