Confessions of an ICU doctor during COVID

I was asked to post some of my responses on another thread on here in hopes it would get more attention to help people. If y’all don’t feel it’s necessary feel free to lock and remove.


Wanted to give you guys an update/insider look as to what COVID has done to this country.

I am an ICU doctor In San Antonio. I have never in my life been more disappointed with the General American population. The response, handling, and public reaction has been incredibly uneducated, politicized and frankly stupid It’s gotten so bad to the point that I, a lifelong Texan born and raised and never moved out, will not be staying here when my contract is up. It has been clear what states take science and the opinion of health advisors seriously and who listens to Wall Street. I will not allow for their decisions to put mine and my family’s life in danger once my civic/contractual duty is up to my hospital and community. I’m not the only one who feels this way. So many of my colleagues are over the handling of this. So many of my colleagues look disdainfully on the public who are lax in their handling of this disease. Why should my life be at risk or forfeit because you couldn’t stay inside during a ****ing war. So a big **** you to everyone who didn’t take this seriously.

we have known about this dIs ease since late January. Not we the public. We the ICU physicians at my hospital. We have internal emails about how bad this disease would be and we started preparing for this war then. And this is a war. Maybe if y’all “patriotic” assholes heard that word you’d give a **** more. But that is exactly what this is. We are dealing with death destruction loss of infrastructure brain drain economic turmoil. What else would you call this. Leadership has known about the impact of this virus since January there is no doubt. So why are we 5 months later leading the world in cases and deaths. Why are we still up trending? Why do we still not have resources to deal with this?

I cannot speak to Houston’s ICU situation but it definitely similar to ours.

Currently all Medical critical care Trained doctors are seeing only COVID patients. Our medical icu is only COVID since we are best trained to handle the ventilator and complex respiratory failure. Our max medical icu capacity is 32. We have gone up to 36. This is just from a beds Standpoint let alone staffing. To give you an example. My last night we had a 44 year old COVID patient lose his heartbeat 4 times in one night. While I and the staff tried to keep him alive another COVID patient pulled her breathing tube out. This happened because we are so short on nursing staff. I had to leave the code to reintubate the crashing patient. While this is going on a non COVID in another floor of the hospital is also coding. I cannot respond to all of these people in a timely manner.

the medical ICU has 36 bed capacity we have more than 150 Covid in the hospital. We are quickly running out of ventilators and non invasive breathing machines to achieve safe care. Last week we had 4 ventilators left in a 300+ bed hospital

while supplies and beds are running short. SurgicL icu is attempting to help treat some of the icu Covid but remember this is outside their training and scope of practice. They are helping because we need manpower.

while Covid is going on remember that people still overdose, get to drunk, collapse their lungs, have heart attacks, have cirrhosis, have cold exacerbation, have heart failure, have serious infections, have flares of chronic diseases. Now those patients are being by non critical care trained staff. Good luck to you now if you are unfortunate enough to have any accidents.

this is not an old person disease. The youngest patients I have are 18 18 29 36 42. Some of them have already been trialed on bypass options. I doubt they make it. If you survive an icu stay there is no telling what havoc this will have on your body going forward. Your body just doesn’t go back to normal after getting nuked. Good luck affording these hospital bills. Good luck finding insurance to cover your new pre existing conditions.

congrats American public you played yourself. If it was so safe to work and not wear masks why is every icu overrun. If the federal government name,y Republicans saying its a hoax or safe or no need for masks or the economy or freedoms are so constant on these facts then why are most federal jobs/institutions closed?

i have never been more ashamed of the American population And the federal government in my life So many people young and old will die or have life long disease because we couldn’t stay inside watch Netflix and eat delivered food while a war was going on on our soil.

 

QUOTE="bigtexxx, post: 12997148, member: 4585"]I am of the belief that the lockdown didn't do much for us. I believe somewhere between 20-40 million Americans got this virus, and we only detect a tiny percentage of the true number of cases. This also could explain why despite all the "new" cases (more like discovered cases...), deaths per day isn't going up.

Just look at Los Angeles - one of the strictest lockdowns in America, and a very high number of cases.[/QUOTE]

You’re a ****ing moron. The lockdown worked I was the admitting ICU physician during the first wave of cases to the IcU. We admitted a 44 year old mom with no comorbidities. She went on later to die. But I remember being thankful on nights that the first wave only took half our available ICU beds. The first peak settled out because we were under strict lockdown. The moment Abbott and that prick Patrick decided to open up every single ICU physician has been mentally and emotionally preparing for this battle. This surge is nothing like the first. We have 200 covids in a 300 bed hospital. The entire medical icu and surgical icu is full of covids intubated. They take weeks to die and crash repeatedly during those two weeks. I have no one over the age of 70 on a vent. The age range is from 18 to 68. They were not supposed to die from your self picked stats. But they will now. The lockdown worked. Our first wave was mild and manageable. Then your repubs opened up the economy and now we’re drowning along with our patients. The death numbers are lagging and will climb. We can not safely extubate these patients even after 2-3 weeks. And as each day passes and we burn through sedation and paralytics their oxygenation doesn’t improve. While these patients occupy my time I’ve had to offload DKa and renal failure patients to physicians who are not trained in medicine or critical care. You’re a stupid **** who does not understand the complexities of medicine. I’m tired of people like you thinking you know **** about the war were in. How about to u shut the **** up and listen to the doctors nurses and epidemiologists on this matter.

 

I’m a physician what that means is I’m 120K in debt. I spent 14 years post hs training and educating myself. I worked 80 hour work weeks to learn my craft. I have professional malpractice insurance. I am required to maintain state licensure. This is the story of almost every doctor.

I don’t see your telling your plumber how to do his craft, or your mechanic, or your lawyer, or your real estate agent, or your chef, or most importantly your generals. So when the most experienced and studied people in your population, scientists and physicians, tell you take it seriously man up and mask up and go lockdown you should listen.

 

These are my thoughts in April. Funny to see that things didn’t change and actually got worse. Lol who would’ve thought.

"]I am an ICU physician who is dealing directly with COVID patients. Trump and the federal government are completely in the wrong. I’ve never been more pissed at a group of people in my life and more scared to go to work. We literally have under 40s in the ventilator and we haven’t hit surge yet which is predicted to be in May. For reference my department and I have been waiting for this since the end of January. We have emails in our department and between intensivists at other hospitals talking about getting ready for when this hit. Trump, the federal administration, and the corporate hospital environment have failed the people. Trump firing the pandemic team is issue 1. Calling it a hoax and underplaying the situation is issue 2. Allowing the states to deploy social distancing instead of mandating it on a federal level is issue 3. We needed the distancing to slow down the coming onslaught into our ICUs and save supplies. This disease may not seem scary to you because of its “low” mortality but ask yourself one thing. If the people who regularly take care of people on ventilators are only taking care of Covids who is taking care of heart attacks trauma and gi bleeders? It’s a resource drain this disease. Speaking of Trump and the CDC delayed available testing so we were blind as to what we were dealing with. Set up no point of contact tracing and delayed PPE manufacturing. He is a ****ing utter failure and deserves any hate that he has coming his way. Make no mistake he killed us to try to save Wall Street. This is from a front liner who is seeing the consequences of his actions up close.[/QUOTE]

 

QUOTE="BallaDoc, post: 12922549, member: 63556"]trump and his base are a bunch of p*****s. Would love for any of these asshats to come to my icu if y’all wanna see what this **** is about. Better yet come into the room of a patient we’re having to rotate on a bed like a chicken to keep their oxygen up with minimal PPE. Then watch us go back and forth into that room 9 times a night to make sure her tube doesn’t slip or to adjust the vent. Then tell me oh yeah y’all are short cause you’re stealing supplies and not cause these patients are sick as dogshit.

How about his fat lardass stay in the patient room before we intubate these patients while praying to god we don’t breathe in aerosolized particles.

**** him and the republican base. Snowflakes and traitors the whole lot of them. Make your vote count this upcoming election.[/QUOTE]

 

QUOTE="BallaDoc, post: 12922563, member: 63556"]they died of covid you ass hat. I’ve got under 50s in my icu vented. There is a genetic predisposition to this that you haven’t gathered yet on your presumed reading. The virus stimulates an inflammatory reaction in your lungs. They stiffen and it becomes impossible to ventilate or deliver oxygen. There is no cure for it only time. Because the virus is so virulent we cannot do our usual tricks to save these people from a ventilator. Any other time you come to my icu I can stave off an intubation with high flow delivery devices. I cannot do that in these patients because it aerosolizes the particles and makes it more virulent. Not only do we intubate from an infection control standpoint but we intubate because they crash fast if you don’t. There lungs fill up with fluids. Th year don’t necessarily die but they use up resources.

You are also incredibly short sighted in your mortality estimates. If the projections are 50% will contract which they will and 5 % critical. Who do you think is taking care of those patients? I am. How many of me are there trained in ventilators. Lol not a lot. Who will manage the ventilators of the regular car accidents, infection , heart failure, Gi bleeder if I’m tied up with covid?....... yeah that’s what I thought.

Get out of here with your false information asshat.[/QUOTE]

 

QUOTE="BallaDoc, post: 12922606, member: 63556"]my case is physical proof. I watch them come in and get intubated for covid. Dig through their chart and labs and find there’s nothing else going on them. Watch as every organ system is fine except the lungs. Watch them code because I can’t oxygenate. Pronounce them dead without seeing any hypotension, cardiac disease, asthma, or kidney failure. They literally die from ARDS you ****ing moron. Every doctor in the world is telling you to take this **** seriously. We go to undergrad medical school train as residents and then fellows. We’re trained 30 year olds watching young ones go on the vent for no reason. Luckily the young ones have enough reserve to bounce back and get extubated some aren’t as lucky. And again if I’m tied up taking care of an intubated young covid who May not die who is taking care of the rest of the critically ill.

you’re completely dense and beyond arguing with. You have no idea of what you’re talking about any making up assumptions.
There is no targeting the vulnerable because everyone is exposed. If there is a genetic predisposition then how would you know until you have it until tested and then pay for it with your life.

The medical field isn’t talking about shutting down for good you imbecile. We’re saying stave the curve. Limit the spread now so we can catch up. By all intents and purposes this virus is here to stay. We need to be exposed to it or to a vaccine. But until then limit the spread so the hospital system doesn’t collapse. Or not. Go ahead enjoy your liberties. Go have a beer go for a drive. God forbid you get into an accident and develop a pneumothorax. God forbid you need to come to the ED and need me to re expand your lung. If you do sorry can’t help you I’m dealing with the covids. So enjoy your liberties assface. We’re saving your lives and all we’re asking for is time. We understand the economy is screwed. But it’s ****ed regardless. Maybe helicopter some money to the people while we try to save lives.[/QUOTE]

 

QUOTE="BallaDoc, post: 12922885, member: 63556"]lol you don’t get it man. If 1-2 million Americans die. How many of them were using up hospital resources for how many days. “Just 1-2 million died from corona” no big deal. But what about all the other people who will die from lack of access to me and my hospital and limited resources. How much of the health care system will go down to keep you guys alive “when all of this eventually died down”. We’re not talking about just old people dying quick. We’re talking about old people dying eventually while using up hospital resources and young people not dying but staying on vents critically ill for protracted amounts of time. The healthcare system is collapsing. You need to do your part and stay home. This is literally a ****ing war. Stop being dense.

He is not my commander and not my president. **** him and his base. For many reasons he ****ed up him and it’s time to stop defending this stupid ****. The moment he put me and my hcw on blast for demanding too much PPE was the final straw. First of all the previous administration had a pandemic team ready for this outbreak which he foolishly fired. Obama set it up for trump to knock it down. Strike 1. We physicians have known about this virus for literally months. We have been awaiting its arrival to the states. There is no doubt he knew it was coming because I knew it was coming in early February and I’m a lowly ICU physician. My department started talking about how we would treat these people in February and we’re doing research on the topic in January. If we knew he knew. Strike 2. He then spends the early portions of this disease calling it a hoax and the invisible scourge and the Chinese virus. First of all it wasn’t a hoax. Italy and China were dropping left and right. Why would they lie and be part of some “democratic conspiracy” they and the WHO were literally warning us for months. His verbiage and defiance of taking this seriously leads to his idiotic repugnant base and stupid people to think of this disease frivolously which stresses the hospital system kills more people and directly puts HCW in lines of danger. Strike 3. We knew we had a PPE issue before all this began. Calls were made to enact the defense production act in February. It took him a week to sign it and then not enforce it. He then makes asinine comments that hospitals are stealing supplies and don’t know how many vents we need. How would it sound if the president told the army. Hey man I’m gonna hold off on making tanks and bullets and missiles during WW3 because I don’t think y’all need more and I think y’all are stealing it. That’s essentially what he did. He limited our ability to defend ourselves. Strike 4. He doesn’t mandate social distancing and leaves it up to the states to figure it out. Strike 5. He is choosing which states get what supplies first because of who kisses his ass. He is killing civilians possibly his voters because of his ****ing ego and exposing doctors and other civilians. Strike 6. His first actions for economic stimuli were not to help people or healthcare but to stimulate Wall Street and infuse it with money to promote confidence. This backfired. People saw through it immediately. The issue wasn’t lack of confidence in the market. It was people worrying about being liquid enough to ****ing eat and pay rent. Instead of helicoptering money or pursuing QE in times of extreme recession he chose to bail out big corporations and wal Street. Strike 7.

you talk about economics a lot. I always hear about the economy was booming. I don’t think you understand there are 2 economies one we live in and one they live in. The median income before this pandemic for a family of 4 was 58K. How in the hell is 58K supposed to afford you a mortgage, food, health insurance, premiums on health insurance, co payments, and college. It’s downright impossible. Of course people can’t ride this out. The system was ****ed to begin with. They don’t scare about us. When I’m in the outpatient setting looking at these hospital bills or cost of medication that I have to prescribe to keep people healthy and alive. I realize I can’t even afford this stuff.

Lol the looting argument always comes up. If it comes to that I thought we had the best military system in the world stacked with 1 billion dollars yearly that are supposed to defend us from overseas threats. Least they could do is come back and protect us from ourselves. The least the government can do is helicopter money to the people to keep things afloat while everyone develops an immunity to this new virus. This is literally what the government is for. Trump time and time again has shown he’s a narcissistic snowflake piece of ****. Not my president.[/QUOTE]

 

**** your appreciation. I’m not blaming trump. I’m blaming him every politician and the general community for not taking thugs seriously and overwhelming our hospital system. I have every right to be in rage at what you guys are costing people the hospital and potentially my daughter.

 

Sorry guys. Never really made a post before quoting my old stuff. I’ll try to clean it up in a bit.

 

Agreed I’m sorry for the sloppiness. I’ll try to clean it up.

 

lol I can’t tell if you’re insulting me or not but I agree with your explanation of why I’m mad. This thing reads like a teenagers diary and I apologize friends. But yes I’m mad because everything going on right now is not being driven for patient and people’s safety and health. It’s disheartening going every night to tell someone we have to intubation you call your wife and kids now before we do this cause it might be the last time you talk

 

It’s disheartening watch 18 and 29 year olds not respond to lung bypass and their parents wail when we tell them the outlook. It’s disheartening watching this and then seeing the general population be lazy in taking this seriously