A Doorway

Original story posted on: May 29, 2020

There is a doorway I pass by every day. Before COVID-19 came to town, I would stop in the doorway and ask questions like, “how many truckloads of cement to fill the vault for our new Radiation Therapy Unit?” or “how far do they drive the pilings down for our new cath lab?”

These were engineering questions, asked by a non-engineer, of our hospital’s chief facility engineer. He always gave me thorough, understandable, patient, and smiling answers. I have done this for years.

This doorway has been shut for many weeks.

About eight weeks ago, I saw our engineer’s face through another doorway – the doorway into one of our ICU rooms. He was swollen, he was sprouting all types of tubes and catheters, and he was in that COVID limbo where intubated patients go – and he stayed there a long time. I didn’t provide his care; I observed his care as part of my reclamation project, as a clinician. I saw him being cared for by many hands, many minds, and many hearts – the hands were of all sizes, the brains of all shapes, but the hearts were all the same: big, very big, hearts.

Hospital staffs are tribal. Mostly, we are many tribes, but when one of our own is dying, we come together as one. COVID was threatening one of us, and we were fighting it with all the medical spears, arrows, and fists we had.

Days passed, then more days. Days of doubting he would survive, days of debating ventilator strategies, days of questioning whether he would he need a tracheostomy, then days of wondering if he could be weaned – and finally, the day the endotracheal tube came out and stayed out. The good angels of medicine had rescued him from COVID limbo and brought him back to our world.

Yesterday, I walked by his closed door again, but it was transformed by a simple sign: “welcome back.” My hand was knocking before I finished reading.

No answer.

Today, the doorway was open, and the answering engineer was at his desk. There was a lot less of his body, but his smile was bigger than ever.

His big smile said, “I remember seeing you through the glass in the ICU.”

And before I could muster words to express what a wonder it was to see him back to work, his smile spoke again: “have you seen the steel going up on the new surgical center? Go see it, I am sure you will have questions.”

I will go see it, and I will have questions, but best of all, I will have him to answer them.

Michael A. Salvatore, MD, FACP

Dr. Michael Salvatore was a pulmonary medicine/critical care physician for 35 years. Since 2012 he has been the physician advisor and medical director of the palliative care team at Beebe Healthcare in Delaware. After earning his MD at the University of Arizona, he trained in internal medicine and PULM/CCM at Duke University. Dr. Salvatore is a member of the RACmonitor editorial board.

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