24 Hours Inside a Brooklyn Hospital: An Update

[0] Hey, it's Michael.

[1] Starting today, the Daily is revisiting our favorite episodes of the year, listening back and hearing what's happened in the time since they first ran.

[2] Up first, a story from this spring when New York City was the epicenter of the pandemic.

[3] It's Thursday, December 24th.

[4] So every morning in the intensive care unit at the Brooklyn.

[5] hospital center, the doctors gather for something called morning report.

[6] The people who were on overnight, they stand around and the head doctor is there, and they kind of give a report of what happened, and then the new doctors who are coming on, they get that information.

[7] When she was at rest this morning, she was breathing 23.

[8] She was very comfortable, thumbs up.

[9] They talk about, you know, who was admitted, who got critically ill. And one night patient is not doing well, so she has to be re -intamated almost immediately.

[10] And one recent morning report was particularly intense.

[11] Okay.

[12] All right.

[13] Okay.

[14] Next patient.

[15] There were patients in their 80s and patients in their 30s.

[16] You know, 30 weeks pregnant, asthma, obesity, amid the ICU.

[17] She was intubated yesterday evening.

[18] She was there part of the...

[19] All right, good.

[20] Next.

[21] There were patients from nursing homes and patients who were homeless.

[22] She was intubated overnight.

[23] She's on a zythromycin, clock with all subtraction.

[24] Okay, next.

[25] Patients with asthma and diabetes and patients with no underlying conditions at all.

[26] But as the doctor's race to get through the cases, they all shared a nearly identical description.

[27] He was upgraded for acute hypoxic respiratory failure.

[28] Okay, next.

[29] Now if you're hypoxic respiratory failure, secondary to confirm COVID.

[30] All right, next.

[31] Admitter for acute hypoxic respiratory failure with confirmed COVID -19.

[32] Next.

[33] Acute hypoxic respiratory failure, secondary to COVID -19.

[34] All right, next.

[35] From the New York Times, I'm Michael Babaro.

[36] This is the Daily.

[37] Today.

[38] It's been more than a month since the coronavirus descended on New York City's hospitals and on Brooklyn Hospital Center where the vast majority of patients in critical care have the virus.

[39] My colleague Sherry Fink has been reporting from the hospital with the permission of staff, patients, and their families and brings us the story of a single day there.

[40] It's Thursday, December 24th.

[41] Morning, everybody.

[42] Josh, do you want to spend a little...

[43] This is Sherry.

[44] at the New York Times, and she's going to spend some time here a little bit.

[45] Pleasure.

[46] It's up to you.

[47] I'm fine with a physician and a...

[48] So for the past few weeks, I've been embedded in the Brooklyn Hospital Center.

[49] I'm going to finish rounding here, and then I'm going to do it downstairs and cover a SI.

[50] And what I've been able to see there is incredibly unique.

[51] What's happening?

[52] What is it like inside a hospital during a pandemic?

[53] Okay.

[54] Do you want to give him your mic or are you willing to wear?

[55] And there was one doctor I met who really embodied that transparency.

[56] Does it beep every time I say a four -letter word like South Park?

[57] Dr. Josh Rosenberg.

[58] I am mildly inappropriate.

[59] I'm just warning you.

[60] An attending physician in the intensive care unit.

[61] How are you, Peter?

[62] I didn't see you hiding over there, my friend.

[63] There are people from all over the hospital recruited to work in the ICU.

[64] So it's not just like ICU doctors and nurses who are used to intensive care treatment, but in fact...

[65] And she's one of the podiatry residents.

[66] So all people who are good with knives and big needles.

[67] When I was there that day, there was a podiatry doctor in two of her residents.

[68] Those are doctors who work on the feet.

[69] No, no, no. What I would like to do is that as much as possible, we're going to try to get all the COVIDs on one side.

[70] And then the whole area is a dirty area.

[71] And the ICU had actually effectively doubled in size.

[72] So it was completely full, and they had to turn to other areas of the hospital to turn them into intensive care units.

[73] In fact, a big part of the ICU is now in a place that just a few weeks ago was where patients would come for outpatient chemotherapy treatments.

[74] That's now in ICU.

[75] Thank you.

[76] Watch out.

[77] Don't trip.

[78] Don't trip.

[79] Don't trip.

[80] Don't trip.

[81] It was also a bit of an obstacle course.

[82] Don't trip.

[83] There were cords everywhere.

[84] Please be careful.

[85] Do you have gloves?

[86] They had pulled apart the ventilators.

[87] They had the control parts of the ventilators that were helping people breathe, those were in the hallways so that nurses and respiratory therapists didn't have to go in and out as much and expose themselves to risk.

[88] What?

[89] This is a disaster waiting to happen.

[90] Yes and no, though.

[91] And the nurses were doing the same thing with IVs, with the tubing that the medicine flows through, so they had pulled the IV pumps out of the room so that they could not have to go in and out and use up the personal protective equipment.

[92] It's great.

[93] Yeah, I mean, you can trip over it.

[94] All have to be very careful.

[95] You just have to be careful.

[96] Yeah.

[97] All right.

[98] It's making the best of what you can do.

[99] Yep.

[100] Okay, guys, can we start with number two?

[101] Appreciate everybody being here and everybody's support massively.

[102] So now Dr. Rosenberg is taking over for the doctors who were working the night before, and he's beginning to make his rounds.

[103] Let's start with number two, and then just go around the unit, please.

[104] All right, so, lucky number two.

[105] So nearly all the patients in the ICU are in ventilators.

[106] So do we have any history of smoking, shisha use, anything like that?

[107] Some have asthma, some have diabetes.

[108] All right.

[109] What did you do for a living?

[110] Occupational exposure?

[111] But a lot of these patients don't have any underlying conditions at all.

[112] I'm just right, because, I mean, listen, on some of these, you have a real reason why, you know, they may have bad lungs and that makes it worse.

[113] Sometimes it's just the disease, but if there's something we can do to them.

[114] So, Josh and the other doctors are kind of confounded by some of the patients.

[115] They don't understand why, if they don't have a lot of underlying health issues, why their lungs look so bad.

[116] Crap.

[117] Poor dude.

[118] Any asthma?

[119] And they also just don't have that much to offer.

[120] Okay, so what are we going to do with him?

[121] Right now, we're small...

[122] At this point, I'm not actually sure what we can do with him.

[123] So what is he on drug -wise?

[124] So, I mean, for most patients, they're trying this thing.

[125] called the COVID cocktail, which is that hydroxychloroquine and azithromycin.

[126] That's that combination the president talks about a lot.

[127] I don't think it's doing much.

[128] But there's really very little evidence.

[129] And Dr. Rosenberg, in particular, is very unsure that those drugs really help.

[130] We'll see about Mendezovir.

[131] We'll see if we can get some COVID results and see what we can do.

[132] So they start talking about other possibilities.

[133] There's this experimental drug called Remdesivir that you have to apply to the manufacturer for each patient and they have to meet certain criteria.

[134] You have to have a test result.

[135] They can't have certain complications.

[136] How do you guys feel about Kalitra or other PI's?

[137] There's another drug called Kalitra that doctors think might have some effect.

[138] The data's very, I mean, I think the data is very weak all over the place.

[139] That's the basic problem.

[140] So I always look at it as where are you starting these drugs.

[141] It's near the end of the sporting event.

[142] You're down by a lot.

[143] I don't care who you throw out there, right?

[144] Even freaking Jordan couldn't recover that basketball game outside of space jam when you're down by 100 points in starting the fourth quarter.

[145] So they kind of toss this around?

[146] Yeah, so we don't know.

[147] I mean, this is the problem.

[148] We really just don't know our data.

[149] But, like, so looking at this.

[150] Yeah.

[151] So we'll figure out, we'll see if we can get the randoms which I doubt we'll be able to.

[152] We'll try to get a positive test result.

[153] Next, let's move on along.

[154] Okay, ICU six.

[155] Going for C -section?

[156] Supposedly, yeah.

[157] There was another COVID patient in the intensive care unit on a ventilator, and she was pregnant, which adds a whole layer of complexity.

[158] She needs another dose of Decadron, No, Becklamath is on.

[159] Oh, sorry, did I say Decadron?

[160] Yes.

[161] And they actually decided to deliver the baby by C -section, two months before the due date, they had to give a couple of doses of steroid medication to help mature the baby's lungs.

[162] The whole goal was to save the mother's life because I think part of it is that it gives more space for the lungs to expand once the baby is taken out.

[163] I have no clue.

[164] So far what's known is it tends to be quite rare that a baby would be born with COVID if the mom has it.

[165] At least that's what the early studies say.

[166] All right.

[167] Number four.

[168] Number four.

[169] How are we doing here?

[170] It might be surprising how enthusiastic Dr. Rosenberg sounds while discussing these patients.

[171] But he's leading this team.

[172] He's trying to keep morale up.

[173] All right.

[174] So I'm going to stop here and head downstairs.

[175] Again, he's going to take 6, 7, 9.

[176] Thank you.

[177] I will circle in with you guys and John.

[178] Good job.

[179] Good job.

[180] But actually, when we were going from one part of the ICU to another...

[181] Let's go downstairs.

[182] I don't like taking the elevators.

[183] He runs into one of his medical students.

[184] How are you doing, buddy?

[185] Wouldn't you be home?

[186] Shouldn't you be home?

[187] My mom's here.

[188] Oh, fuck.

[189] Which bed is she in that side?

[190] She's in 10.

[191] Okay, I'm rounding here now.

[192] Call me at any point, all right?

[193] I'll see you later.

[194] Call me if you need anything in all seriousness.

[195] You have myself, right?

[196] Perfect.

[197] He's one of our medical students.

[198] He's been here forever.

[199] So we sent home all the medical students that rotate with us.

[200] It's very early in this crisis because I kind of looked at this and I said, one, we don't have enough PPE, you know, for all the medical students that are coming through.

[201] And two, you know, I hate to say it like this.

[202] Like, I don't want to expose them.

[203] They have enough time to get the living deal I'd scared out of them.

[204] Let them actually be students for a bit.

[205] Next patient, Santos.

[206] Yeah, so this is our, she's our 54 -year -old female history of hypertension, came here here with short of breath, fevers, admitted for acute hypothesis.

[207] She's the mom of our med student, right?

[208] Yes, she's confirmed positive COVID.

[209] And when we get to this medical student's mom, things are not looking good.

[210] Her FI