Front Burner - ICU workers on the job, in their own words

Episode Date: April 23, 2020

Since January, the staff at Markham Stouffville Hospital in Ontario have cared for hundreds of COVID-positive patients.Through a series of self-recordings and interviews, CBC's Wendy Mesley was able to access what life is like inside the hospital's intensive care unit. Today on Front Burner, she shares stories of the physical and emotional toll faced by front-line workers there, in the midst of the COVID-19 pandemic.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. Hello, I'm Jamie Poisson. He came into the ICU on April 13th. He's sat in 92 to 95 at rest, but his respirators above 45 at most times unless he's sleeping and it drops down to 38. A dozen frontline workers are gathered for rounds by the intensive care unit at Markham Stouffville Hospital. They've been dealing with COVID-19 since early January, with 30 positive

COVID-19 patients and more than 30 awaiting test results. And beyond providing for their physical needs, these healthcare workers are providing a different kind of support too. physical needs, these health care workers are providing a different kind of support too. Families are cut off from patients. We've become their support system. It hurts us too, but we're trying to do our best to try to connect patients with their families. And at the same time, they're also caring for their families at home. Today on FrontBurner, we take you inside Markham Stouffville Hospital and hear from the frontline workers themselves on how they're dealing with this unprecedented health crisis. I'm here with my colleague, Wendy Mesley, host of The Weekly on CBC. She's also been covering COVID-19 for The National, including the story about Markham Stouffville Hospital, northeast of downtown Toronto.

Wendy, it is such a pleasure to have you on the podcast. Thank you so much for being here. Oh, Jamie, it's so great to talk to you. Normally, we get to work together in the same office. Now we're both sort of at home. It's very weird, but great to be on the show. Thank you so much. Yeah, I was going to say, I've been waiting for you to come onto the show.

Wendy actually works right beside us. You've been a wonderful mentor to me since I started at the CBC. Aw, aw, thank you. And now we kind of hover and try and steal your stories. Okay, so tell me about the hospital. When did they first start treating COVID-19 patients? Well, they prepared for this like everybody did at all of the hospitals. They did all of these drills. They thought they were ready. And then they got hit really hard and really early. They're in York region, just north of Toronto, and they had hundreds. In the last few weeks, they've had

hundreds of people test positive and go through. Nine people have died. You're breathing. Since you came into hospital, has it gotten better or has it stayed the same? Every time I just take a deep breath. And I guess the scariest thing for them right now is that they've got outbreaks in a number of long-term care homes and shelters and so on very close to them so it's it's like a brand new surge of of people and in the past they thought well you know we've we've trained for this we'll be okay the hospital's downtown in toronto they're not yet full they're not yet at capacity we can handle this but now there's another surge and it's not ending so it's i mean it's not the triage that everybody i mean you guys have talked about it, the idea that we would somehow end up like Italy, where doctors would have to make this horrible decision

about who would live and who would die. One specialist told local media they are overwhelmed and are having to choose who to treat. And in some cases, older patients may not get the same level of care. Doctors also making the ultimate sacrifice. One physician reportedly didn't want to take an intensive care bed from another patient. It cost him his life. They're not there, but it's still terrifying. They're just surrounded by COVID. When we talk about preparedness,

how are they feeling on the personal protective gear part of this? Because I know that that's something that a lot of hospitals have had to deal with as well. Yeah, we noticed that when they were doing an intubation they were they were gearing up like they were fully going into war. And they all wear masks and they actually have somebody called a PPE guide. So she talks them through which gear they're supposed to wear. And when they did the intubation, we could see actually the PPE guide telling the anesthetist through the glass how to take off his gear, because during those operations, those procedures, sometimes they risk being splattered with COVID.

So they're terrified. They know that they're exposed to this all the time. But they've been trained for this and they feel like they are protected. And it's their duty the most emotional part for them is dealing with the families because normally you know somebody is sick or dying in hospital and you can go in and visit them and you can comfort them but now nobody's allowed in because of the risk of COVID and so the doctors and the nurses and the staff they're all trying to fill that role too so that that we hear the chief of the medical

staff, Dr. Anna Ndube, we watched hours and hours of tape that they sent us of him doing his rounds in the morning. And he's told by the staff, actually a guy that we thought was going to be okay, he's having a lot of trouble breathing, he's failing. And he's like, oh, I'm going to have to have the talk. I'm going to have to talk him into going on a ventilator of being intubated which you have to be you know we have to be sedated for it's a big deal they know that not everyone's gonna come back from that because he wasn't a fan he was not interested that much he was sort of convinced now we're sort of getting to that he wants to know when he can go home so he has

he is not grasping this everybody was so emotional so intense i know that you got to talk with several of the staff there you mentioned dr jube uh i also want to talk about dr subarna tirunaman who is one of the intensive care doctors there can you you tell me about her? She's seen it all. I went into medical school, decided to be an intensivist. And then I was thinking, had I known that there was a pandemic coming, would I still have done the same thing? And it's a lot of, it's a question that my family asks me a lot. But I can't imagine doing anything else. But she's also got three kids and we watched as she called her kids on FaceTime. They're all three young ones. How are you? What are you guys doing? I have social studies, science, math and English. I have math. When are you coming home? So I have a few more things to do. Hopefully I'll be home

in time for dinner if not after that. And she's like, that's my biggest nightmare, is I deal with COVID patients all day, and then I have to go home, and I'm terrified of infecting my family. I'm taking all of these precautions, but I'm terrified. So she says that she showers before she leaves at the hospital, then she showers again when she gets home, and she's showering so much she's afraid her hair's gonna fall out so it's it's it's so moving and yet she's also really proud of the of

the work that they're that they're doing and she was she spoke of this one fellow that she dealt with a patient of hers who like her is from Sri Lanka and he's a young guy and we got to hear an interview that was done for us with him where he talks about you know my dad was infected I brought him home then I got infected and I thought I'm a young guy I'll be okay I'll be fine and then he started to deteriorate quickly and they told him I have 15 minutes to talk to my family and I know when I would be up up again a few minutes to talk to my family and I didn't know when I would be up again. A few minutes to call your family and tell them you're going to be sedated, you're going to be intubated, you're going to be put on a ventilator and he

says it was the most heart-wrenching thing he's ever done. I was a little bit scared coming into the ICU. There were a lot of people, a lot of people, a lot of doctors and nurses. And then after that, it's all a blur. To be honest, the integration period, I don't remember much. I actually don't remember anything. He was on it for 10 days. All he remembers is that Dr. Taranyanam... ...kind of gave me the confidence that everything would be okay. And so that kind of put me at ease. She like held his hand because the family's not

there. She held his hand and said, you're going to come out of this. But then she told us afterwards, you know, we don't always know that someone's going to come out the other side, that it's that sometimes people just never wake up. It was so, so difficult to see. We talk to them and to their families about what to expect. And sometimes patients are so weak and so short of breath that they can't hold up their own phone. So we're holding that and it's heartbreaking. It really is because, you know, these are people with families and a life. And it's scary that family is not there.

But it really also prompts us to, and makes us passionate to get them better and get them back to their families so they can say those same things to their family, to their face. It has struck me, watching this, that these doctors are not just playing the role of doctors in so many of these cases. They're also playing the role of family members and friends and support systems in ways that they may not have had to have played before. Oh, it's so overwhelming. We talked to Lakeisha Mohan. She's a critical care nurse, and she's young. She lives with her family, with her parents, with her grandparents. So she doesn't worry about her kids.

She worries about infecting older people in her own household. That's one of my biggest nightmares. Before I can even say hi to them, I run upstairs, take a shower, put my clothes for a wash, keeping myself further away from them. I'm always isolating myself in my room. It gets lonely, them. I'm always isolating myself in my room. It gets lonely. But even then, I'm always asking myself, do I need to do more? Do I need to move out? She deals not only with the COVID patients in ICU, but she also deals with COVID patients downstairs and just the medical unit. And some of them, she says, she does become like family for them. And it's so hard because she has to be the one to tell them, I'm sorry, but you're older, and you're frail, and I know you're having trouble breathing, and we would love to put you on a ventilator because that would probably help, but you won't.

The odds of you surviving the ventilator are not very good. We're trying to do our best to try to connect patients with their families. Nurses are going into the isolation room, gowning up, holding an iPad so they can talk to their loved one. Even when the patients are connected to a ventilator, they can't speak. Family just wants to talk to them. So I can see sometimes the families are telling them to get better. I can see sometimes the families are telling them to get better. They're making future plans and they're pleading to the family. And it's devastating because you know sometimes these patients won't make it.

And normally there would be a husband or a child or a brother sitting there holding the patient's hand and she has to be like family. And then sometimes the patient will need other care, be sent sent to another hospital and they'll be sent off alone and that's that's one of the the biggest emotional tolls on on not just the patients but also on the medical staff is that they're alone that they're the only ones that are dealing with this and that's that's not what these people were trained for no one trained them for this it's exhausting it's been both physical and emotional um stress on us but we put our fears aside and we we are there for our patients that is something that i've been thinking so much about watching this story unfold is just the people who end up dying alone. It is sort of one of the most tragic parts of this whole story. And it also just does put so much pressure on these doctors to be there for these patients as well. I know, Wendy, how these doctors are

treating patients has literally changed as well. We see that in a video of an intubation process that you were able to get when you were sort of collecting all this material from the hospital. And can you describe what you saw and how this procedure is so difficult in this current context? Unfortunately, me and my family have spent a lot of time in emergency rooms and surgeries and so on. I've never seen anything like that. They have all of this amazing technology that they don't want to take into the room and contaminate, so they set up everything outside,

everything from the sedation to the tubes that are going to be used for the intubation, all of the monitors, the're doing for the patient because they may not survive but also for the medical staff doing it because there could be so much COVID in the air it's what's called an aerosolized procedure so they wear the garbs they wear the the masks they wear the shields over the masks they wear the gloves they write their names on the back of their gown so that they know who each other are. And then they go in and they anesthetize the person. They don't know if they're going to save the person. They don't know if they're going to put themselves at risk. They're doing their best, but it was just,

it was so, so intense to watch. We are all properly gowned and gloved in all of our PPE, but you still worry that if something doesn't work properly in your own PPE, that you're putting yourself at risk. Most of our patients have been young and aware of what is going on. They're surrounded by a bunch of strangers, completely gowned, and they can only really see our eyes. And it's very hard to watch someone because we're all human. And it's quite difficult to put yourself in their position and think about how they must be feeling in that moment. Being on the front lines of this, you know, it feels like something that a lot of us will never really be able to fully comprehend, you know, what that feels like. Are the doctors and the nurses and the staff at Markham Stouffville Hospital, are they encouraged by how Canadians are reacting to this, you know, how they're doing to stop the spread? Or are they worried?

Well, I was kind of taken aback because they're very proud of what they've been able to, all the lives they've been able to save. And there were some happy moments of, you know, one fellow was extubated, as they say, and taken down the hall after 17 days on the ventilation. They were so proud. Hold on, can I just put this one over your nose? And they're so grateful to Canadians for all of the efforts that they're making,

and they're saying that the social distancing is working. But it was fascinating. We talked to a woman named Jaya Nataraj, and she is the infectious disease specialist in the ICU unit. And she was very calm and cool until we said, you know, what's been the hardest part for you? And she says, it makes me crazy when we call these 20 and 30 year olds who have been diagnosed as positive with COVID. And we can tell that they're in a large gathering that they're out in their car and having fun and they're positive with COVID. One of our nurse practitioners who calls them will tell them,

how old are your parents? How old are your uncles and aunts? And you realize when you go back home and you haven't distanced yourself, you are going to get them sick. Do you know how many people we have in our ICUs right now? I feel that people are not taking it seriously because they're not actually able to see these patients and see them come in here, be away from their families. Some of them pass away without seeing their families. And basically, how dare you that this is irresponsible?

She was so mad. And then we talked to the chief medical officer, Dr. Anand Dube, or the chief of medicine at the hospital. and then Dubé, the chief of medicine at the hospital. And he says that the idea that people might now think that they can ease off is terrifying. It's almost an insult to what we've been doing, because we are working so hard to get these people back to their families. And if we get inundated with more patients, it just means that our mortality rate in our province, in our region, in our country is going to be higher.

So I was really taken back by that. Wendy Mesley, thank you so much. Jamie, so great to talk to you. Thank you so much. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. You can watch the incredible footage from Wendy's story on CBC News Online. We'll link to it in our social media account. That's all for today, though.

I'm Jamie Poisson. Thanks so much for listening to FrontBurner, and we'll talk to you tomorrow.