A tale of evolving conversations

Somewhere deep inside, there was hope that the need to apply this information might never arrive.

As a hospitalist at a tertiary care center in Wichita, Kan., I've seen COVID-19 as a tale of evolving conversations. Sitting in our office while charting late in the afternoon, I remember discussing how we felt that social media was primarily responsible for creating paranoia about this new and little-known disease. This was near the end of January, a time when we shook hands and celebrated birthday parties without guilt.

As we slowly crawled through February, the number of cases began to slowly rise. We knew that COVID-19 was now a reality, though it was still far from our reach, since we were in the middle of the country.

That was also when our conversations began to change. A slight tension could be felt in the atmosphere in our office. New information started rolling in with each passing day. We tried to stay updated with the tsunami of data that came our way through emails, text messages, and news media. Somewhere deep inside, there was hope that the need to apply this information might never arrive.

And then came March. A nearby county started becoming an epicenter of cases. We felt prepared for what was coming, though we could hardly ignore the anxiety that had engulfed our entire group, in different proportions, depending on individual characteristics.

One day in the last week of March, I received a frantic phone call from a PA in a small rural ER in Kansas. He presented the case of a hypoxic patient with possible exposure to COVID-19. He wanted me to accept the patient to my ICU. I requested that they stabilize the patient prior to transfer. The patient ended up getting intubated. I talked to the intensivist on call at my hospital, updated my chief, and called the PA back. The patient was already on the way to an air ambulance.

Upon his arrival, we sent a PCR test and provided care to the best of our knowledge at that time. Later that night, I received a phone call from our lab. The patient tested positive. I shared the news on our group's communication thread, and virtually felt the collective adrenaline rush through our entire group. COVID-19 was finally here, in the middle of Kansas, announcing itself with a sick intubated patient on multiple pressors. Our conversations were now drenched in anxiety, coupled with a slight undercurrent of ambition, and topped with the uneasiness that accompanies uncertainty.

As we enter the final quarter of the year, our conversations continue to evolve, as does our understanding of this menace that has transformed our lives.