For COVID-19 patient, a trip across the hospital is an epic journey with no room for error l Expert Opinion

Our patient was a young man in the intensive care unit whose heart and lungs had both failed, a consequence of COVID-19. He had needed both a ventilator and a portable heart-lung machine, but had recovered enough to come off of the latter. This meant surgery.

But just moving him to the operating room was such a Herculean task, our nurse-manager declared we needed a “pre-transport huddle.” This is the new policy since coronavirus came along, complicating surgical procedures that were never all that simple to begin with.

So about a dozen people – the surgical team, the anesthesia team, the nurses, the respiratory therapists and the perfusionists — all gathered to talk about what would happen next.

Our patient – who before COVID19 had been perfectly healthy — had four large machines connected to him by 20 or so tubes. Among them were one that protected his airway and two large ones that were carrying five liters of his blood every minute to the machine that would enrich it with oxygen and then send it back into his body.

If our movements were not perfectly in-sync, if we all failed even for a moment to move at exactly the same pace, any of those lines could catch on something, kink, or disconnect, potentially killing him.

Add to all that the fact that both the patient and the team had to be fully decontaminated before leaving the ICU. We all wore multiple layers of protective equipment, which trapped heat around our tense bodies and made communication more challenging. The N95 masks we wore to keep our own respiratory droplets to ourselves tightened against our cheekbones and muffled our voices.

All we could see of each other was our eyes, which all conveyed the same trepidation. Once we start moving, we could not stop. We could not make a single mistake on the way to getting the patient to the operating room, and then safely back in his ICU room, one step closer to overcoming the disease.

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Our procession moved slowly and steadily, pushing the heavy ICU bed like the current carrying an iceberg. We packed into small elevators and slipped through tight doorways. As a unit, we pushed hard going up ramps and pulled back going down ramps. We paused many times — always planned, always together — to rest and collect ourselves, drenched in sweat. The trip took about an hour each way, nearly three times as long as it normally takes.

At the beginning, many challenges are so complex and demanding as to seem insurmountable. From the base of the mountain, the summit is barely visible; it is hard to imagine yourself at the top.

But an intimidating snapshot becomes an attainable goal when you look down and force a step forward, then another one, then one more.

As we move closer to the summit, our perceptions change. We grow taller as the adversary becomes smaller, until we look it in the eye, and then pass it by.

Once our patient was safely delivered to the O.R., successfully taken off the heart-lung machine, and then brought back to his bed, a series of tasks that seemed so daunting were behind us. This time, the glances we all gave each other were nothing but happy, as if we could barely remember what had so worried us a few hours before.

I hope that one day we will be able to look back on the pandemic in the same light. We will never forget the terrible toll in lives and health it has taken. But perhaps we will, by moving forward each day without giving up, look it in the eye, and then pass it by.

Jason Han is a cardiac surgery resident in Philadelphia.