Can I Open My Eyes??

Is it over yet?  Can I open my eyes??  Unfortunately, no.  It's not over and likely won't be anytime soon.  COVID-19 patients are still walking or riding through the doors everyday ... they're just easier to spot now.  We have a better idea of what to look for ... meaning symptoms, presentations, which labs and scans to order, etc. And now we can do our own rapid in-house COVID test that gets results within about an hour.  But they're still coming in and being diagnosed daily.

Side note ... the rapid COVID tests at this point are painfully inaccurate ... and it's probably most likely due to the administrators.  For those of you that haven't had the pleasure of enduring a COVID nasal swab, please consider yourself HIGHLY FAVORED.  I'm not going to lie ... it sucks.  And basically if you don't make your patient cry during the process, then you're probably not doing it right.  And because it is so painful for the patient, many staff are not administering the swab correctly.  They offer a quick apology and a three-second in-and-out of the nostrils just to get it over with ... but doing both the patient and the system a huge injustice.  Yes, it hurts!  And sometimes I've prayed with my patients before doing it because I've scared them so much in the name of honesty.  But you've basically got to shove that swab all the way up to their sinus cavity and swirl it around for 20 seconds .... on.each.nostril.  But because most tests are not being performed accurately, the number of false negatives is staggering.

I don't know if you've heard or read that there is some speculation that the virus may be attaching to red blood cells or hemoglobin in the bloodstream?  I've read various arguments on both sides and honestly it just made my brain hurt.  But what I can share is something I experienced yesterday first hand...

I had a patient who walked into the ED complaining of headache with associated high blood pressure because she had run out of her blood pressure medication.  That's it.  Headache and needed a med refill.  She conversed with ease.  Her breathing was not labored.  No other symptoms.  As I talked with her my eye caught the wall monitor mounted above her bed.  Huh ... that's not right.  I readjusted the pulse oximeter on her finger (it measures oxygen saturation).  It still read 66%.  I reached over to feel her fingers.  They weren't that cold.  Try another finger.  63.  Hmmmm ... is this thing working??  Unplug it and plug back in.  Try her left hand.  Damn, it's still 63.  "Hey Ms. So-&-So ... how are you feeling? Are you feeling short of breath?"  "No baby, I'm good.  But I'm sick of this headache and I'm sick of this place.  It's not that I don't like you but I don't wanna be here.  Can't y'all just give me something for this headache and get me home?"

I quietly finish my blood draws and assessments.  All the time evaluating her respirations and color.  I suggest that maybe a little supplemental oxygen might help with the headache until we can get some pain medicine on board.  I slip a nasal cannula under her nose and discreetly watch the wall monitor.  It starts to climb slowly ... 68 ... 72 ... 80 ... and stops.  Oh wow .... she's responding to the oxygen but it's not nearly enough.  A normal person with no respiratory disease should be in the upper 90s.  I increase her oxygen to 4 liters per minute ... it starts to climb again ... but maxes out around 89.  I double checked her triage stats and she was 97% on room air when checked in.  Uh Houston ... we have a problem.

I step out for a minute.  I bring the provider back in with me.  He orders an arterial blood gas to confirm her true oxygen saturation.  The first test results 38% PO2.  The patient wasn't having it ... cause those arterial sticks hurt too. They call in a second RT for a second ABG.  Then a third test is done.  All confirm Mrs. So-&-So is oxygen starved and doesn't know it ... literally suffocating and is oblivious.  She hasn't missed a beat ... or a breath.  She's been on the phone with her husband of 38 years and both her daughters.  She's now more than a little annoyed with all of us.  She doesn't understand what the commotion's about. "I don't care WHAT you say ... I'M NOT STAYING!!  I don't have that virus!  You can't make me stay!  You can't hold me against my will!"  All the time yelling like she's got more O2 than a scuba tank.

No baby ... you gonna die if you go home.  As in drop dead ... Cause you don't have the symptoms but every test result you have says you are extremely sick and will not survive if you leave.  To a woman sitting upright in bed yelling at you it's hard to convince her otherwise.  XR and CT scan show her lungs are full of COVID.  One hour later she is in ICU and intubated.  And it all started with a headache ...

Oh ... and she hadn't left her home in 8 weeks ...

I'm not saying this to scare anybody.  I don't believe in scare tactics and I'm not afraid myself.  But what I am saying is this happened to me yesterday ... in my ED room with my patient.  She literally deteriorated right in front of our eyes and we never convinced her she was truly sick.  And I think that speaks as to why some people are just dropping from this virus ... they don't know they're sick.    Both of my patients in the ED today had it ... and neither one of them believed it.  One was admitted.  The other left AMA.

So ... the virus is walking around or laying on surfaces all around us.  It's not going away and I believe we will see a second wave once the public resurfaces again.  I disagree with the Governor's order to end shelter-in-place.  It's too soon from a healthcare perspective. However, God gave me the grace to put the shoe on the other foot and hear it from a different perspective over the weekend.  A friend came to my house to cut my daughter's hair.  I've known her for 20+ years.  As she shared what her family is going through as her husband has been laid off from his job, losing his company car and company cell phone.  Three children.  One in college.  Private school tuition.  Just bought a new house 6 months ago.  Unemployment hasn't kicked in.  The pressure of watching their income source be cut off and questioning how the bills will get paid ... what could happen to the house ... only have one car now.  God opened my eyes to the other side of this struggle ... and I was convicted.

I still think it's too early from a healthcare perspective to reopen the state.  But I also saw the stress and fear in my friend's eyes and realized they can't keep going without income much longer.  Many of my friends can't.  She looked straight at me and said, "I mean I get it ... but I'd risk my health to put food on the table for my family."  Yes ma'am, I would too ...  I see it now ... and at risk of being a Debbie-Downer I'm just gonna put it out there ... this is a lose-lose situation.  Damned if we do, damned if we don't.  People are going to suffer either way.  And it sucks.

I don't have an answer.  I'm just thankful that my kids and I are still healthy and that I can pay my bills right now.  That's got to be enough.


And since sometimes you have to laugh just to keep from crying,  I'll share a little of what we've dubbed #coronacockfighting  ... because often laughter is the best medicine!

It was always more than COVID ...

I settle in for my second cup of coffee this morning and light a candle.  My four four-leggers are as close to me as possible making it impossible for me to move even if I wanted and all four are snoring to some degree or another.  The kids are gone.  It's raining.  And I've silenced the music so I can hear the beating of the drops against the window pane behind me.  They echo down the black metal chimney into my fireplace.  I wish there were more days like this.

The COVID curve is softening, and I am thankful.  Although it peaked in many nearby communities it did not "devastate" Newnan as we prepared for.  I am thankful for our leadership teams and management ... despite our shortcomings and limited resources we were well prepared and positioned for war.  And COVERED in prayer.  I don't know if God chose to spare Newnan because of fervent and effectual prayer.  I like to believe that He did because many of my colleagues are struggling and have sacrificed much in this season.  Last weekend we said good-bye to my friend Eric who left his husband Tim and foster son for a 13-week assignment to Coney Island, NY.  They celebrated their one year anniversary apart this week.  Another of my friends said they were operating at a 6:1 patient:nurse ratio in her ICU just last week and many patients had to be transferred out to other hospitals for safer staffing ratios.  So it's taking its toll in other places and somehow Newnan has been allowed to exhale ... even if for just a few minutes.

But as we return to "life" I don't expect it will ever look the same.  What is our new "norm"?  COVID's been the big man on campus these last few months, but in reality that's not all we were fighting.  Many of us were already facing giants .... challenging family relationships, chronic illnesses, financial strains, depression, etc.  All of us already had a battle we were knee deep in when this hit.  I lost a daughter right before we were ordered to shelter-in-place.  She left to go live with her dad.  I'm still adjusting.  My other two children are still adjusting.  I set the table for four all the time ... forgetting that we are now only three.  I fix too many dinner plates and end up having to scrape one back into the respective pots and pans.  I see the sadness in my other children's eyes that they try to be brave and hide from mom.  I cry in my prayer closet and pray that God hears what only tears can  say.

I've been fighting in faith for over a year on a battlefield too personal to share.  Believing God for the impossible, believing the spoken Word of God over my life despite what I see and hear.  Getting out of the way and letting God fight ... for salvation ... for me ... and for His glory.  Experiencing beautiful and supernatural encounters with my Jesus that I never DREAMED of before.  Letting Him recklessly pursue me and transform me.  

This is a season of re-creation.  When all of our recreation has been suspended and God is standing at the door saying "It's time for you to be still a while and visit with Me."  He's not knocking to judge or destroy you.  His intent is not for your harm.  Trust me, I've wrestled that one out for quite a while and I'm now standing on the other side saying He's NOT here to harm you!  He's NOT hear to hurt you!  He's here to RE-CREATE you into the EXACT PERSON you were always intended to be.  Maybe you lost your way ... or maybe you were traveling a parallel "moral" path but not walking in relationship with Jesus, then took a wrong turn.  But regardless, deep down inside, you know that you still feel "lost."  You still feel like you're jockeying for a position in life to fulfill you but after all these years still haven't found it yet.  This is Jesus' invitation to sit and listen to Him .... let Him speak words of Life into you.  Let Him reveal to you WHO you were always meant to be.  Uncover those ugly places, the ones you can't even bare to look at, and let Him start to breathe healing over them.  They will fester and rot without Him.  I know and can speak with authority because I've been there, I've experienced His healing breath and touch.  I've stopped beating the air with my fists at Him and now RUN to crawl up in His lap!!  I've never known before the Jesus that I know now!!  And I'm so desperate for you to know Him too!!

I spent a long time praying and crying in my car on the way back from returning my daughter to her dad's Easter Sunday night.  The snotty, ugly kind.  Begging God to show me something ... anything ... in the natural to confirm what I already know and have been claiming in the supernatural.  After about 30 minutes back home my youngest daughter came into the kitchen and said "Mom, somebody's here."  I walked outside to find no one.  Whoever was there was gone.  But what I DID find was a four-foot wooden cross standing up in my front yard.  No note, no initials, no sign.  It was just THERE.  About an hour later when I went outside to check a few things and close the garage door .... it was GONE.  Like it had never been there.  GONE.  I have no clue where it came from or where it went ... though my gut has an opinion.  But I DO KNOW that I had just spent an hour snotting out ugly prayers for a sign in the natural .... and my GOD placed an unmistakeable wooden cross in my yard.  I don't really need to know where it came from ... or why it was only there a hot minute ... I'll take it at face value .... THANK YOU FATHER.  It was a physical sign of the promised resurrection I have long been claiming.  What was dead is now alive.  Beauty from ashes as I softly heard a voice call "Lazarus, come out!"