Profiles in Courage

 Zoe Manarangi Bake-Paterson  Jonathan Hayward/CP

"I just wonder how this will change me or change my co-workers in our practice or in our personal lives, because I think it's a lot that's going to come our way."
"I just wonder, when we come through the other side, how different will we be?"
"People have been joking about how their skin is already feeling abrasions because of this constant friction with the masks."
"Even in the masks where you can't see people's smiles and glasses are fogged up and ... there is this physical disconnect, it feels like we're in this together."
Zoe Manarangi Bake-Paterson, registered nurse, emergency department, St.Paul's Hospital, Vancouver

Duncan McTavish    Jonathan Hayward/PNG

"It kind of looks like pneumonia. They're short of breath,  usually pretty high fevers and they tend to deteriorate pretty quickly, the people who are really not doing well."
"Every single action I take I have to think about [everything he does related to who might be carrying the virus]."
"What kind of mask I need and if I enter the room, swab this person, leave again -- I have to make sure I've changed my gloves and washed my hands between every single step."
"We do that all the time, but certainly the awareness of that right now is really heightened."
Duncan McTavish, registered nurse, Vancouver

"I actually cried when I got my result [of the coronavirus test]. Every time I go to work my fear is 200 percent, because I always think of my son, my mom who lives with me."
"What would happen if I got sick?"
"So far we're doing OK, but that can change any second. Just continue to be cautiously optimistic."
"We are all in this together. We just need to keep going."
Maria Alonzo, registered nurse, single mother

Maria Alonzo had her experience with what she thought of as a close call, after waking one morning, her body aching. She had a fever and experienced the sensation of a dry throat. Now, what would an experienced nurse, working with COVID patients first think of? Particularly since one of the physicians with whom she works closely had contracted the coronavirus. That, added to the fact that as a dedicated professional she is daily confronted with the needs of people in the hospital she works at, all of whom are considered potential carriers of the virus.

Her test result gave her great relief when it was returned negative. This time. Yet, despite her deep-seated fears for her 73-year-old mother and her son, there is no question in her mind that she will continue going in to work. She and thousands of other health-care professionals dedicated to the healing profession, and prepared despite their fears, to offer their qualifications and experience in the universal struggle the world is now experiencing, in an effort to bring the SARS-CoV-2 virus under control.

All of these health professions working at St.Paul's Hospital experience self-doubts and fears, but know that their profession though under huge duress means the difference between life and death for populations the world over. The dreaded surge of cases haunts them, and they all share a feeling of uncertainty, palpably under stress from the moment they awake to the time they finally, exhausted, go back to sleep, hoping to be able to rest so they can face another day.

"It feels like we're in a lifeboat in the ocean waiting for the tsunami to arrive", explains Manarangi Bake-Paterson. The hospital where she works specializes in treating the flotsam of society's homeless and drug-addicted. It was one of the few centres to treat HIV-positive patients in the 1980s in British Columbia. Many of the patients treated back then who survived now live on the streets in the Downtown Eastside, with the more current episode of a crisis of overdosing; one that continues to this day.

If and when the province succeeds in slowing the spread of COVID-19, the situation the nurses dread of a potential Downtown Eastside outbreak among the homeless and the health-vulnerable will remain unabated, simply because physical-social-distancing is a challenge. In these special circumstances, at this special time, the hospital remains closed other than for the presence of patients and staff. Beds have been vacated, triage overhauled to accommodate patients presenting with respiratory symptoms.

The staff, awaiting the anticipated surge, rehearse urgent intubation protocols to increase their skill levels post-shift and work on adjusting to operating in zero pressure rooms, even as updated directives are received in reflection of new evidence emerging on the outbreak. Typically, it is unknown whether a patient has been infected with COVID after taking swabs when the patients may be sent home instructed to manage symptoms. Alternately be in intensive care by the time results of their tests are received.

Staff are conflicted in their concerns that flood their minds focused on the coronavirus. Concerned over the welfare of patients as well as their own personal welfare and those intimates in their personal lives. Their morale is lifted when they become aware of the admiration elicited by their courage and their plight on the part of the public who celebrate them as heroes. Cheers ring out nightly throughout the city for health workers.

Donations of food and other supplies are dropped off for them by members of the public, as an expression of gratitude. "At those times it feels so incredibly joyous to experience that", said registered nurse Rachel Mrdeza who had never given much thought about the protective gear she must wear; now, given the current situation aware that it is her shield against an implacable, unseen enemy.

St.Paul's Hospital, Downtown Vancouver