‘Now I Know the Horror That They’re Living’

Dr. Caroline Burmon (right) and nurse anesthetist Connie Bruch-Harrison intubating a patient with presumed COVID infection in the ER on April 21. Photo: Patrick Schnell M.D.

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As the COVID-19 crisis continues to unfold, the staff at Mount Sinai Brooklyn is documenting its experience with regular dispatches. The last time we heard from chief nursing officer Claudia Garcenot was just over three weeks ago, when she spoke about the anxiety of watching her staff get sick and the heartbreak of seeing patients die without their families beside them. Shortly after that interview, Claudia was diagnosed with COVID-19 and hospitalized at the main Mount Sinai branch in Manhattan for seven days. After being successfully treated with plasma infusions, Garcenot finally got to go home, and this week, she plans to return to work. Now, she says, she understands what her patients have been going through in a whole new way.

I was tested around the time I last spoke to you. I had started to feel weird. Nothing specific, just tightness in my chest. Although I’m over 60, I have no chronic illness, and I kept thinking maybe I’m developing allergies and that’s why I feel this way. But then sanity took over and I said: I need to be tested. Sure enough, I was positive.

I stayed home for a week, lying in my bed, not really doing anything. I live with my daughter, so I was trying to quarantine from her. She would bring up food to me and put it at the door of my bedroom. But I never got any better. I just kept feeling this terrible difficulty breathing whenever I took in a deep inspiration. And it just gradually got worse and worse.

My daughter is 24. My children are not medical people. I was lying there thinking about how much trouble I was having breathing. And I thought, What’s going to happen if something happens to me? And then Quinn — that’s my daughter’s name — would be left with trying to figure out what to do with me. It was the fear of leaving my child with trying to deal with my illness that kind of prompted me to say, “Let me go to the emergency room and really see what’s going on.”

I went to the emergency department in my own hospital. It was crazy busy that day, there were so many patients. The team was wonderful. They were so considerate, and yet also very conscientious about the fact that I do have the chief-nurse role, so they put me off in a corner so I wasn’t seen by everybody who was there.

I was so afraid of being intubated. I’m not a physician. I’m in no way an expert. But I knew enough to be afraid and to know if I didn’t do something, it could be very bad.

They did a chest X-ray, and I had bilateral viral pneumonia in both of my lungs. I went home for another two days and just didn’t feel any better. I started to have more symptoms. I started to get fevers. One minute, I would be fine, and the next minute, I would be burning up. I also was getting headaches. Simple things like getting out of bed and walking to the bathroom would make me really short of breath. So again I spoke to my doctor, and he said, “I really think that you should go to [the main Mount Sinai in Manhattan].” I think part of that was just out of consideration that it would be very difficult for me to be in my own hospital, plus the fact that our hospital was so overrun at that time. I don’t even know if they would’ve had a bed for me.

The moment I had to leave my child — that was probably the most difficult part of it. Because I wasn’t sure what was going to happen. I knew nurses who work with COVID who were admitted to the hospital who were on respirators. I had heard stories of former colleagues on Staten Island, where I used to work, that had passed away. If you recall, when we spoke, I told you that we had those refrigerated morgue trucks out in Brooklyn. And we had gone from one truck, which held 44 bodies, to two. They were filling up; we were losing a lot of people per day. So those are the stories that we hear, you know, and then you’re leaving your kid at the door saying, “Okay, remember, you can’t visit me.” Still, as nervous and anxious as I was, once I was in the hospital, I kind of calmed down. There was this comfort level that that said: Someone’s watching you now. They’ll know what to do if something goes wrong.

I was put in a negative-pressure private room and placed on isolation. You and I talked before about what I thought it was like for patients and family members who couldn’t visit. Before my hospitalization, I thought to myself: That has to be the worst situation in the world. But I tell you, Anna, what I thought it was, was nothing compared to the reality of it. You’re in a room alone. Someone would come in maybe eight times a day. I couldn’t really see what anybody looked like, everybody was completely gowned with a face mask, so most of the time when people would walk in, I didn’t know who they were or if I had met them before.

Hours would go by and I wouldn’t speak to anyone. You’d say to yourself: Does anyone remember that I’m here? My mom is 89, and she was beside herself. One day, I accidentally put my phone on silent and forgot to turn it on, and I didn’t call my mom or daughter for 24 hours. And when I finally realized it and called them, and their level of anxiety [was so high]—they were also feeling that isolation.

Part of the problem is I had been in the hospital for the weeks prior. So I was watching this thing snowball every day. On my work phone, I get the emergency codes all night. So I was seeing how many of them we were having, and every day we would report how many people were on respirators. And that’s what I kept waiting for in the beginning. Every day, I would wake up in hospital and say: Today’s the day they’re going to tell me that I need to be intubated. And I didn’t want to have that conversation with my kids. I didn’t want to tell them I was afraid. I’m the mom, I’m the nurse, I’m the health-care person. I wanted to be the one to take control; I didn’t want to tell them I was so scared and freaking out.

I was very lucky. My oxygen saturation never dipped below 90. They gave me Plaquenil (hydroxychloroquine) for five days. After about two days, one of the doctors came in and said to me, “We think that you might be a candidate for that experimental plasma treatment.” I think it’s because I had no other chronic illnesses, I wasn’t on any kind of medication. Still, you want someone with you to help you make the decision. I had to make the decision myself. As far as the plasma, I felt so sick. I think if they had said to me you have to stand on your head for three days, I probably would have tried that. I didn’t spend a lot of time thinking about it, I just said: I need to do this.

I had two units of plasma. Each unit took about two hours to infuse. It’s like a blood IV transfusion, but it’s plasma, so it’s just like the yellow part of the blood. Forty-eight hours after that, I still had the tightness in my chest, but I didn’t really feel sick anymore.

I can only speak about my experience. But for me that treatment really was the thing that turned the corner for me. And that’s when I realized that I wasn’t going to end up on a ventilator — that I was going to get better. I was going to get out of a hospital.

I was in the hospital for seven days. And for seven days, the only people that I spoke to were whichever nurse was assigned to me, and phone calls to my mom and my kids, and then I just sat in the bed and waited. I can’t describe the isolation. I was lucky I had all of that technology available. But imagine if you were 85 or 80 and you have a cell phone, but maybe you don’t use it to its fullest or you’re feeling so sick you’re not well enough to have the conversation? There’s nobody there to hold your hand and just sit next to you — someone who you know loves you. That piece of it’s not there.

I was so concerned about my patients before, but it’s even worse for me now after living it.

There before the grace of God, I did really well. Eventually, I didn’t need the oxygen. And, you know, they said to me, “Okay, you can go home.” And it was like I had won the lottery. I went there with hardly anything. I just had this little bag that took me about three minutes to pack it. My daughter had been quarantined in the house for that whole week, and she drove up and picked me up. It was like I hadn’t seen her in a year. I was so excited to see her.

That was on the 9th of April. Since then, I’m at home. I feel really good. But if I do any exertion, I still feel short of breath. My primary-care doctor tells me it could last for three months. I’m going to go back to work on Thursday, and I am going to have my antibodies drawn. I think that I will feel better, even though I know antibodies don’t mean anything at this moment. And then I’m ready to go back to work.

Nurses really are different breeds. My children are saying to me: “What, are you crazy? Why are you going back to work?” First of all, sitting home, I feel like I’m going to lose my mind. It’s not like there’s nothing to do in the house. I mean, God knows I could clean a closet. But to me, that’s not meaningful work. I want to work with my nursing staff to figure out, How are we going to manage these patients? I want to be there to come up with the answers about, How do we manage these poor people who haven’t seen their families? I’m ready to jump back in and work with my nursing staff and be there for those patients, because now I know the horror that they’re living.