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New York Doctor Spends Yet Another Medical Crisis In The Emergency Room

ARI SHAPIRO, HOST:

Now for the story of one New York doctor who's witnessing the worst of the coronavirus epidemic up close. He works in an emergency room. And it's not his first overwhelming crisis, but as he told NPR's Deborah Amos, this time is different and more shocking.

DEBORAH AMOS, BYLINE: Dr. Antonio Dajer recently posted on Facebook about his city's dire medical emergency, and he agreed to read it.

ANTONIO DAJER: (Reading) Seven p.m. on a Sunday evening - firetrucks and flashing lights fill the street fronting the hospital emergency department where I'm a physician. The scene erupts into applause and sirens.

AMOS: In early March, he saw the first cases of COVID-19, caused by a virus that threatens patients and the health care workers who treat them.

DAJER: (Reading) The virus has the world by the throat, and New York City is the epicenter.

AMOS: It's not his first pandemic. As a medical student, he saw the first AIDS patients in the 1980s. It's not even his first medical emergency.

DAJER: (Reading) On 9/11, I was the doctor on duty in this same E.R., five blocks from the World Trade Center.

AMOS: The planes struck during his shift, an avalanche of injured in his emergency room. Now an avalanche has arrived again.

How different do you think that this crisis is from the other two?

DAJER: This one is certainly more universal. The age range is everybody.

AMOS: It's an alarm-bell routine, he says, the staccato rhythm of notifications as the ambulances arrive at his emergency room.

DAJER: The paramedics and the EMTs and the ambulance crews - they will bring us patients that had a pulse at the scene that they tried to resuscitate, that they morally and medically need to bring in but that then we don't continue resuscitation on because by then, the pulse has been lost. Families aren't allowed in. It's just the medics, and it's us. And there's nothing more to do. It's a new kind of death I have not seen before.

AMOS: The details of so many deaths are numbing. There are promising drug trials but no surefire treatment.

DAJER: We're not really doing much for these patients. I know that sounds bizarre. They need oxygen. They need positioning. But there's a feeling of futility in that, despite all the measures you take, there's still going to be a very high death rate of patients that end up on ventilators.

AMOS: For now, the breakthroughs are shared through the medical grapevine and on podcasts doctors make for each other. Medical practices are changing on the fly, like roll the patient over in bed; it helps them breathe.

DAJER: It's all mechanical, in a way - in a very strange way. It's also medicine as practiced by nurses, that the people at the bedside hands-on physically positioning them are critical to their survival.

AMOS: Day to day, the nurses are the most at risk, he says. But when another ambulance arrives, he and his team don extra protective gear, and they all rush in.

DAJER: You know, it just brings out your best self. And it's not a backslapping camaraderie 'cause we're all in masks and gowns and, you know, looking like robots. It's almost like when you hear about combat - that the reason soldiers fight is they fight for each other. That's - that applies here as well.

AMOS: Finally, the avalanche of patients is now a trickle. There are debates about reopening New York, but he says it's still dangerous for the city and for his team.

DAJER: This virus is more infectious than anything we've ever seen before. When influenza waves are going through the hospital, everyone is not - we're not - influenza never - and you always got a vaccine. The infection rate from influenza is nothing compared to this.

AMOS: Does it scare you?

DAJER: Very much, and I'm scared every day. I've never been scared as a doctor before.

AMOS: Now in his 60s, he wrote on Facebook the lessons learned from AIDS and 9/11 were squandered. Then, he still believed that everything could change. This time, the emergency is more acute.

DAJER: All the structures that we trust - I mean, whether it's government or health systems or the preventive apparatus of the world - has been shown to be so flawed.

AMOS: He knows there's an impatience to reopen but asks, what is an acceptable death rate, and how will normal work?

Deborah Amos, NPR News. Transcript provided by NPR, Copyright NPR.