Essential

Nine months ago, I lost my sense of smell. Its comeback has been egh... I'm probably at like five percent. A couple things -peppermint, gin- smell noxious. Relatively easy to cut out, I now have a tooothpaste collection that pre-smell loss would've made me hurl... I'm working on a whiskey-based apple cider drink served hot.

There were certain days and weeks that this new reality of mine felt life altering. I have drafts of prior posts to prove it (they go: "this feels life altering"). I also have drafts of prior posts that prove that smell used to be a very important sense for me (they go: "those smells though, on this walk home, they're what really got me. Those memory inducing smells.").

But most days and weeks, it's obvious what actually altered, shook, and changed me... changed us... this year. What’s heavy, as we steer unsteadily towards the next phase of this all. My... our... long haul symptoms are the grief, the memory, of those we left behind.

This past Tuesday, actually, I woke from sleep panicked. The day before I realized a patient list I'd created on my hospital’s electronic medical record system to collect the names of the patients I treated with COVID was gone. I’d called it aCOVID, so that it showed up atop my other lists. And suddenly it was no longer, probably accidentally deleted as I clumsily navigated the newest update to EPIC. 

Why was losing this registry, this access to names and medical record numbers and notes and vital signs, causing heartache.. a recycle of the emotions I’d felt when so many patients on this list had passed away. That’s rhetorical, I know why. 

At work I went through my pent up papers and found the hard copies. Every morning at work I print a list of the patients I’m responsible for each day, and use it like a note pad. As I remembered, as my panic quelled en route to work, I’d kept the Lists from those cold April days. I’m looking at one now. 

Looking back at me, on creased yet crisp paper, are the names that lived and didn’t. In blue ballpoint pen, next to each name, I scribbled oxygen requirements, oxygen saturations, and respiratory rates. Some examples, which some will decode like it was yesterday: “NRB + NC.. low 90s”, “NRB + prone.. 92%, RR 38”. Other notes too, “coughing less”, “desatting when talking”, “discuss with son + wife”. A lot of family phone numbers. Not a lot of To dos. Because there wasn’t a lot to do.... no helpful labs, no helpful medications. 

Looking back at me, on this softly creased yet crisp white paper, Printed by Rebecca Lazarus on 4/19/20 9:12 AM, are the names that lived and didn’t. 

There’s Mr. and Mrs. A, a couple in their late 60s. He was slightly sicker than she was, but they both did great and survived. She was a teacher, and I remember talking to their daughter on the phone as the pair rallied towards their discharge date. It was a public hospital triumph that the 2 shared a hospital room. 

There’s Mr. C, who only spoke Cantonese. And Mr. N, who only spoke Mandarin. I swear I remember standing at their bedsides like it was yesterday. Mr. C was a little better on my 4/14 list but tired, hungry by 4/19. I remember his tall thermoses of soup. His family couldn't come to his room, nor even the floor. But if they left items like this in the lobby they'd be brought up and to the bedside. I remember Mr. C was stoic, proud, and fighting. He really was tired. You're entering the chart of Mr. C, who passed away on 4/28/2020.

Mr. N was younger. He shared a 4-bedded room which was OK because his 3 roommates all had COVID too. He had the window bed on the left; a southeast view taken up by the Harlem River drive curving East. Mr. N's hypoxia made him anxious, jumpy almost. Every day on the phone his family would ask me to give him fluids. He's asking for them, they'd say, he thinks they'll make him better. So eventually I gave him the smallest of boluses, cautious to not overcrowd his already failing lungs. Slightly better I wrote on 4/15. Even more stunning to think about now- that I treated this virus with salt water. You're entering the chart of Mr. N, who passed away on 4/23/2020.

I'm trying right now, as I lie longways on the couch in my warmly lit apartment. Full from dinner. The Brooklyn Nets are on mute... I'm trying to imagine what in the world this must have felt like for these patients. I close my eyes as they did as they took these fast and shallow breaths. As they panicked, some solemnly and some with more animation. To have felt so helpless. So out of control. So out of breath. 

There's Mr. J; with a cross out through his name. Because he was very old and weak and died before I even met him. There's Mr. R who dutifully would lie on his stomach when I told him he had to, because any other way his oxygen level dipped. Because his life depended on it. There's Mr. T whose sister-in-law worked in the emergency room and came to check on him most days. He was always breathing fast but was relatively young and otherwise healthy and survived. There was Mrs. M whose daughter I FaceTimed at the bedside. And then again once out of the room to comfort her as she broke down across the line.

There were so so so many more. On my aCOVID list. In my hospital. In our city. And the list goes on and on.

It's silly, but there's evidence to support olfactory training for post-viral smell loss. It's done via essential oils, and at this point I've amassed dozens. I can actually smell them, they're pungently concentrated, but it feels good, so they're scattered between my work office and bedside table. 

Last week, in a sign that we're heading towards normal, but that normal in the healthcare world can still be sad, a patient of mine admitted to begin cancer treatment was experiencing horrible post-chemotherapy nausea. Though none of our anti-nausea meds were working, she seemed to be comforted by sniffing alcohol swabs. Yo tengo otra aromas, I sputtered. Peppermint? She asked. 

I raced to my office and back to her room, with my small vial in tow. And in that brief moment, for that small shard of time, amidst the chaos and sadness and tears and memories racing through my mind, it felt like I was right where I was supposed to be, doing exactly what I was supposed to be doing, passing on this essential oil, to someone who needed it more.