THE HOST

DAY ONE

I locked my car, left the parking garage alone, crossed High St., and passed through the small crowd in front of the hospital with their signs:

“Fear Is The Real Virus!”

“Muzzles Are For Dogs, Not People!”

“Take Off Your Mask and Smell The Bullshit!”

I tried to ignore them as I entered the building. The banner above the sign-in desk read “Honoring Healthcare Heroes” with a string of sunny emojis, and I shook my head as I looked at it before I clocked in for the day.

A new patient came in that morning, a hard case. White male, late-50s, goateed and obese, complaining of chest pain and breathing problems. Complained about having to spend hours in the waiting room like everyone else. Complained about having to wear a mask, and wouldn't answer questions about whether or not he was vaccinated, which means he wasn't. He said we were violating his HIPAA rights by even asking, which is not at all how that works.

His blood 02 levels were 82%, so we put him on supplemental oxygen and admitted him to the ward in the afternoon. He complained about having to wait so long, then asked me what was wrong, if he was having another heart attack.

“No,” I said. “You have Covid.”

“Bullshit,” he said. Then he tried to get off the gurney, but fell down and hit his chin on the floor. His blood covered the tiles.

I repeated his prognosis, then offered him the AMA papers, which he refused. So Bruce, the security guard, strapped him down over his protests Julio mopped up his mess, we patched up his chin, and started his treatment: paxlovid, dexamethasone, and an interlukin blocker. It had been almost two years of this now, so we had it down cold.

He was taking deep, rapid breaths, had a fever, body aches, was light-headed. It was all new to him, but textbook to us. He whined that he couldn't hear us with our masks and face-shields and PPE, and I almost laughed at him when he asked us to take it off.

We had him take a CT scan, which showed COVID-19 pneumonia in all parts of his lungs. His lungs were already shredded. By the time I left my shift that night, his oxygen saturation was 79%.

DAY TWO

When we finally got him in a room, which had just opened up because another patient coded, Nancy asked me, “Do you know who that is?”

I didn't.

She told me he was famous, a local AM radio host who was often on cable TV. It was then that I realized I recognized his face from billboards on the highway.

We checked on him once he got settled, and he said he felt like he breathing through a wet bag, a band around his chest like he was a bourbon barrel. He asked again if he was having another heart attack, so we showed him the PCR test that showed he was positive for COVID-19, then gave him morphine.

We only had a few minutes to tend to him, since we were so stretched thin. We were still dealing with Delta, and Omicron spread faster than anything else we'd seen before. Plus, a bunch of nurses in the ward were out with symptoms, so we were always more short-staffed than we should have been. I worked a 14-hour shift that day, and my legs felt like jelly when I left.

After clocking out, I trudged into Carolina Liquors on the way home. They had the the local news on, and a clip of my patient was being played, under the chyron “Local Radio Host Admitted To Area Hospital.” He was talking in the video about not trusting vaccines.

I was so exhausted, I thought I was hallucinating, sleepwalking, imagining the whole thing.

When I took my vodka to the counter, the maskless, bleach-blonde clerk was on her phone, talking about how the government was against ivermectin because they couldn't patent it. As she bagged my bottle, she asked if I was a nurse. I said yes, lamenting that I hadn't changed out of my torquoise scrubs before leaving work. She asked if I had heard the “jab” causes magnetism. I took an Outer Banks souvenir magnet off the cash register, put it to my arm, and let it fall on the floor. I didn't pick it up.

“Get vaccinated,” I said. I grabbed my bottle and strode out the door.

DAY THREE

The Host told us he felt like he was drowning, was gulping for air like a goldfish out of its bowl. We transferred him to the ICU, which had, at that point, reached capacity.

In the ICU, they put him on high-flow oxygen. He moaned in pain, every part of his body hurting in ways he didn't know was possible. He said he felt like he was suffocating.

As nurses came in and out of the room, and doctors reviewed numbers and charts, all fully equipped gowned in blue and white PPE and only for a few minutes at a time, he also confided to me in a low voice that he felt lonely. He was close with his family, especially his wife, and he hadn't seen them in person since he got to the hospital. Even though we're a relatively lax state as far as COVID-19 protocols go, we still didn't allow family to see positive patients while they are being treated in the ICU.

I told him I understood his situation, but I had to rush off to check on other patients. After all, we were at capacity.

DAY FOUR

It was getting harder and harder to come into work, and a big reason was the smells. On that particular morning, I treated The Host as much as time would allow, and the stench was overpowering: perspiration, stool, and dried mucus stained his sheets. The nights were usually the worst for patients, since their fevers were highest and their breathing especially labored. So when we got to them in the morning, everything was a mess.

Even when I got home, showered, washed my hands, sanitized my hands, burned incense, and ate the meal I made in the crock pot (pulled pork), I still smelled like the ICU. I tasted death on my meat, could hardly eat. I tossed most of it in the trash.

The irony is that many of the patients I treated had anosmia, the complete loss of sense of smell and taste. They, at least in one respect, had it good.

DAY FIVE

His lungs had hardened. We maxed his oxygen, then put him on a BiPAP machine, the bulky mask strapped over his mouth and nose. Still, I could tell from his numbers that his blood was becoming acidic, torturing his organs, his kidneys compromised. But this was the course of treatment, and besides, what other choice did we have?

He took his mask off to eat. He was sitting in bed, breathing like he had just run a marathon. He looked utterly exhausted as he ate red jello from a cup, drenched in sweat, wires and lines and tubes attached to every part of his body.

He threw his plastic spoon down and looked at me. He took a gulp before he spoke.

“Am I going to make it?” he asked. “Be honest.”

“I hope so,” I said.

“You guys gave me all these drugs, all this shit,” he said, waving his hands around all the medical technology keeping him alive. “But it doesn't seem like I'm getting better.”

“Well,” I said. “You are at high risk.”

“You mean because I didn't get vaccinated?”

I didn't answer, just looked at him.

“The jab. The fucking jab. It's not that I'm against it, I just don't trust Biden and the government and all them with the rollout and the mandates and all that overreach. Plus, I'm worried about the long-term effects, you know?”

“What about the short-term effects?” I said. “Aren't they bad enough?”

He nodded. He took another deep breath.

“Tell me the truth: am I getting out of here?”

“If you want my advice, I'd tell you to have a serious discussion with your family. Right now, today. While you still can. There's a chance things turn around, you recover. But there's also chance it goes another way, and you want your family to know what your wishes are. Do you understand?”

He didn't say anything. Just took more rapid breaths.

“Is there anything else?” I asked. “I'm sorry, I have to go to the next room.”

“Can I get vaccinated now?” he asked.

“No,” I said. “I'm sorry, it's too late.”

“There's nothing that can be done?”

“Unfortunately not,” I said. “Although it's too late to vaccinate you, please know we're doing everything we can otherwise.”

“Maybe I should have taken this thing more seriously. I honestly thought it was bullshit. I don't know, I guess I just didn't want to be told what to do.”

“Well,” I said. “Now you know it's not bullshit.”

“Yeah, now I know,” he said. Tired from all that talking, he gulped again, and slipped his mask back on.

DAY SIX

The Host's wife called every day since he arrived. The patient's families often thought, because of Fox News and Facebook and Joe Rogan, they knew better than us how to care for them. I told her the same thing every day: we were treating him as best we could, and there had been no significant change in her husband's status since she last called.

“There's no change because you're not giving him the right stuff,” she said.

“We're doing everything in our power,” I said.

“Oh yeah?” he said. “What about hydroxychloroquine, ivermectin, Z-packs?”

“Those are not approved treatments,” I said in an even tone that surprised even me.

“Of course they aren't,” she said. “Because you can't make money off them. How about vitamin C, vitamin D, zinc? You aren't even doing that, are you?”

“We're treating him the best we can,” I told her.

“You don't know what the hell you're talking about,” she said.

“Then why did you bring him here?” I asked, then hung up on her.

DAY SEVEN

Our admin offered us free mental health counseling sessions. I took them up on it, coming in for an hour on my day off.

“Why brings you here?” the therapist asked. Her name was Dr. Castro.

I laughed bitterly.

“I’m here,” I said. “But I’m not 'here', you know?”

“Can you say more?”

“I'm just going through he motions,” I said. “I'm just exhausted. Physically. Emotionally. I can't sleep, I basically drink myself to sleep every night, and every day I wake up I dread going to work. I sit in the parking lot, crying or staring off into space for about ten minutes every single morning before I finally turn off the car and go into work. Sometimes I just yell and pound the steering wheel until my fists hurt.”

“Does that help?” Dr. Castro asked.

“I'm not sure anything will help. I can't seem to give a shit anymore. When you see what we've seen, you can't help it. You become numb to it.”

“There's a term for that,” she said. “'Compassion fatigue'.”

“Yeah, I'm just so tired. So when I come to work now, I'm just mentally checked out. I'm burnt out.

“Because people still don't believe us. They think we're playing it up. They still think it's a hoax or that it isn't as bad as the media says it is. But they don't know what we deal with every single day, they don't know how many of the patients don't make it out of there once they come in.

“But the worst part, beyond all the death, beyond the fatigue, beyond the patients, is the lack of hope. Last year, we had hope. We were dealing with so much, but we felt like, once the vaccines are out, things would get better, things would get back to normal.

“Now, we're dealing with patients who, most of them, shouldn't be here if they'd just get vaccinated.

“What is there to look forward to?”

After seeing Dr. Castro, I got another bottle of vodka, and that's how I spent the rest of my day off.

DAY EIGHT

I locked my car, left the parking garage with Jill, crossed High St., and passed through the growing crowd in front of the hospital with their signs:

“This Jab Ain't Fab!”

“Say No To The Fauci Ouchie!”

“We Hate The Mandate – No Forced Vaccinations!”

I tried to ignore them as I entered the building, but someone was shouting through a megaphone. The banner above the sign-in desk read “Honoring Healthcare Heroes” with that familiar string of emojis, and I smiled sideways at it before I took some aspirin and clocked in for the day.

Later that day, it seemed like they were holding a rally or a sit-in or something, and they were playing clips from his radio show over a loudspeaker. I only caught snippets here and there:

“I'm just asking questions. Isn't that what freedom is about, being able to question your government?”

“I don't consider myself a conservative. I'm an independent. I think both sides are corrupt and contributing to making America worse.”

“The intolerant left thinks you can mandate behavior to anyone who doesn't agree with them. I don't think so. That's fascism.”

“I'll sign off like I always do: God Bless You, God Bless America, and Foxtrot, Juliet, Bravo. Let's Go Brandon!”

There were cheers from the crowd outside.

Inside, there was a 10 hour waiting room time. The ER was bottlenecked with COVID-19 patients exhibiting mild symptoms, so there was almost no movement in treatment. They just sat and waited. Everyone was sick. Nurses and doctors too, and their families as well since people gathered together to celebrate Christmas.

The Host was put on a ventilator that day. I could tell he was delirious based on the look in his eyes, the way he thrashed his limbs around. The respiratory therapists came into the room, wheeling their the machine and their orange tackle box in. He was sedated and given a paralytic first, because otherwise they struggle when the tube goes down their throat. Dr. Patel put the laryngoscope on his face, endotracheal tube in his other hand, and then it was over. He was no longer breathing by himself, the vent pumping air into his wrecked lungs.

Considering how vitriolic she was at me and the rest of the staff, I was surprised when his wife signed the paperwork to have him intubated. Then she Facetimed in to pray at him and tell him she'd see him soon.

They didn't get the sedation right at first. He yanked the tube out, so they had to adjust. Then they inserted a catheter and a new IV line for the new meds, and he finally settled down, but it was touch and go for a few minutes.

DAY NINE

His revised course of treatment now required almost constant, around the clock care from myself and my fellow nurses. The Host was now on blood thinners to prevent clots and strokes, a fistula for dialysis, and had a central line placed, usually triple lumen so we can give multiple meds through one site.

Because of the ventilator, he was being proned. We tried to get the fluid in his lungs to move in such a way that his alveoli weren’t submerged, but the weight of his body made this difficult. So we had to take turns flipping him every twelve hours, which took four nurses and the respiratory therapist.

Sometimes, in the proning process, he woke up momentarily. He gained consciousness for several seconds or so before we were able to put him back under. During those seconds, he couldn't breathe until the machine pumping another round of air into his lungs. The look of panic in his eyes during that brief moment of time made me think that dying would be preferable.

His hands and face and neck swelled like a bullfrog because of the vent. His labs were getting worse by the day. He was developing an embolism, fluid was building up in his already damaged lungs.

When you entered the room, all you could hear was the rhythmic pumping sounds of air being forced into his lungs, the beeping of all the machines keep him alive, the intercom squawking: "Adult protected code blue".

His own voice, known to so many over the radio, was silent.

DAY TEN

The Host's wife had stopped calling. The families usually did around his time, since there was no news, and when there was, it was never good.

His vent settings were now maxed out. He continued to desat. The proning was helping, but the doctor determined we needed to start doing it every four to six hours now.

After the last proning of the day, I checked his lines and noticed the maggots. Sometimes, when a patient's body is breaking down, maggots develop in orifices, and in this case, they were in his nose, crawling around his oxygen line. I cleaned it out and replaced it, then went to the next patient.

Since she wasn't calling anymore, I was glad I wouldn't have to tell his wife about that.

DAY ELEVEN

When I went to check on him that morning, his arms and feet had turned black. Blood clots.

I told the doctors immediately, who rushed into the room. The doctors had a pow-wow with the surgeon and decided to operate.

Later that morning, they amputated his right arm at the elbow and his left foot, which gave me a short break from having to care for him, since we were otherwise slammed.

When he got back to the ward covered in bandages, they started him on ECMO. This acts as a set of lungs outside the body, oxygenating the blood so that your body can focus on healing itself. Blood was transferred out from his neck veins to the machine, which removed carbon dioxide, and returned the fresh blood back to his heart.

DAY TWELVE

The Host's numbers looked better. His labs had improved. Maybe it was the ECMO. Maybe it was the amputations, relieving the stress the blood clots had placed on his body.

This was typical in cases like his. We called it The Bounce.

They brought a therapy dog into the ICU for us to pet. I spent way too long in the break room, laying down next to him, petting his belly as his legs stuck up in the air.

He was a French bulldog. His name was Tug.

DAY THIRTEEN

Kidney failure was usually the first sign that death is imminent. He started dialysis, but without a lung transplant, the heart eventually stops. We did CPR, and he was revived, which was a pleasant surprise.

Still, the doctors thought it best to contact his wife and let her know the end was near. After all, he was still on the vent and ECMO, and now sores were all over his body. They had inserted in his chest cavity to clear out the air that had leaked there. The meds we gave him were so harsh, it would have been hard for anyone to survive them, especially someone overweight with co-morbidities.

The doctor called and told her there nothing more to be done. Maybe we could have kept him alive a little longer, but the odds of there being much left of him if he woke up were remote.

The doctor told her about extubation with benzos and terminal palliative care, which are difficult phrases to come to terms with if you're not familiar with them.

The doctor informed her, when she protested, that he had already coded and been brought back to life, and that those procedures include rescue breaths, electric shocks, and violent chest compressions, all to diminishing returns.

She eventually agreed to suspend treatment so he could die with dignity, but she was in shock. After all, he had been fine just two weeks ago.

DAY FOURTEEN

The Host coded. He went quicker than most because he had already had a heart attack and was obese. On average, people lasted about six weeks.

We brought out the iPad for the wife to say goodbye. Unlike the early days of the pandemic, she could have risked full PPE to see him in person, but since she wasn't vaccinated, this wasn't possible.

So, he died alone. We drew the blinds first. I held his still hand while they pumped his IV full of pain meds, removed the breathing tube, and shut the vent off. He had built up a tolerance for the sedatives, so he coughed and gasped, fought for agonal air for a few minutes. His body twitched and contorted until his heart stopped, and the doctor called his time of death: 3:21PM.

As I wheeled him from ICU room to take him to the mortuary, I looked around. When he arrived, half of the rooms were empty. Two weeks later, it was overflowing.

I went right back to the unit. There was a whole unit full of patients with the same story. But I broke down crying in the break room while petting Tug in between shifts, so the doctor sent me to see Dr. Castro.

“What on your mind today?” she asked when I sat down in her calming salmon-colored chair.

“Another patient died today,” I said. “I don’t know why it is affecting me like this. I knew he would, the moment he came in.”

“How did you know?”

“They all die. Last year, there was sometimes hope that when a patient came in with severe symptoms, we might see them leave in a wheelchair, balloons tied to the side, the ward clapping for them. No more. Everyone unvaccinated who comes in with Covid leaves in a black bag.

“It's not normal to deal with this much death. The only people who see this many dead people on a daily basis are battlefield medics. We're not in the military here, but this is a warzone; this is our war. I feel like every time I put on my PPE at the beginning of a shift, it's like putting on armor for battle.

“But I didn't sign up to go to battle, I signed up to help people. And it doesn't seem like I'm doing that anymore, so I'm done. I can't do it anymore. I quit.”

DAY SIXTEEN

I didn't quit.

When I put in my two weeks notice the next day, my supervisor gave me the usual line about how we were down to a skeleton crew and couldn't afford to lose any more good people, about how the ER wait was almost twenty-four hours long now, how they were going to be flying in more traveling nurses to combat the unit's attrition. I knew she was right, but I was salty about the new nurses coming in, enticed by ten thousand dollar bonuses and pay that exceeded mine.

But what was I supposed to do? As much as I hated it, I didn't know how to do anything else, and at that point in my life, I didn't want to have to start over.

So I took a day off, spent it doing laundry and getting day drunk at home by myself.

I woke up hungover to texts from Diane, who was on the night shift the previous day. Turns out The Host's wife summoned the local news stations and gave a speech to the crowd outside about how the hospital had killed him, that we were all murderers. So they assigned us all security guards to escort us on campus for the rest of the week, just to be on the safe side.

I locked my car, left the parking garage with Bruce acting as my security guard, crossed High St., and passed through the large crowd in front of a stage in front the hospital with their signs:

“Medical Apartheid Is Fascism!”

“Say Yes To Freedom and Body Autonomy! Say No To Medical Tyranny!”

“From Heroes To Zeroes – Health Care Workers Are Killing Us!”

One of them spit on me as I entered the building; Bruce accosted him when I went inside. The banner above the sign-in desk read “Honoring Healthcare Heroes” with that mocking string of emojis, so I went over to it, tore it off the wall, and threw it in the trash before I wiped my face off with a paper towel and clocked in for the day.