Cleavon Gilman had seen the news footage of the crowds on the beaches in Florida and California.
But this was Central Park on Saturday afternoon, a jog away from New York Presbyterian/Columbia University Irving Medical Center. The 40-year-old emergency resident had lost so many patients that he keeps a chair between the ambulance bay and the trauma room where he sits to call families with the worst possible news.
And everywhere he now looked in the sun-splashed heart of the COVID-19 epicenter, he saw throngs of people ignoring social distancing as they milled about and relaxed amidst the trees and lawns, many without masks. He took it as a deep insult.
“It’s a slap in the face,” Gilman said. “It really is. I can’t explain it any other way. It struck me as very selfish and not in touch with the reality.”
Gilman served as a Navy Corpsman in Iraq in 2004 and he considers the pandemic to be another, more deadly kind of war, in which more than 18,000 New Yorkers have died in eight weeks.
“That’s twice the American dead in Afghanistan and Iraq,” he said. “That’s insane, right? And people are suntanning and picnicking with wine and cheese in Central Park.”
The sight of the heedless crowds in the park prompted him to take a cellphone video. He stopped recording after an ambulance and a police car rolled across the park, roof lights flashing.
“People looked at the ambulance as if the ambulance was out of place,” he said. “I was shocked.”
Some unfortunates infected by such selfish carelessness in the sun are sure to end up in an ambulance and a hospital, where health-care workers will struggle, and too often fail, to save them—while endangering themselves.
“Many of my colleagues are becoming ill,” Gilman said. “I’ve had three colleagues die over the past two weeks.”
One of his more eminent colleagues, Lorna Breen, had recovered from COVID-19 and returned to work to continue the fight but proved to be still too weakened to finish a 12-hour shift. She was recuperating at her family’s home in Virginia at the time Gilman got a slap in the face from the selfish in Central Park.
On Monday, Gilman was devastated to learn that Breen had died by suicide. Breen’s father rightly called her a hero, telling The New York Times “She tried to do her job, and it killed her.”
Gilman had considered Breen a hero long before COVID-19 struck. She had devoted herself to providing excellent care to the vulnerable and underserved in upper Manhattan.
“We’re talking the working class and the working poor,” Gilman said “She did that for years. That was her community.”
And she did so as a major figure in the field of emergency medicine who could easily have gone elsewhere.
“She was the top of everything she did,” Gilman said. “Just a really classy person as well.”
She guided and inspired a long succession of new doctors.
“She mentored thousands of people and made them better human beings and better physicians,” Gilman said.
Then the pandemic hit.
“This was a surge in a war zone,” Gilman said. “Gurneys back to back to back... Patients being intubated left and right.”
The death rate was highest among the vulnerable people who were closest to Breen’s heart.
“Those were people she had devoted her life to helping,” Gilman noted.
She lost patient after patient. And, upon returning to her apartment at a shift’s end, she had to observe social isolation.
“This virus causes us to be alone,” Gilman said. “It’s not good to be alone with your thoughts.”
He added, “The quiet times of this war are real hard on everyone... It’s hard on the soul. It’s real hard on the soul.”
And it may have been even harder on Breen when she was down in Virginia, away from the fight for the vulnerable.
“She’s a clear casualty of war,’ Gilman said. “This is a lot harder than being in Iraq, definitely a lot harder.”
He added, “On top of that, there's no end in sight.”
Gilman noted of himself, “I’ve been to war, but even I got beat down. The hardest part, harder than being in Iraq, is actually having to hear loved ones on the phone, three times a shift, crying at the other end that their mother died, that their husband died.”
Always much too soon after he made one notification, he would have to head for the chair just inside the ambulance bay and make another.
“You just hear those cries and you anticipate it on every call,” he reported. “It is a horrible deja vu that I relive over and over again. It just wears on you over time.”
He called one woman to tell her that her sister was dying and she told him she was burying her husband in three hours. She had lost her brother a few days before. All of them died of COVID-19.
Meanwhile, President Trump was tweeting for other locales to “liberate” themselves.
“I’m like, ‘Dude, there’s a deadly virus out there,’” Gilman said. “I’m on the front lines every day and he’s telling people to liberate themselves. I’m like, ‘No, we’re all in it together. Show some leadership please.’”
He has little doubt about the results of a premature reopening.
“This virus is going to spread all across the U.S.,” he said.
He believes that most New Yorkers are taking the needed precautions, but a selfish fraction can cause monumental hurt.
“If you have 5 percent of 8 million people doing their own thing, that's a lot of people,” he said.
That would include the folks he saw in Central Park picnicking with wine and cheese on Saturday. They might not have been so casual if they had read the online journal Gilman has been keeping on his website during the pandemic. One entry describes going back over the records of patients he had intubated.
“I did have ONE patient who was extubated, which I was excited about. Yeah!! 👏🏽👏🏽👏🏽😀
“What, this patient was extubated?” my heart filled with joy as I clicked around the medical record trying to find the most recent progress note. [click, click, click] so many clicks, trying to find the information!
“Oh here it is!” I said with a smile on my face. The note said, patient is on 5L of nasal cannula.
“That’s amazing! I’m so happy for this 50-year-old man!” I told my co-workers, “his family must be so happy!”
“Wait, Wait… what is this?”... as I read further my heart filled with fear and an uneasiness. The note read: “Patient continues to hallucinate and sees wolves in the chair”
“Oh maybe that’s just a prolonged medication effect from being intubated for weeks,” I reasoned using my medical background, “that should wear off soon.”
But as I delved deeper into the medical chart, the prognosis only became more grim. His neurological exam mentioned that he had left sided neglect from hypoxic-ischemic encephalopathy, meaning that he had brain injury from not having enough oxygen to his brain. This is usually seen in patients who have strokes or cardiac arrest.
I was devastated! Even the patients that are extubated are not having good clinical outcomes. The left part of the world does not exist for this patient. He will be unable to drive and likely unable to even dress himself.
Gilman noted another kind of crowding on a relatively quiet day at the hospital: “Eleven ambulances outside of the Emergency Department and it’s only the afternoon.”
Earlier this week, Gilman summed up his job in this war that in eight weeks has killed more of us than in all the years of our longest wars.
“I go to the hospital,” Gilman told The Daily Beast. “That’s my job. You have a very easy job. Your job is to stay in your house. If you go outside, you wear a mask.’”
If you or a loved one are struggling with suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741