"Covid Won't Win": Meet the Force Powering Brooklyn Hospital CenterBy Victor J. Blue, Sheri Fink and Catrin Einhorn
Photographs by Victor J. Blue
During the spate of Covid-19 cases this spring that filled the emergency room and intensive care unit at Brooklyn Hospital with the critically ill and dying, staff went in day after day trying to save as many lives as possible. Now they are preparing for a second wave.
These hospital staff portraits were taken during the grueling first wave. In interviews over the past few months, workers have reflected on this period – what they had been through and how they had dealt with it, what they had learned and how it had changed them.
From the doctors and nurses to the workers serving behind the scenes, everyone played an important role, and everyone knew that gambling can be deadly. Fighting this disease took sacrifice and courage from the laundry room and supply depot, laboratory and security desk – throughout the hospital to the chief executive's office.
The experience of so much death in such a short time was overwhelming. It seemed somehow impossible, so unbearably sad that it couldn't be real. And yet they went in.
Many spoke in combat metaphors. The virus seemed to come from all sides, they said, threatening not to spare anyone. They talked about the front, service and "training for war".
The interviews conducted between May and July were edited and compressed.
The first day I got into this truck, I went home and cried for about two hours.Alexis Gomez, patient transport
Alexis Gomez, patient transportI say I'm the taxi driver in the hospital. I move people with a bed, stretcher or wheelchair. I knock on their door introducing myself and trying to make a joke or something else so they can smile because they are probably not having the best day in the hospital.With Covid, I became a mortician at the same time as a van. The number of bodies we had to move – it was probably the hardest thing I ever had to do. My job would be to check in, probably make a phone call or two, and then be able to put about 15 bodies in a freezer truck every day. Dead weight is probably the heaviest thing you could ever feel.The first day I got into this truck, I went home and cried for about two hours. My wife had to hold me.The scary part is the next day, I was desensitized. I put on my suit. I sat down. I took a deep breath and just said, "Let's go."Then the pandemic took one of our vans, someone who had been with us for almost 30 years. He was our delegate. He was a big brother. He was one of the most popular and important people in this building.Since he died, I truly feel everyone is dead.This was my time to be called, you see? There were six or seven of us who rode these trucks every day and we could all tell you the same thing.I am extremely proud.
The coronavirus has probably made me even more aware of the value of the human connection in treating disease because that is really being withheld from us, that is withheld from patients. It made me more vulnerable and grateful to be there and be able to do something to help those I could help.Dr. Sylvie de Souza, chief physician for emergency medicine
Dr. Sylvie de Souza, chief physician for emergency medicineMy job is to oversee a team of doctors and residents in training. And to ensure that the emergency room is operating efficiently, providing high quality care and efficient care and safe care.My favorite part of my job is the team, the E.R. team, my colleagues. My least favorite part of my job is in situations where I feel like I can't help.The coronavirus has probably made me even more aware of the value of the human connection in treating disease because that is really being withheld from us, that is withheld from patients. It made me more vulnerable and grateful to be there and be able to do something to help those I could help.The fear of that return is now the hardest part, and when we think of those we lost, we couldn't help and really couldn't honor in the end, or their families couldn't honor the way they wanted to would have. I am thinking of that now.Facing the day brings a mixture of emotions. There is a fear of simply returning to the scene of so much death and sickness and pain and suffering. The hope is that we will never have to see this again in our entire careers. It's a mix, it's fear and fear, but once we are involved in the action of the day and the task at hand, it just dissolves.Definitely coming home is a different story. Then we all have trouble sleeping and resting. Although it seems quiet now, I don't think either of us is at peace.
We had so much more each day, sometimes several patients would crash at the same time.Christine Ciaramella, clinical pharmacist for emergency medicine
Christine Ciaramella, clinical pharmacist for emergency medicineThe public knows pharmacists in retail stores, but I work in an emergency room. I am physically present at the bedside with patients and work with the doctors to find the best medication regimen. I also prepare bedside medication.I usually work with a team and respond to cardiac arrests and intubations. We had so much more each day, sometimes several patients would crash at the same time. We had to prioritize and walk from person to person to keep up. It got to a point where I had a belt pouch full of intubation medication, so I kept all medication with me. I was pushed to my limits.As pharmacists, we also had to deal with drug shortages. All hospitals used certain drugs, such as sedatives, to keep patients intubated on their breathing tubes. We have to get creative and find alternatives very quickly. What would be the next best option?When I was there, I was just there. The days flew by, I didn't even know what day of the week it was. I've just been to this marathon. And then when it slowed down, it caught up with me. I needed some time to myself. I rested and processed it. Now I feel normal again.
I live in the neighborhood. I was born in the church. I wake up more motivated every day and want to do my best to help my community.Lenny Singletary, senior vice president of external affairs, strategy, and marketing
Lenny Singletary, senior vice president of external affairs, strategy, and marketingI left Wall Street to take this job. The younger me would have said, “What? A hospital? You? "As a younger me, I never thought I'd ever have a career in healthcare.The favorite part of my job is really the engagement. I love hearing different stories about what people are dealing with and how you can help find solutions to their problems and concerns. The least preferred part of my job is attending I.C.U. My mother died on this floor in 2013, the day after Thanksgiving.My job has changed due to coronavirus. In many ways it has expanded. I never thought I'd be a person to take a leadership role in serving the community by building a tent that would provide screening and relief to over 2,000 community members.In general, I don't know that you would ever believe that you would face the mass casualties while doing a job like foreign policy, marketing, or strategy. But nothing about the pandemic was normal. Some I knew, some were friends and family, some were friends of friends. That was very intense.I live in the neighborhood. I was born in the church. I wake up more motivated every day and want to do my best to help my community. The people hardest hit by this pandemic suffered from socioeconomic disparities that led to health inequalities. They are one and the same. I don't know of any billionaires or people who have access to capital and who also deal with health inequalities.The hardest thing about this job is how we get people to come back. I don't want someone sitting at home and having a routine illness grow to the point where it becomes very complex because of the fear of going back to the hospital.
There was one day I cleaned 10 beds, and of those 10 beds, six patients died.Maribel Sanchez, housekeeper
Maribel Sanchez, housekeeperI started entering data at a company that was closed. At that time I had a year without a job, without a job. My friends said if something comes up just take it and then you can go on with whatever you want. It was 1992. My godmother was doing hair for a hospital secretary. She said they needed someone. I felt so comfortable with it, it just kept going and 27 years later I'm still there.I clean the beds when the patient leaves, changes or suddenly dies. I do the floors, dusting and housekeeping. I work for I.C.U. Units: mopping the floor, taking out rubbish, picking up a small piece here and there, filling up paper towels, soap disinfectant and all that stuff.My favorite part of my job is cleaning the bed because once I start a bed I think there might be someone from my family or myself so I have to get it right, like no rough edges.The hardest part during the pandemic was cleaning all of those beds. You know these patients were not transferred, they died. There was one day I cleaned 10 beds, and of those 10 beds, six patients died. It was difficult for me because I never saw so many people die in one day.I see life differently. It is short. You love your family more than before because you don't know whether you will see them again or not. My mother in Boston is 77 years old and has dementia. I want to see her before she forgets everyone.Sometimes I say I'm just a housekeeper. Other people come and tell me what I'm doing and what role I'm doing, that it's important and stuff. I don't think about it that much. I love what i do.
When they brought those fridge tags and saw those bodies rolled in there, it was overwhelming, you know? All of these bodies. It's hard to take.Louie Ortiz, electronics store foreman
Louie Ortiz, electronics store foremanWe are in the background. We run the hospital. We are responsible for the generators and patient rooms and we need to make sure that all sockets and lights are working.It's different every day.Now one has to be aware of wearing a mask. There were some rooms that we had to convert to patient rooms. We had to set up outlets to make sure everything was ready.When they brought those fridge tags and saw those bodies rolled in there, it was overwhelming, you know? All of these bodies. It's hard to take.I think we had four people in the engineering department who got sick from it. But they did it, they are fine. We had other people, about five people actually, I think, who died. One of them was my patient transfer friend, a good guy named Ed Becote.As soon as I'm in the door my wife sprays me on. She sprays my bags, clothes. She's an asthmatic so she needs to be careful too.I wake up in the morning, I'm fine. But when I'm ready, I just don't want to. I say to myself, "Let's make it through another day. Watch out."
Even when I think about it, I get goose bumps. It was a very scary, very overwhelming experience. It was a nightmare. Dr. Kiran Zaman, intensive care carer
Dr. Kiran Zaman, intensive care carer
Even when I think about it, I get goose bumps. It was a very scary, very overwhelming experience. It was a nightmare.
Towards the end of the morning report there was a quick response or an unfortunate code blue almost every day and we would run over. And the day would just go on and run into these rooms and find Covid patients in extreme shortness of breath gasping for air. Some of them made it. Unfortunately, some of them didn't.
I will never forget their faces, the things they said just before they were on the verge of death or were intubated. "Oh my god, doctor, please make sure I'm alive" or, "Here's what you tell my wife, I love her."
There was a very sick young Covid patient. He actually looked at the pictures of his daughter just before he was intubated. He said to me, "Tell my wife that I will come home." And he wiped his daughter's pictures on the cell phone, made a cross on his chest and held his cell phone on his chest. And then he was intubated and sadly died that same night. We did everything to save him, but we couldn't.
I've seen doctor drama or soap on television, seen these people save lives, and wish I were like them one day. I don't think anyone has ever imagined being in something as intense as this pandemic.
It was a very humbling experience. I feel very fortunate to have been part of this hospital. I have learned from every experience, whether as a person or as a doctor.
When your sickest patients improve, that feeling just can't keep up. I don't know how to explain it in words – it's like magic.
I think, "Oh man, I could be on the machine in this state."Chostene Phanord, laundry service
Chostene Phanord, laundry serviceI've worked at Brooklyn Hospital for 31 years. I came from Haiti when I was only 20.Every day is the same for me. I start at 4 a.m. I'm picking up the dirty laundry because the truck comes at 5 a.m. and we want to give it as much dirty laundry as possible. The more dirty laundry you give, the cleaner you will get back. Then we just slide all of the clean laundry upstairs and start deliveries. I do half the hospital and my partner does half.We cover up very well to protect ourselves from the virus. Sometimes you see people at the machine and you are sorry. Nobody should go through this. I think, "Oh man, I could be on the machine in this state." I'm scared and I say, "Forget it, let me keep moving, let me move on." I am making my delivery and I am trying to get off the floor asap.
You are in the middle of the storm and you do not know if you will get to the other side. It was a very intense moment for me. They couldn't stop people from dying.Dr. Vasantha Kondamudi, Executive Vice President, Chief Medical Officer
Dr. Vasantha Kondamudi, Executive Vice President, Chief Medical OfficerEverything we were before is a story. Covid taught us. It taught me how to be a vulnerable leader and resilient.When the climax came, I had to calm my front lines, I had to deal with them in the tent, in the emergency room, in the intensive care unit, talk to the nurses, talk to the doctors, make rounds when we didn't have enough PPE how to protect you Your patients and your staff? Because that is your responsibility. We had to be very innovative. We all had to carry garbage bags for a week.The instructions changed every week. It was such a dynamic situation. We had to react quickly to the information we received instead of just sitting there and wondering, "I wish we'd known." None of the knowledge would help you with this pandemic. Nobody knows anything about this pandemic. It's brand new to everyone, to the whole world.When we were at the height of the deaths and had to have the second morgue, a video came out of an outside person saying that people are dying here. It just wakes you up and shows you where you are. You open your eyes and see. Oh my god am i there And you don't know if you're going to get out. You are in the middle of the storm and you do not know if you will get to the other side. It was a very intense moment for me. They couldn't stop people from dying.There was a moment when many health care workers were sick. Patients have died, colleagues get sick, and bad news is everywhere. So you don't know if we as an institution and as a nation will ever get out of this pandemic.Today is good for me. I can look back and say, "Really, did we go through this?" But at the time when that happened it took a lot of strength and courage and hope and faith to get out of it. That was a scary moment emotionally.
We lost a lot of our employees here, very close people. That really hurt us. We are still grieving.Elvin Cruz, security officer
Elvin Cruz, security officer
I've been doing this for about 20 years. My mother was sick and I'm the oldest so I just wanted to work.Safety was the easiest thing for me to do quickly. You get your certification and start to work.The job is to more or less monitor the hospital. Security issues, crowd control to make sure everything is okay.That changed drastically with the virus. Many of our employees were on the road, so many of us had to take on different roles. I helped the guys with the transport. We took the bodies out in stretchers.We lost a lot of our employees here, very close people. That really hurt us. We are still grieving.The mind plays with you. When you work in the hospital, you don't know whether you are exposed or not. God forbid something happens and you come home and one of your family members goes to the hospital. Then you feel like it's your fault.Do you know what I think is one of the greatest things you learn from it? You discover that you have a heart. Some people don't seem to have any emotions. They don't care about anything. Through this ordeal, you saw people change. They have learned that they have something to give, that they can make a difference. During this time, people could see how good you feel when you let the good come out of you.It was a bad experience, but also one of the greatest learning experiences I've ever had. I still study every day.
I've seen it all – tears, exhaustion, sadness, anger, helplessness, regret. I often went home and cried because I saw the agony on their faces and hearts.Donna Mosley, employee, emergency room
Donna Mosley, 64, employee, emergency room
I am the heart of the E.D. I started in 1982 as a registrar in the emergency room, then as a department head. And then with E.M.S. as E.M.T. and then as a medic.
I come here every day with an open minded attitude because we are with a lot of sick people, with a lot of negative energy, and that's why I keep people informed. For many of them, it makes a huge difference.
I think being a part of 9/11 prepared me for this because when I saw this tragedy, that I had experienced the trauma of it, I was able to deal with it a little better.
P.P.E. Equipment was very scarce. I had to make sure these doctors had N95 on every shift so they could effectively do what they need to do. Because if the front isn't good, we're in trouble inside and out.
The families couldn't communicate with their relatives, it was really difficult.
I would take the family member's name and phone number and make sure that doctor reached that family. That was the least I could do to give them the information they needed.
We could have been exposed at any time. Nobody knew what it was really doing – if it's in the air, if it's not, we don't know. We were just as blind as everyone else. What scares us the most is what happens when this flares up again? Will we be prepared for this when the whole country is in crisis?
I've seen it all – tears, exhaustion, sadness, anger, helplessness, regret. I often went home and cried because I saw the agony on their faces and hearts.
Sometimes it just felt a little out of control, but the doctors held it all together. There was a great tour – from the doctors, to the nurses, to the clerks, to transportation and building services. Although we were overwhelmed by patients, we had to be there for each other.
Now it hits a little more for me. I have time to think a little more, which isn't exactly wonderful.Judy McLaughlin, Senior Vice President and Chief Nurse Executive
Judy McLaughlin, Senior Vice President and Chief Nurse ExecutiveWe zeroed our patient on the first weekend in March and within two weeks the escalation was rapid. I didn't know where to take the patients. I can open units, but I need staff to cover them.Usually, in a non-disaster mode, you can't really float out of their assigned areas because of R.N.'s union contracts. When you call a disaster you have to get people where you need to. So we had to do a lot of on-site training, relocation, and training and support the on-site staff to make sure they knew what they were doing.You just worked, came home, fell asleep, got up and did it all over again. Even on the weekends when I was out of the hospital, I spent the whole weekend on the phone trying to monitor things.The hardest part now is reassuring patients that they can return safely. I think there is still fear of falling. Will he come back? Will we be better prepared, maybe not with a vaccine, but at least with treatment for it?I tried to get well again because everything fell by the wayside. Now it hits a little more for me. I have time to think a little more, which isn't exactly wonderful.We are a safety net hospital. We are not rich. We don't have a lot, so sometimes we have to get things going with a little less, which makes it harder.I was very proud of us. I think we did a great job given the normal challenges we face. Much of it was a lot of key people, the teamwork that adapted to the occasion. I don't think anyone did it better than us.
I call it the little engine that could. You have this community hospital that goes against the big systems.Gary G. Terrinoni, President and CEO
Gary G. Terrinoni, President and CEOI call it the little engine that could. You have this community hospital that goes against the big systems. I think we are a gem.The most frustrating part is really dealing with the issues surrounding justice. Covid has pointed out even more differences and problems in reimbursing Medicaid. It's the drum I've been beating for four and a half years. We are a safety net hospital. For Medicaid patients, we get roughly 70 percent of the dollar, which means the reimbursement doesn't cover our costs.Before Covid we were not subsidized by the state or city. We actually held our own, but marginally at best.We're sitting on a billion dollar real estate. I know a big system would pick us up. We're fighting like the hell to make sure that doesn't happen.
We had to find a way to test for something that didn't exist before. We worked about four months in about four days.Wade Winchell, the laboratory's administrative director
Wade Winchell, the laboratory's administrative director
I was originally majoring in respiratory therapy. I had to give someone CPR while on this program and I quickly realized that I couldn't handle direct patient care. My professor said, "What do you think of the laboratory?" Laboratory is something that adds to care in a really great way, but it doesn't involve meeting a patient face to face.
The day before the outbreak, I became the administrative director. Our previous administrator had passed away. Charline Falletta. She was a great mentor. We have around 70 employees in total. And we have a laboratory information system that integrates around 200 technologies.
We had to find a way to test for something that didn't exist before. We worked about four months in about four days. I was there with my microbiology supervisor Shakeela [Jones] and her team all weekend from 9 a.m. until probably midnight, just collating the data to train everyone. It was pretty wild.
Seeing the data jump every day and not knowing if today would be the day when it would be the largest number was really exhausting, just not knowing when it would stop.
The hardest part is falling asleep, but once I fall asleep, it is really difficult to wake up. When I wake up, I'm usually just exhausted. The emotions are different every day. Some days I feel ready to rise to the challenge and get into it, and other days I feel like I could just sleep until it is over.
I remember just panicking. How are we going to get through this? How can we do this every day?Janmeet Purewal, clinical pharmacy manager
Janmeet Purewal, clinical pharmacy managerIn the end we had several pharmacists who got sick. It was very humble. You never expect something like this to happen and you really realize the impact your job is having. It's very easy to get burned out, but it really helped us remember that at the end of the day, it comes down to the patient. We don't feel that way. It's way bigger than us and we have a bigger role to play and we just have to do our best to take care of the things we do day in and day out.There were times when so many patients were taking the same medication and we were running out and I thought, what do we do now? The things are reordered. Things didn't come in. You would hear, "Code blue, code blue," then the commands flood in. I remember just panicking. How are we going to get through this? How can we do this every day?It was very intense for a couple of weeks and you only expected it to be like that for months. Suddenly it just flattened out. We're still pretty nervous.I'm an Indian and it has always been something that was forced on you: Oh, become a doctor. As a pharmacist, it's not that prestigious. It is always like that with our parents, our families. But now I am very happy to be in this field. I think our work goes unnoticed and that's fine. As long as we know what work we're doing and how we're making a difference.Sometimes I catch it. You're outside ringing the bells. Yesterday they had E.M.S. Church services and people from the congregation just dance outside. And then the N.Y.P.D. come and they all have their sirens howl. It's a nice feeling to see that. It's such a unified moment for the community.Whenever a patient is discharged, we all scream and yell together. Here we play Bob Marley.
There are new challenges ahead and I am preparing myself and my team for the next wave. Covid won't win.Dr. James Gasperino, chairman of the medical department, chief of intensive care
Dr. James Gasperino, chairman of the medical department, chief of intensive care
I go from bed to the boardroom. But I always appreciate the role of the front line. I still go to every quick response and cardiac arrest in the hospital. And during Covid, I wanted to let people know that I am by their side every step of the way. We are a team and I will walk you through this one.It is the oldest hospital in Brooklyn, a team of people committed to patient care and community support. We did it for a safety net community, which means that the social determinants of health play a big role in their outcomes and put them at a significant disadvantage in the event of illness. And I'm really proud that we did a great job for them when they came to the door.I want to be able to deal with anything, anywhere, anytime. Basically training for war. I personally underestimated Covid. There really isn't anything I haven't seen. I felt this was going to be a bad flu situation, that's what we're doing. I think it was a very complicated war.I remember one night – it was patient after patient, patient after patient. And they were so sick. I told myself that if it stays that way we will be overwhelmed here. Because I had never seen anything like it.After one of my night shifts, one of my close colleagues who I really trust said, "Listen, you have to go home." I was tired, I must have looked different, I worked 30-hour shifts.And then it hit me. My tastes were changing and that was a sign that I was coming down.I wanted to get up and just collapsed. I thought I broke my jaw. That's when I knew this thing was real. It was close. There were a couple of dark moments there.A lot of people said, "Oh, you've changed a lot, you seem happier." I am grateful that I am alive because a lot of people didn't make it. And you know it could have been me