Amy Callahan was a small boat on an ocean of bobbing New Yorkers, trying to get to each one she could to offer some bit of rescue.
Make no mistake: There were many she could not hope to save.
But this Air National Guard member, this Nebraska born-and-raised Lincoln High grad, was going to go bed to bed to bed each night in this makeshift Bronx hospital to do what she could ... until she couldn't anymore.
A young man goes into cardiac arrest. He's been my patient for three days. I know him well. I jump onto the bed and begin CPR. I remember yelling ... "Can you feel a pulse? Are my compressions hard enough?" No one is running the code. It was overwhelming for me. The rapid response team shows up, and after two minutes someone else takes over ... which is helpful because I have been paged to another floor. Mrs. M has desaturated again and we can't go up on her Fi02 (concentration of oxygen). The rest of the night is fuzzy.
This wife and mother of two elementary-age children, whose family moved three years ago to the Kansas City area, has tried to write down this experience that took her from the relative safety of her Midwest home to the belly of the COVID-19 beast. She doesn't want her kids to hear these stories now, but someday they can know what their mother did those three weeks in April 2020.
* * *
Amy Callahan, 42, joined the Air National Guard in 2005 and graduated with a certificate in respiratory therapy in 2008. For most of her time she was attached to the 155th Air Refueling Wing Medical Group in Lincoln. She has since moved on to the 139th Airlift Wing in St. Joseph, Missouri.
She'd never worked in a hospital, but had done a lot of trauma training work with the Guard. About a year ago, with her kids now older, she decided to study, take the test and become a registered respiratory therapist.
"But before I could even start writing my résumé, the COVID-19 crisis hit," she said.
Her Guard unit told her to pack and be prepared to help in Missouri, which she did and then waited, she said. During that wait, she realized her calling was to do something more. She volunteered to go to New York City.
Two days after she arrived, she got her assignment. A night shift, 7 p.m. to 7 a.m., in a Bronx hospital. She felt ready, but nervous. Inexperienced. She can see the pain and frustration on the faces of the staff that have been there since Day 1. They are tired and scared, but hopeful and thankful that relief workers have arrived.
I hit the ground running. Codes everywhere. The worst was 15 codes in one night. The 155th and 139th did an amazing job preparing me for mass casualties, triage and transport ventilation. I was basically in my element. The only difference was this time I was in a hospital and not a tent.
Callahan worked in a wide, open bay with 15 to 17 patients, average age in their 50s, but some as young as their 20s. Some others joining her were nurses who had no intensive care experience. One doctor was an obstetrician-gynecologist who had not intubated patients and had never worked in a trauma setting.
"That first week was a huge learning curve for a lot of people," Callahan said. "I was so lucky I was with an amazing group of people with the attitude, 'Hey, I've never done this before. Let's do it together.'"
She knows her limitations and that she needs to connect with nurses, nurse practitioners, physician assistants and doctors, to make sure she has the whole picture on each patient.
"When those connections are made and relationships develop, trust is gained and patient care is at its finest," she said.
* * *
The first week was rough. Doing chest compressions and feeling their body die under my hand. It's a feeling that isn't forgotten. ... Maybe it's naive of me, but when I look through my patients' charts I make a mental note: Stable? Healthy? Strong likelihood of survival? With this f***ing virus, it's a whole different ballgame.
The rules with this virus shift. Sometimes the blood thickens and darkens and clots, even in the syringe. Sometimes secretions are thick and tenacious. Fingers and toes get hard and stiff and slowly die. Hearts stop and give up with no clues. Lungs become rock hard and can no longer be ventilated.
Some medical professionals are so scared they can't be at their best, Callahan said.
She learned that an N95 mask cannot protect her the way she thought it could.
A picturesque 87-year-old lady, white hair with streaks of black throughout, beautiful dark skin. And when she can open her eyes, you can see a happy life shining back. She doesn't speak English, only Spanish. She is a severe asthmatic and has tested positive. She's in a negative pressure room, she needs albuterol (to relax her airways). I give her a nebulizer (to administer the medication). I can feel the effects of the drug through my mask. She needed it but I sure didn't. No regrets.
Callahan is on day 6 of the same N95 mask, recycling the small ones that fit her better. She hopes the next day will bring a new shipment.
* * *
Ryana Swift is Callahan's sister and a Lincoln licensed clinical social worker.
"I wasn't surprised at all when she told me she was going," Swift said. "I'm worried and I'm concerned, but the United States is made up of people like her that do this work. That's what makes our country so successful."
Her sister Amy has a skill set and has dedicated a portion of her life to helping other people. And it helped Callahan, Swift believes, to work with providers from all over the country in that crisis environment like no other. One in which there is no reprieve.
"With this, there's just no end ... It's really scary," she said.
Swift kept in close contact with her sister in New York, sometimes getting up at 4 in the morning to talk to her when she would get off her shift. And she was on the phone with Amy one night at 7 when many New Yorkers came outside to play music, ring bells, clap and holler in appreciation for all those caring for these patients.
"Even I got teary because it's such a significant thing," Swift said. "They're all part of a huge wheel that's going to get us through this."
* * *
Callahan is home now in Kansas City.
She had signed up for four more weeks. But she woke up April 23 with a scratchy throat and then a headache. She went to work, reasoning that in a new part of the country she could have caught any number of cold viruses.
But by the next day, she had added a "little cough ... a sticky one even after drinking lots of water."
The weekend was approaching, and she stopped by the hospital's occupational health desk to tell them her symptoms. They checked her temperature, blood pressure, heart rate, lungs. They told her she checked out in the normal range. No testing, unless she wanted to find her own.
But nothing was open for testing on the weekend.
So now it's Saturday. I'm feeling scared and very much alone. In the past four days, I've watched three people my age or younger die from this virus. I know my odds are low, but I can't stop thinking about my children, my husband, my heart condition (I have A-fibrillation), and the elephant in the room: The New York City hospital system can't handle another coronavirus patient.
So she got herself home to Kansas City, self quarantined, called her doctor and got tested Monday morning.
On the phone that morning, she is sniffly and her voice a little raspy. She is very tired. She says she can't watch the news. She is watching TikTok videos to decompress.
Thursday, she got her results. COVID-19.
She thinks she knows the exact patient cough that exposed her, a comedy of errors with a days-old mask, her face shield tilted slightly, the bed elevated a tad higher than normal. And still, she has no regrets, because she had to do something to help the cause, and she learned so much in New York.
But she feels guilty for leaving.
"I know that when people leave a crappy war scenario they feel bad for leaving. I know that that's a thing, but I've never experienced that until this week," Callahan says.
She sighs heavily, and what escapes is a combination of penitence and relief for what she was able to now say out loud.
If Missouri gets hit hard, she can be a helpful resource, because she's gone through it.
"There's a part of me that wants to go back," she says. "But I think I'm just going to see what happens in the world."