Matt Morgan: A letter from ICU—one year on

A year on from the start of the pandemic, Matt Morgan writes another letter from ICU

To the lucky ones,

Many who read my first letter will not read my last one. 

Many cannot. Many have died.

I said a year ago,

“We will sit with you and with your family. We will be honest, we will hold your hand, we will be there. We have not forgotten about you.”

And we have not.

There are now empty corners and empty spaces. Everything feels like a clockthe trees, our children, our own facesreminding us how much time has past. Thankfully, many people survived. They were not special, just lucky. But even a survivor may still feel broken.

And for healthcare staff, working through these dark days, means sometimes you see everything. The last year has acted like a sorting hat for life. Those who thought they could not, often did, without knowing where their courage came from.

But there have been better times too. Science has given us hope through a needle. And the world knows what intensive care can, and cannot, do. The word “intensivist” is now in the dictionary.

The best advice I had last year wasno matter how busy you are, always sit down and eat food at a table with a knife and fork. Like a human. No sandwich-on-the-go-nonsense. It’s great advice that few staff have been able to take. Maybe tomorrow will be better and we will remember this.

Covid-19 has brought new memories for us all to carry. In a decade’s time, I’ll remember pressing rubber keys on a telephone because this is how we broke bad news. Though the twisted cord of a telephone where silence could be mistaken for a hang-up. Calls began with “I’m so sorry to do this over the phone…” Calls ended with quiet sobbing. We promised to hold the patient’s hand. To play their favourite song. To tell them that their family loves them. Loved them. Past tense. Because soon, they die.

These are now the people I will carry with me. So too will the nurses, the physiotherapists, the receptionists who file the death certificates, the cleaners who clean the empty beds. We all carry covid-19 with us, not on our skin, but in our heads and in our hearts.

How did it feel working during a deadly global viral pandemic? It felt a bit like being a first time parent, living in a one bedroom flat, when your baby comes a month early, and that baby is one of triplets. You worry about your ability to care for more children that your hands can even carry. You also worry how you are going to get through this. Yet, you do get through it. Adrenaline, love, teamwork, and hope are your fuel. The early days were hard, the later days even harder. But your children did survive. You cry, but you also laugh out loud. Will you come through unscathed? No. But most of the scars are ones that will heal and remind you of what you have achieved. Life will never be the same again. Some parts worse, many partsmaybeeventually better. 

The darkest time often comes just before the dawn. This crisis will wane. Things will get better. The daffodils will come this Spring, and next Spring too. But for the staff, and patients, and families that have been there at the dark times, they will need your help now and into the future. Please turn the hands that were used to clap, into hands held out to help pull us all back on to our feet.

Nye Bevan said that the purpose of power is to give it away. This crisis has been fought not only by the nurses, the cleaners, the doctors, the care workers, the delivery drivers, but by the peopleby you, by you all. Thank you. Thank you all. 

Now we have the power to think about and choose the future. It’s understandable that many people are in a hurry to return to normal. But I think we should all be in a hurry to remember which parts of normal are really worth returning to.

Matt Morgan, honorary senior research fellow at Cardiff University, consultant in intensive care medicine, research and development lead in critical care at University Hospital of Wales, and an editor of BMJ OnExamination. 

Twitter: @dr_mattmorgan.

Competing interests: none declared.