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Speaker 1: Literally every hour, you would hear an overhead call wherever

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Speaker 1: you were in the hospital of a code being called,

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Speaker 1: an emergency airway being called. These are all different announcements

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Speaker 1: over the loudspeaker to tell you there's an emergency in

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Speaker 1: this room or in that room, and it's a call

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Speaker 1: to get people there to help. And it would be

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Speaker 1: every single hours, sometimes three at one time at the surge,

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Speaker 1: whereas now, thankfully we're hearing the music the hospital plays

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Speaker 1: when someone's getting discharged, so that we could celebrate the

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Speaker 1: successes even though there were so many scary.

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Speaker 2: Moments from futuro media. It's Latino USA. I'm Maria Inojosa.

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Speaker 2: At the peak of the COVID nineteen outbreak in New

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Speaker 2: York City, about three thousand patients were seen every day

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Speaker 2: in local hospitals. It was right around that time that

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Speaker 2: some disturbing statistics were revealed. Black and Latino patients were

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Speaker 2: dying at twice the rate of other patients. Manhattan's Bellevue

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Speaker 2: Hospital has historically been at the front lines of public

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Speaker 2: health crises in New York City. We wanted to understand

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Speaker 2: what the situation looks like now at Bellevue, a hospital

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Speaker 2: where thirty five percent of the patients are Latino or Latina.

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Speaker 2: Now we're no longer at the peak of the pandemic

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Speaker 2: in New York, but intensive care units in the city

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Speaker 2: are still busy. So I asked doctor Susan Cohne, who

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Speaker 2: works in the hospital's ICU, to take me inside the unit,

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Speaker 2: which is where the most severe cases are treated.

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Speaker 3: Doctor Susan calm. Welcome through Latino USA.

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Speaker 1: Thank you, Maria.

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Speaker 2: Thank you for having me over the phone safely. Doctor

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Speaker 2: Cohne walked us through the unit.

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Speaker 1: We actually have some rooms with two patients in one

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Speaker 1: ice cubicle. Almost every cubicle has a big red stop

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Speaker 1: sign telling you that as a room where you need

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Speaker 1: proper ppe to protect you from infection from COVID.

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Speaker 2: So Bellevue's ICU unit has been converted these past several

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Speaker 2: weeks to make more room for COVID nineteen patients. So

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Speaker 2: what that looks like is that you have more of

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Speaker 2: these negative pressure rooms installed, which are those rooms where

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Speaker 2: you kind of feel like the air sucks in and

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Speaker 2: sucks out when you open a door, and this keeps

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Speaker 2: the virus from spreading in the air. The hospital really

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Speaker 2: transformed itself to accommodate the needs of this pandemic. Can

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Speaker 2: you just describe what you're seeing? Just describe what you're

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Speaker 2: seeing right now.

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Speaker 1: We see, which we would not normally see, a lot

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Speaker 1: of information written in magic marker on the glass doors

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Speaker 1: and windows that goes into each ICEU cubicle room. So

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Speaker 1: it says things like, you know, this person needs a

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Speaker 1: repeat COVID test, or this person is going down for

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Speaker 1: a cat scan, or this person needs to have a consult.

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Speaker 3: With a certain service. It's like a to do list.

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Speaker 1: We would never see that in normal times. The other

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Speaker 1: thing we see is IVY pumps and IVY bags and

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Speaker 1: tubing that extends into the hallway area outside of the cubicles.

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Speaker 1: To adjust an IVY bag or at IVY drip, it

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Speaker 1: can be done from outside the room. There's a lot

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Speaker 1: of beeping and dinging and these beat being monitors, beeping,

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Speaker 1: ventilators beating.

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Speaker 2: Over the last several weeks, as the city where I

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Speaker 2: live in has become the epicenter and Latinos and Latinas

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Speaker 2: are dying at higher rates than the percentage of their

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Speaker 2: population in the city, I became intrigued and almost obsessed

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Speaker 2: with wanting to understand when did you realize that this

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Speaker 2: was in fact going to be a pandemic that was

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Speaker 2: going to really attack Latinos and Latinas, black men and women.

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Speaker 1: Because at Bellevue we always see a high number of

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Speaker 1: Latino patients black patients, it didn't feel any different initially,

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Speaker 1: but then I did start noticing that my ICU list

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Speaker 1: we all traditionally Latino names or a high majority of

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Speaker 1: Latino names, and so when they started writing about it

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Speaker 1: in the paper and in reports, it didn't surprise me.

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Speaker 1: It does feel like specifically Latino men, and we do

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Speaker 1: know that this illness affects men more than women have

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Speaker 1: been impacted by this.

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Speaker 2: So what I wanted was to understand who are those

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Speaker 2: Latinos and Latinas who are in your ICU who were

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Speaker 2: fighting for their life.

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Speaker 1: In my experience here at Bellevue, it's patients from Mexico,

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Speaker 1: Dominican Republic, Ecuador, El Salvador, and they are hard working

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Speaker 1: people who were working in their job until the day

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Speaker 1: they got sick. Many of them have extended family here

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Speaker 1: who are very devoted to them and we speak to

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Speaker 1: every day. Others have one or two family members here

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Speaker 1: and the rest of their family is in Guatemala or

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Speaker 1: Mexico or El Salvador, and we're calling those countries. We

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Speaker 1: have had several occasions where we've had more than one

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Speaker 1: family member of a family in the hospital or in

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Speaker 1: the ICU, or one in this ICU and one in

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Speaker 1: another ICU in another hospital in the city, which is

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Speaker 1: just devastating for these families.

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Speaker 2: So, doctor, you look after patients usually who are battling serious,

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Speaker 2: life threatening diseases.

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Speaker 3: You're a palliative care specialist.

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Speaker 2: Can you explain that work a little bit and how

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Speaker 2: it applies to what you're doing now during the pandemic.

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Speaker 1: As a pallative care doctor, one of the things we

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Speaker 1: do is we try to get to know people who

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Speaker 1: they are as people. Right, but most of our patients

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Speaker 1: before coronavirus were so chronically ill that they were no

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Speaker 1: longer working. So the question would be what did you

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Speaker 1: used to do when you were working? Now it's someone

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Speaker 1: who was at work two days ago and is now

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Speaker 1: in the ICU. That's the real difference. I hope that

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Speaker 1: as healthcare providers we do try to see our patients

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Speaker 1: for who they are, the personhood aspect of people and

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Speaker 1: hear their stories, you know, But we sort of don't

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Speaker 1: take notice of a delivery person or the person at

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Speaker 1: the construction site as we're driving by, because they're not

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Speaker 1: the people we typically see in the hospital. We typically

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Speaker 1: see people with heart failure, your serious lung disease, serious

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Speaker 1: liver disease, cancers. These are the people that end up

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Speaker 1: in the hospital, not young healthy people. We've had patients

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Speaker 1: in the entire adult age range from late teens to nineties,

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Speaker 1: and some of the ninety year olds do well and

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Speaker 1: some of the twenty year olds or thirty year olds don't.

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Speaker 1: There's just no way to predict, really.

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Speaker 2: So you say that you really want to connect with

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Speaker 2: your patients, that that's an important part of the work

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Speaker 2: for you, But you're also suited up in scrubs, you're

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Speaker 2: wearing a mask, you have to keep your distance. So

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Speaker 2: talk to me about losing that sense of touch and

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Speaker 2: closeness during this pandemic.

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Speaker 1: I often will sit down next to a patient, and

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Speaker 1: if it's appropriate, I might hold their hand or they

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Speaker 1: might reach out for mine. If it's somebody I've developed

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Speaker 1: a relationship with. It's not even not being able to

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Speaker 1: touch them or hold their hand. It's not even being

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Speaker 1: able to go in the room everybody. In the beginning

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Speaker 1: of this pandemic, we didn't know what the PPE supply

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Speaker 1: would be like, so there was a very concerted effort

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Speaker 1: to minimize the number of people going into a room.

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Speaker 1: And fortunately in the ICU, the rooms are glass so

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Speaker 1: we can see the patient and then one or two

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Speaker 1: people would go in, Usually the nerves of the primary

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Speaker 1: team doctor in the ICU might go in, or people

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Speaker 1: would go in when they needed to do a prothedra,

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Speaker 1: but really limiting the amount of time interacting with the patient.

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Speaker 1: A lot of the patients in the ICU, they're sedated

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Speaker 1: on ventilators, and we don't know what they can be

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Speaker 1: aware of in terms of those things. But for the

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Speaker 1: patients on the medical floors where we can't look in

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Speaker 1: through a glass and they are in a room isolated,

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Speaker 1: and fewer people are coming in, and when they come in,

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Speaker 1: they are masked and gloved and in gowns, and the

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Speaker 1: amount of confusion and delirium and interactions being so odd

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Speaker 1: and not normal really really clearly impact patients.

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Speaker 2: So in the ICU you have to work closely with

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Speaker 2: families and loved ones. Especially now this is something that

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Speaker 2: you do with a lot of your patients anyways, But

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Speaker 2: throughout this crisis, have you had any interactions with any

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Speaker 2: of the family members that has really stood out for you?

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Speaker 1: Doctor, I'm struck by the loving sons and daughters of

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Speaker 1: a parent. You know. I've had both mothers and fathers

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Speaker 1: where the children are just so devoted to their parents

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Speaker 1: and so worried about their parents speaking to them every

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Speaker 1: single day, and really, you know, you really get to

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Speaker 1: know someone when they're sharing how they're coping through what's

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Speaker 1: probably the worst weeks of their life and talking about

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Speaker 1: and thinking about some of the hardest decisions and care

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Speaker 1: that they ever had to think about.

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Speaker 3: No, I don't want.

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Speaker 1: To give away anyone's identity, but I have several families

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Speaker 1: where it's just incredibly devoted sons and daughters. And then

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Speaker 1: you see the siblings and how they interact and appoint

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Speaker 1: one of them as the spokesperson or you know, one

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Speaker 1: of them maybe the caregiver in normal time, and another

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Speaker 1: one might be the decision maker regarding healthcare. Just how

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Speaker 1: they come together just abort each other. I get tearful

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Speaker 1: when I think about the families, not just Latino families,

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Speaker 1: all families have taken the time to thank us for

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Speaker 1: what we're doing. I'm getting chilled when I talk about it.

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Speaker 1: I've also been saddened to hear patients worry about what

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Speaker 1: they read in the paper. Will my loved one get

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Speaker 1: a ventilator if there's not enough. I reassure everybody that

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Speaker 1: nobody has gone without the there wasn't enough of something.

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Speaker 1: But people have covertly and overtly asked that question of me,

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Speaker 1: worrying that they'll be rationing and that their loved one

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Speaker 1: won't get something. And I've heard them worry that saying

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Speaker 1: things like I promise we'll pay you later, worrying about

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Speaker 1: their love when not getting care because they can't pay.

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Speaker 1: I always stop the conversation very sternly and reassure them

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Speaker 1: that we're proud to be in a hospital that serves everyone,

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Speaker 1: regardless of the ability to pay, regardless of insurance status.

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Speaker 1: But to think that this is what they're worrying about

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Speaker 1: at home before I talk to them is just heart benching.

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Speaker 3: Doctor Cohen, thank you so much for speaking with me.

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Speaker 2: I really appreciate your time and all of the work

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Speaker 2: that you're doing on a daily basis.

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Speaker 3: Thank you so much, Oh, thank.

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Speaker 1: You for all you do thank you for having me.

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Speaker 2: This episode was produced by Alejandra Salasad and edited by

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Speaker 2: Sophia palisa Ka. The Latino USA team includes Me and Masis,

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Speaker 2: Luis Reyes, Antonia Serejido, Genes, Yamoca, Gini Montalbom and Alissa Scarce,

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Speaker 2: with help from Raul Perees. Our engineers are Stephanie Lebou

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Speaker 2: Our director of programming and Operations is Natalia Fidelhutz. Our

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