Illustrations by Bill Robles
For everyone delivering care to COVID-19 patients in UCLA Health System’s ICUs, the pandemic has been a dark and tumultuous time, but also one that has been brightened by surprising flashes of light and hope.
Since the COVID-19 pandemic began to really hit home, in March 2020, the doctors, nurses, respiratory therapists, care partners and others working in the medical ICUs of UCLA and its affiliated hospitals have been on the frontline of providing ongoing care to patients critically ill from the disease. They have performed dangerous intubations, placed essential lines, done CPR when necessary, held a cell phone to the ear of a critically ill husband, wife, parent or sibling to hear the voice of a loved one and, too often, been the only ones present in someone’s final moments. Here, in their own words, drawn from emails, social-media posts and journal entries, are reflections and experiences from some of this team of heroes.*
“I still remember like it was yesterday, pressing
on the kid’s chest. I say kid because he wasn’t
even 30 yet. I didn’t even have time to throw on
the PAPR, knowing that compressions would
aerosolize the disease. I looked at my colleagues
who feared entering the room because of that. A
couple of nurses quickly threw on PPE and took
a chance and came into the room to help. It was
a very intense moment. I just couldn’t bear the
thought of COVID taking a life of someone so
young, and I couldn’t stop caring, even though
my own life was at risk.”
— Romain Penet, RN
“This is our moment; we have been called. And
though we may have been drafted into a ‘war’ none
of us saw coming, we are ready to step up to help
our community. I have taken a lot of inspiration
from others who have highlighted the unique
privilege we have in this crisis to be capable of
helping. And that is a calling that will help me to
push through any of the fear or doubt, knowing we,
together, will pull through this.”
— Lawrence N. Benjamin, MD, first-year
pulmonary/critical care fellow
“I have always thought the 4ICU was a special
place, where we see all kinds of deterioration
and unstable patients, but witnessing such a high
degree of professionalism on top of such camaraderie
throughout this pandemic has changed my
nursing practice forever.”
— Catherine Fairbanks, RN
Illustration by Bill Robles
“I just left the hospital after a
14-hour day, walked back to my
hotel room, and I think I need a
long, good cry tonight. I cry for
the patient I just lost. I cry for
the mother who is not allowed to
be at the bedside of her disabled
son. I cry for the patient who
hasn’t seen her husband for
nearly three months. I cry for
the newly widowed husband. I
cry for the protestors. I cry for
the senseless loss of Black lives.
I cry that there is a need for
curfews and military in the city
I love. I cry for the businesses
that have been looted and destroyed.
I think of all the reasons
we have to cry right now, and I
cry harder.”
— Thanh H. Neville, MD ‘05 (RES ‘08, FEL ‘11),
attending physician
“There was a moment at the beginning of the
COVID crisis when my heart sank. I was in
charge of our UCLA Health System ventilators
and found myself surveying both my thoughts on
our hospital’s current inventory state and what
that potentially looked like against the worst-hit
hospitals across the country. It was like standing
at the foot of Mt. Everest, staring up and considering
the massive terrain and elements. Where do
I start the task? Eventually, you realize that your
lamp may not shed enough light for you to see
what’s in the far distance, but it will illuminate
the path that’s right in front of you. If you take
one step at a time, you find yourself making the
necessary progress to become successful.”
— D’Mitri Champion, clinical operations manager
for Respiratory Therapy Services
“There has been a lot of talk about ‘resilience’
among health care workers. I am not a fan of
this term. Resilience is defined as an ability to
recover from or adjust easily to misfortune or
change. ‘Grit’ is a better word. Grit is showing up
every day, no matter how hard it is, or how tired
you are, or how scared you are. It is putting on
PPE when the skin on your face is bruised and
broken. It is adding on an extra shift because we
are desperately short on staffing. Grit is showing
compassion when you have nothing left to give.
It is smiling when it seems like there is nothing
to smile about. Grit encompasses passion and
perseverance. I’m not sure that any of us have
recovered from our experiences over this past
year. And when we do, we will never be the same.
But we have grit, and we will persevere.”
— Nicole Agee, RN
Illustration by Bill Robles
“Most days, if I squint, I can see
some silver lining in this new world
— which can be described as some
sort of wonderful combo of kindness,
gratitude, support, resilience,
generosity, strength and solidarity.
And even some hope that many
lives can be saved and that maybe
we will become better humans and
physicians in the process.”
— Tisha Wang, MD (RES ‘05, FEL ‘08),
pulmonary/critical care clinical chief
“I’ve seen some amazing stories of survival,
many patients on the brink of death who pulled
through with our help and who are now at home
safe with their families. I’ve seen just as many
heartbreaking stories of defeat, including a
patient who promised to give me golf lessons if
I got him through COVID. Sadly, those lessons
will have to wait until we are both reunited on
the golf course in the sky.”
— Jaime Betancourt, MD, attending physician
“Truly being present, bearing
witness and providing the care
and comfort at these COVID-19
patients’ most vulnerable and
scared time is the essence
and the heartbeat of nursing.
With misty eyes, we are
together in this.”
— Sherry Xu, RN, unit director
“First, there was fear. Would the PPE actually
protect us? How do you best treat a novel virus?
Then, there was community. The nurse would help
me don my PPE, and I would check the patient’s
urine output inside the room to minimize the
nurse’s exposure. Outside of the hospital, it was
social isolation, yet inside the hospital, I felt
more connected than ever. Now, there is grief.
Too many patients are dying. Those who survive
are seen in our post-ICU clinic with a tremendous
road to recovery ahead. So we continue onwards,
both for them and for us, and we put our heads
together and work.”
— Kristin E. Schwab, MD (RES ‘16, FEL ‘20),
co-director of post-ICU recovery
“Walking into the rooms of our first COVID-19-
positive patients was extremely nerve-racking,
but knowing we all felt the same was something
of a comfort to everyone involved in their care.
Assisting with the organization and training of
the emergency-response team was one of the most
rewarding things I have done in my career. This
experience has shown what we all are capable of,
and for that I am forever grateful.”
— Matthew Dartt, assistant director of
Respiratory Care Services
Illustration by Bill Robles
“I began my training in the MICU during
COVID-19. I was assigned COVID-19 patients for
one full month. Needless to say, I learned more
about respiratory distress, PPE and ventilator
management in one month than I did working the
one year since I was hired.”
— Ferdinand Castro, RT
“This ICU week is particularly horrible. During my
last stint, I had discharged the last COVID patient,
but this week, there seems to be a new patient
transferred to the ICU with COVID every day.
Today, we admitted the patriarch of a family, all of
whom have COVID. He wants his daughter to have
his durable power of attorney. My residents tell
me all she does is cry on the phone; I cannot bear
to call her myself. We asked the patient to enroll
in a clinical trial, and he consents, stating, ‘Even
if I don’t benefit from this study, I hope the information
will help others.’ I am so tired of kindness
being a poor prognostic factor.”
— Thanh H. Neville, MD ‘05 (RES ‘08, FEL ‘11),
attending physician
Illustration by Bill Robles
“I’m emotional about leaving the UCLA MICU. I’m
leaving because I’ve finally given myself permission
to take care of myself. For months while working
in the COVID ICU, I lived through countless panic
attacks, traumatic deaths, depression, being the
main emotional support for patients who couldn’t
have family members visit, comforting emotional
and fearful family members on the phone, the fear
of exposing my friends and family. I’ve carried this
weight for months. I carried it because I knew I was
skilled and trained to help during this pandemic.
I’m fortunate to work for a health system that is
supportive, encourages self-care, and tries its best
to attend to the needs of employees during this
time. Still, I don’t have the emotional stamina to
continue working in the COVID ICU anymore
during this pandemic.”
— Tatiana Johnson, RN
“While I’ve been fortunate enough
to take care of many kind, amazing
patients, I don’t think I’ve ever
heard as many words of gratitude
and appreciation as I did last week.
Although these #CovidWarriors
were essentially recovering from
near-death experiences, they still
asked how they could help others,
by donating plasma or offering support
to people who have survived
the same or by doing something
else positive. They cared about
things bigger than themselves.”
— Nida Qadir, MD, attending physician
“Work has been a mentally and
physically challenging time with
magnified emotions. We’ve seen
both unexpected recoveries
and unfortunate losses. Given
the circumstances, we’ve found
our own ways to celebrate life,
whether that be through lining
up to clap for a patient being
discharged or providing our
patients a personal experience
through our 3 Wishes Program as
they transition on. The teamwork
among all the staff — doctors,
nurses, therapists, care partners
— shows how resilient we all are.”
— David Yadao, RN
“I recall a gentleman struck hard by COVID that
landed him in the ICU. Even though he was alone,
we assured him that he wasn’t. I felt the highs and
lows of this patient case. To see him get reintubated
numerous times, I was almost losing hope.
I did my best to keep him connected to his wife
via video chats, and when I overheard how much
he meant to his family, I could no longer think
negatively. The doctors, nurses, care partners and
ancillary staff did a magnificent job of staying
calm and patient throughout his course. He beat
COVID and was reunited with his family. It was
such an awesome moment.”
— Luis Sandoval, RN
“During these dark days, I received an email from
the wife of a successfully discharged post-ICU
COVID-19 patient. She is giving me words of
encouragement and writes, ‘We are forever grateful.
This is nothing compared to giving us life. Giving
our kids a father. Helping me not be a widow. Please
focus on all the people you save. We are some
of them.’ She included a picture of her husband
writing me a thank you card. This is a man I put an
endotracheal tube down! Needless to say, I cried.”
— Thanh H. Neville, MD ‘05 (RES ‘08, FEL ‘11),
attending physician
“I’m coming to appreciate that I get to witness
such a dramatic range of human experiences
and emotions in the work that I do. I can either
be drained by this reality or I can embrace the
possibility that it may give me wisdom that I
otherwise would not have obtained.”
— Nida Qadir, MD, attending physician
“Anxiety is pretty high right now at
the hospital, between how difficult
it is to predict how patients will
do, how to counsel patients and
their families, and the worry about
the well-being of colleagues. I can
only imagine what it’s like for those
nurses, the other fellows, the RTs
or attendings who have families at
home and some of the decisions
being made about whether to remove
themselves from their loved
ones or simply return home and
take as many precautions as they
can. I have the ability to essentially
quarantine myself at home after
work, so I don’t risk infecting others,
though it has been pretty isolating.
My parents are worried sick, but I’m
reassuring them as much as I can.”
— Lawrence N. Benjamin, MD, first-year
pulmonary/critical care fellow
“I checked in on a trainee of mine last night who is
quarantined. Made sure they were doing ok. Got a
reply that they were fine but frustrated about being
‘put on the bench.’ That made me smile for the first
time yesterday. It is the ‘put-me-in-coach’ attitude,
even when you are potentially walking into a fire, that
makes me love and appreciate the people that
I am surrounded by.”
— Tisha Wang, MD (RES ‘05, FEL ‘08),
pulmonary/critical care clinical chief
Illustration by Bill Robles
“I’m sleep deprived, physically tired, mentally exhausted
and about as beat up as I’ve ever been after an ICU
rotation, but I’m happy and proud of the work my team
and I did, and continue to do, every day.”
— Jaime Betancourt, MD, attending physician
“I am so very thankful to work
alongside a compassionate and
hardworking team in the MICU and
all ICUs. Not only do we support
each other and help each other out
to meet the needs of our patients,
we are all there for each other
emotionally as well.”
— Amanda Hill, RT
“As I sit here thinking of my mom’s battle with COVID,
it’s hard not to question every decision made along
the way. I think of all that was done and how things
could have been different. I think, ‘What if I would
have brought her to the hospital earlier? What if she
would have received remdesivir? What if we didn’t
intubate her on May 12th and had waited?’ I’d have
one more day with her. I could tell her how much she
means to me and how much I love her without feeling
rushed. I could have let her know I couldn’t have asked
for a better mother. I could have talked to her about
what she wanted done if she reached a point where her
quality of life did not meet her standards. But, oh, how
she wanted to live! She could have told me what dress,
shoes and jewelry she wanted to wear as she was laid to
rest. She could have told me who she wanted to receive
her jewelry, clothes, furniture, etc. She could have told
me what bills needed to get paid. But, then again, we
never thought she was going to die.”
— Cindy Valadez, RN
“I’ve gained an even deeper
admiration and respect for my
nurses and respiratory therapists,
the true frontline heroes in this
COVID nightmare we are living.
My ability to help any patient is
only as good as those who execute
my orders, and I am thankful I
work with so many like-minded
heroes and heroines.”
— Jaime Betancourt, MD, attending physician
“We trached a man despite his COVID PCR continuing
to be positive, because we didn’t think this represented
true infection. But, truth be told, even if it was absolutely
clear he was positive, I would still have done the
trach, because I wanted so badly to give him a shot.
He went home after a long hospitalization, and he was
doing well. Then I heard he had a sudden cardiac arrest.
It’s been story after story like this for months. These
stories have taken a piece of my soul that I don’t think
I’ll ever get back. Like many of us, I’m certain I’m going
to emerge a different person when this is all said and
done, hopefully for the better, but who knows.”
— Nathan Yee, MD, third-year
pulmonary/critical care fellow
Illustration by Bill Robles
“The hardest thing every day is to have to bet against
your fears of a dreaded outcome, to pray that the inert
patient in the bed is not suffering, to hope that their
family will see them again, to bat away fears of futility
and the memories of the times you’ve withdrawn patients
from care. It is a struggle to consciously expend
energy to undermine the validity of your instincts
and experience, all in the name of hope.”
— Kimberly Coppin, RN
“For my entire career, if I ever intubated someone
for what I believed could be the last time, I invited
their loved ones into the room while I prepped and
encouraged both parties to say to each other anything
they wanted to say. I could write a book about the final
words I have heard, often fighting back my own tears.
Being present in those moments is hard in its own
way, but now, often it’s just the docs and the patient,
and so many of these patients are terrified, crying and
often asking the health care professionals in their final
moments to not let them die. Now we are the only ones
who might hear their last words.”
— Tisha Wang, MD (RES ‘05, FEL ‘08),
pulmonary/critical care clinical chief
“There I was, making out my will, preparing to die,
nauseated, scared and in scrubs going to work in
the COVID unit. It is not what you think. Well, yes,
it was, and is, a war zone. But in the war zone was
LIVING, BREATHING TEAMWORK, GENEROSITY
OF KNOWLEDGE, CARING, CHEERING
WHEN A PATIENT MADE IT, YELLING WHEN
A NURSE WENT IN A ROOM WITH NO
PROTECTION TO PREVENT A PATIENT FROM
EXTUBATING THEMSELF. I was witnessing
and experiencing a type of nursing like no other.
Everyone trained me. I loved working in MICU. We
were doing everything together as a team. The more
we learned about COVID, the more we became the
warriors against it.”
— Meilani Renger, RN
“Our souls may never be the same.”
— Tisha Wang, MD (RES ‘05, FEL ‘08),
pulmonary/critical care clinical chief
*Editor’s Note: These reflections have been lightly edited for clarity and length. Patients or the families of patients referenced in these reflections have given their permission to be included.
About the Illustrations: The illustrations for this article, by award-winning courtroom artist Bill Robles, are based on photographs taken by the men and women who work in UCLA’s ICU units. For five decades, Robles has chronicled such trials as those of Charles Manson, Patricia Hearst, O.J. Simpson, the Unabomber and Michael Jackson.
