Fighting the Coronavirus, from New York to Utah – The New Yorker

In late March, Scott Aberegg, a critical-care doctor at the University of Utah, was eating lunch in his hospital cafeteria. On his phone, he noticed an e-mail that was circulating among the trainees in his department. It was from the American Thoracic Society, a professional organization of physicians who treat lung disease and critical illness. As you have undoubtedly heard, there is a coronavirus surge in New York City, the message read. The situation is dire...and your colleagues need your help. The e-mail offered same-day credentialling and licensing, as well as free travel, housing, and meals to doctors who volunteered to work in the citys hospitals. The e-mail was so extraordinary that Aberegg wondered if it could be a scam.

Aberegg grew up on a small horse farm in Alliance, Ohio, about sixty miles southeast of Cleveland. His father worked in retail at Sears and later trained horses and sold livestock equipment; Aberegg was the first in his family to attend college. In the winter of 1997, when he was in his third year of medical school at Ohio State, he did a rotation with James Gadek, a legendary critical-care doctor. A few weeks in, Gadek heard that a trainees relative was dying in a hospital several hours away. The medical team there believed the case to be hopeless; Gadek rode down in an ambulance, brought the patient back, and started treatment himself, in his own I.C.U. The patient recovered. Watching his supervisor go to such lengths, Aberegg thought, I want to be like that guy. Now, in Salt Lake City, he replied to the e-mail from the American Thoracic Society, saying that he was available.

Around the same time, Tony Edwards, a third-year critical-care fellow who worked at Abereggs hospital, got the same e-mail. He and his wife, Ashley, a former I.C.U. nurse, had been working in Dallas in 2014, when the first Ebola patient on American soila man fleeing the outbreak in Liberiagrew sick there, and the virus threatened to spread. Tony was a medical resident in the infectious-disease service; Ashleys I.C.U. was chosen as the one to which Ebola patients would be sent if the outbreak grew. Though the virus was contained, a patient died and two nurses were infected. The Edwardses felt that theyd experienced a near-miss. We kind of went through the drill before, Ashley said. Being through that got us ready for this.

At dinner, Tony told Ashley about the e-mail. Shed seen it, too, and also wanted to go: the need for I.C.U.-trained nurses was, in many cases, even greater than the need for physicians. Soon afterward, the Edwardses learned that Aberegg had volunteered as well. The three began making preparations. Aberegg backed out of a family vacation. The Edwardses began arranging child care for their fourteen-month-old daughter. Tonys mother, Marianne, cried when she heard that theyd volunteered; she agreed to drive from Denver to Salt Lake City to take care of the baby. Before leaving, Tony and Ashley bought life-insurance policies, which wouldnt take effect for another month. They tried to make a joke out of it. Tony told his mother, If we get sick, make sure you keep us alive until then!

In early April, when New York City was recording around five thousand new coronavirus cases per day, I met Aberegg in a makeshift I.C.U. in the hospital where I work, on the East Side. We stood near the central nursing station. Doctors and nurses darted around us; alarms sounded; monitors flashed red warnings. The wooden doors on the patients rooms had been taken down and replaced with metal ones; they had large glass windows that allowed us to see the patients, connected to ventilators. On each window, dry-erase markers were used to record ventilator settings, oxygen levels, medication rates, and the number and location of the tubes and catheters keeping each patient alive. Aberegg, muscular and no-nonsense, seemed relatively at ease. When someone says they need help, you go help them, he told me, describing his decision to come. If they didnt need help, they wouldnt be asking. He had arrived a few days before, and was staying in a hospital-run hotel across the street, in a room two floors up from the Edwardses. He had already seen dozens of critically ill COVID-19 patients. In the mornings, he met Tony in the I.C.U., and they talked about what had happened overnight: some patients had improved and might be extubated, others had worsened and needed immediate attention. Then they started their rounds.

Later, I went to see Tony and Ashley in their hotel room, where we sat pushed back from the small dining table, six feet from one another, with our masks and surgical caps on. They recalled the frenzied week between their decision to volunteer and their arrival in New York. Ashley, who had changed her specialty from critical care to interventional radiology, had reviewed I.C.U. procedures online and in old textbooks; Tony, while caring for patients in his Utah I.C.U., had tried to sort out the requirements for New York State credentialling. Twelve hours before they were set to depart, the airline cancelled their flight. They scrambled to book another. On the way to the airport, Tony became apprehensive. He was freaking out, Ashley said. He was shaking and couldnt talk. Thats when I think it hit him.

On their flight, there were fewer than a dozen passengers, all wearing masks. There was no food or drinks service on board, and they were hungry when they landed at J.F.K., a little after midnight. As they walked through the empty terminal, past a lone T.S.A. officer sitting in a chair, their sense of unease grew. Their Uber driver seemed tense. At the hotel, they ate a pizza theyd ordered from a food-delivery app. Five hours later, Tony picked up his I.D. badge and got to work. Later, Ashley went to an office in midtown to complete her credentialling process. Afterward, she walked to Times Square. The lights were on and the signs were flashing, but the streets were deserted. Theyd been to New York before, but not this version.

For Tony, nervous energy quickly gave way to reflexive action. There was almost no time to meet his new colleagues. His first day was marked by a constant flow of patients: just as one was stabilized, another arrived, gasping for breath or already intubated. When a spare moment presented itself, he and his team would swap theories about the coronavirus and discuss the few studies that had been published. He felt disoriented, not just by the tumult of the ward and the uncertainties of the virus but by the unfamiliar faces and layout of a new hospital. One morning, he entered a break room and sank, exhausted, into a chair. Hey! Youre the Utah guy, one doctor said. Around him, many others were reviewing cases and debating treatments. He had known that all of the units on his floor had been transformed into COVID-19 wards; only now did he realize that the same was true of nearly the whole hospital. He took the stairs down to a surgical floor and made his way along a hallway with operating rooms on both sides. There, he got a hint of the pandemics true scale: in each room, rows of unconscious patients were connected to ventilators, their alarms echoing eerily down the empty corridor. It was straight out of a science-fiction movie, he recalled.