I’m the guy who doesn’t need help at the Apple Store. Thirty years as the family IT department, the one who sets up everybody’s phone at Thanksgiving. So I can’t tell you why, when I bought a new iPad Pro in June 2022, I walked into the store to have them move everything over for me. Habit, maybe. A slow afternoon. I figured I’d be out in ten minutes.
I always keep a tablet with me at work. There’s usually a movie or playlist running in the background, low, something I’ve seen or heard a hundred times: Casablanca, Coco, or Dropkick Murphys, whatever fits the mood that night. Sometimes you need a constant, recognizable sound. Something familiar among the unpredictable din of a night shift in the ER.
The kid helping me paused during the transfer. I couldn’t tell you a thing about them now, not a name, not a face. “Before we switch these, you might want to save these FaceTime numbers into your contacts.” “What FaceTime numbers?” I said. “I barely use FaceTime. When I do, it’s for family.” They turned the screen toward me.
Fifty-three numbers. Almost every one carried the area code of the hospital where I used to work, several states from where I live. And the dates. The dates ran from the middle of 2020 into and through 2021. The worst of it. The very worst of it. It came back the way a wave does when you don’t hear it until it’s already on top of you.
Real physician voices, twice a week
Free, and one click to unsubscribe.
There was a stretch at the height of the pandemic when we weren’t allowing families into the ED, when we were begging them to stay home for their own safety. And sometimes, the last thing I could offer a person before I put them to sleep and slid a tube into their throat was that tablet.
Prop it on a pillow. Angle it so they could see a wife, a son, a daughter. Give them a minute. Sometimes less than a minute. Then I’d take it back and go to work. Fifty-three times, I did that.
Here’s the part I need you to sit with. During that stretch, most of the people we intubated for COVID did not come off the ventilator. They did not go home. Many of my patients never. went. home. For many of those fifty-three patients, those were the last words they ever spoke to the people they loved. The last time a familiar face looked back at them.
And I was standing in the middle of an Apple Store, holding all of it in my hand, while someone asked if I’d like to keep it. I bawled. Right there at the counter. I couldn’t stop. I couldn’t explain it to that poor kid, and I couldn’t finish. I had to leave and come back the next day. I brought my wife, who had fought her own war with breast cancer that whole terrible year and who somehow still had steadiness to lend me when mine ran out.
I didn’t let them delete the numbers. I took the tablet home and did it myself. One at a time. It felt like the only right way to do it.
I’m telling you this because lately I keep hearing people (people with microphones and podiums) say the hospitals were empty. That the ICUs were quiet. That it wasn’t what we told you it was. I don’t have a graph for you. I have a tablet that used to hold fifty-three goodbyes. COVID killed people. A lot of people. I know because I watched them say goodbye.
And some of us are going to carry that for the rest of our lives. Quietly, mostly. Until a kid at a store hands us a screen and asks if we’d like to keep it.
This article is discussed on The Podcast by KevinMD in the episode Stop calling it burnout: COVID denial and the wounds ER doctors carry.
Howie Mell is a board-certified emergency medicine and emergency medical services (EMS) physician licensed in six states. Before he ever put on a white coat, he ran calls as a firefighter/paramedic in the Chicago suburbs, where he learned that medicine happens at the worst moment of someone’s life, and that showing up matters. He earned his MPH at the University of Illinois Chicago (UIC) School of Public Health and his MD at UIC Rockford, and completed his emergency medicine residency at Mayo Clinic.
He has served the American College of Emergency Physicians (ACEP) as a national spokesperson and as past president of its Illinois chapter. He is a frequent guest on emergency medicine podcasts and lectures on the specialty throughout the U.S. He practices in the Midwest, but home base is North Carolina.
A husband and dad of four, he writes about the front line: the patients, the systems, and the moments that never make the chart. Some of his patients never went home; he tries to tell their stories the way they deserve. His research publications are collected on Google Scholar, and he shares updates on LinkedIn, Instagram, and Facebook.
