A Locum’s ScrapBook: Hospital 58


Editor’s Note:

As part of this series A Locum’s ScrapBook, I tried to detail every aspect of perfusion life that traveling contract perfusionists such as myself encounter during our travels to various contract sites. I think we all like to acknowledge the things in life that make it just a little easier to do the things we do, and as we do them throughout our individual journeys.


A Locum’s ScrapBook: Daniel Boone Country…

This is Daniel Boone country for sure.  I’m writing from Hospital 58, with its black monolithic towers carved into the sides of Appalachian coal and granite.  It’s 3 AM on an ECMO shift. 

Hospital 58 was an unexpected turn of events as I made a last minute course correction that would have taken me somewhere in Iowa.  I always feel that things happen for a reason, so I’m glad to be here- albeit this is day 5 of a possible 22 days of COVID ECMO night shifts.  The staff personalities here reflect the temperament of the geography here- winding roads, steel mountainsides, with small enclaves of group dwellings here and there.  This particular hamlet reminds me of a ski Village in Colorado.  A world unto itself.

Getting back to the staff.  Strong personalities with surprisingly well honed clinical skills.  The ICU staff here is top notch and deceptively disarming in terms of how relaxed and chill they are- with a little bit of a backwoods Southern flavor laced into their personal interactions on the floor.  ENGLISH 101 was probably an afterthought for a lot of the conversationalists I have spoken and listened to here- but who cares about grammar when you are busting your ass to save a COVID patient from de-satting to death.

The people here know what they are doing, do it quickly, do it safely, and do it well. 

We have 4 Cardiohelps here- and only running 2 right now- but that can bump to 3 at anytime.  The pandemic has definitely settled in and taken it’s toll here.  Many of the staff are COVID survivors, and they shake it off and go right back to the front lines- and that’s what hero’s do- they mend fast and get back into action- and carry the load.

The learning curve that is so essential to improving ECMO survival rates for this opportunistic virus, well that curve has been negotiated at a heavy price here- but we are starting to reap the fruits of their labor as protocols evolve to outpace this rapidly mutating virus.  We are getting some X’s in the Win Column.

There are two different night rotations here, pretty much a Boyz club on some of the nights, and a Girlz club on the other nights.  Tonight happens to be the Boyz and between moments of ECMO Anxiety (a semi – paralyzed ECMO patient bucking down and diminishing the venous outflow return to the CardioHelp to the point where you encounter significant line chatter and turbulent flow) we talk about guns, hunting, fishing, and the lay of the land so to speak.  It’s a comfortable mix of acute clinical awareness tempered with self confidence and team comradery that make it an easy fit here in this ICU.

The Frontline Boyz A2 (Allen & Anthony)

As stated earlier, the job gets done and it gets done well.  All of us are in the same boat.  A long string of 12 hour night shifts, keeping COVID patients alive to see the next day- which with this Pandemic- is all you can realistically hope for.  You have to go day by day.  If you think too far ahead and down the road, or you are looking for a miracle recovery or quick medical fix- then this isn’t the place you want to be.  COVID is a hungry animal and is absolutely no joke.  It doesn’t relinquish it’s prey easily, and can sneak right back through the same door you just tossed it out of.  But we settle in the ICU hallway, outside our patient rooms, and exchange our stories and points of view just as hunters did throughout the ages, sitting around a fire and keeping their families safe and fed. 

This is Daniel Boone Country alright, and this team is up to the task at hand.