Welcome to hell
By Jaime Herndon
In late winter 2020, when the full gravity of Covid-19 was only starting to come to light in New York City, journalist Dan Koeppel sent a text to his cousin, Robert Meyer, an emergency room doctor at the Montefiore Medical Center in the Bronx.
"How are you doing? I’m worried for you."
"Hanging by a thread," Rob replied.
"Are you seeing a lot of cases?"
"Yes."
"On a scale of 1 to 10, where do you think you are?"
The answer arrived 10 minutes later: “100.” After that, Koeppel encouraged Meyer to text, email, and call him about what was going on, as a coping mechanism.
It eventually became a diary of sorts, and that, combined with interviews with Meyer's colleagues, became "Every Minute Is a Day: A Doctor, an Emergency Room, and a City Under Siege."
Montefiore is affiliated with the neighboring Albert Einstein College of Medicine and is home to the second-largest medical residency program in the United States, after the Mayo Clinic.
It is part of a sprawling system with many buildings, labs, classrooms, and even housing for residents. Montefiore is the largest employer in the Bronx, “one of the poorest, least healthy urban counties in the U.S.,” as the book points out. The area is also filled with nursing homes. All of these factors came together during the pandemic to flood the hospital’s ER.
Meyer’s nearly 25 years at Montefiore had given him a wealth of experience, and he and his colleagues were prepared for everything. Everything except Covid-19. But in fairness, no hospital was ready.
As early as January, doctors at Montefiore had started to hear about patients with symptoms similar to the U.S.’s first confirmed patient, who had returned from Wuhan to his home in Washington state on Jan. 15 and tested positive for Covid-19 a few days later.
Around the same time, Meyer reports hearing stories of New Yorkers coming to the hospital complaining of symptoms like fever, cough, and fatigue and being treated for the flu and released.
One doctor told him that they had sent information about a suspected case to the Centers for Disease Control and Prevention, but there was no response. Later on, Meyer muses: "Were they Covid? Later studies would say probably, but at the time Covid-19 wasn’t even on our radar."
By early March, positive Covid-19 cases were detected in New York and the number of patients admitted to the hospital with Covid-19 started building slowly — and then exponentially. Because of its location near many nursing homes, the Montefiore ER saw many of the city’s sickest patients.
Meyer and Koeppel are not shy about pointing out the systemic factors that made everything about the pandemic worse for this hospital. "Life in the Bronx is hard and resources are scarce," they write. "All those comorbidities that have led to all those Covid fatalities in poor communities around the world were preventable in a way that Covid itself wasn’t.”
Through Meyer’s eyes, the authors paint a gruesome scene of the early days of the pandemic: ERs packed with stretchers, not enough ventilators, and soon, not enough personal protective equipment. The speed with which the virus took hold was unexpected, even for medical professionals, which led to overcrowding and the turning away of patients.