Field Notes

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Field Notes

Thu, 11/05/2020 - 04:14
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THIS IS THE 200 HALL at Hemphill County Hospital. The entryway is draped in plastic, marked with signs warning visitors not to enter. The hall—which has been converted to serve as the hospital’s COVID Unit—is restricted now to medical personnel and the acute care patients who are hospitalized there.

It is not your typical intensive care ward, nor is it intended to be. Hemphill County Hospital usually transports patients who require 24-hour acute care to larger metro-area hospitals in Amarillo or Lubbock or Dallas— hospitals that are equipped with ventilators and cardiac monitors and other life support equipment designed for patients with critical illnesses or injuries.

But today, if you have a heart attack or stroke, or sustain critical injuries in an accident, and are taken to Hemphill County Hospital or to any one of hundreds of smaller regional community hospitals like this one, you have likely arrived at your final destination.

“If you come here,” said HCH Chief of Staff Tony Cook, “do not expect to be transferred anywhere else. There is nowhere to go.”

Dr. Cook’s words are blunt and his message, clear.

“We will do what we can do,” he said, “but you will not get the standard of care you may need.”

“Yesterday, when we worked on the transfer of a critically ill patient,” he said, “we looked as far south as Austin and San Antonio, and as far north as Denver, which has already cut off all transfers from out of state.”

“We called over twenty places,” Dr. Cook said. “No one is taking patients now.”

“The big places have been full for a long time,” Dr. Cook said. “We’ve been going to Elk City, Woodward, Liberal, but now, there’s nowhere to go.”

“According to EMS, Pampa has no ventilators left,” he said. “Every room is full.”

Dr. Cook’s patient got lucky this week, if a COVID patient on a ventilator can be considered lucky. “We managed to transfer him to Elk City, simply because they had a patient die right at the time we called. Otherwise, they were full. There are no ICU beds.”

The reason is simple. The coronavirus pandemic is spiking again, and this time, its impact on rural communities like ours is significant. When we asked Dr. Cook what he thought was going to happen, he did not hesitate. “This is a critical situation,” he said. “People are going to die. That is the bottom line.”

Hemphill County Hospital is doing everything it can to prepare for the worsening pandemic. They have supplemented two old ventilators with new ones, which they hope to be trained to use next week. They have also ordered high-flow nasal oxygen for use in treating COVID patients. It should arrive next week.

At the request of HCH CEO Christy Francis, four nurses have been supplied by the Panhandle Regional Advisory Council Trauma Service to provide relief to her depleted staff, some of whom have been tested positive after caring for COVID patients and are now quarantined themselves.

“I’m kinda’ surprised one of the physicians hasn’t gotten it yet,” Dr. Cook said, adding, “I just don’t think people understand how bad it really is.”

It’s hard to believe that people don’t understand it by now. Maybe all they need to do is imagine being wheeled on a gurney through those plastic curtains into the improvised COVID unit at Hemphill County Hospital, because there’s nowhere else to go to get the care they need.

That should not just be a concern of COVID patients, but of everyone served by Hemphill County Hospital. “The issue now is not just the COVID deaths,” Dr. Cook said, “but how

“The issue now is not just the COVID deaths,” Dr. Cook said, “but how many, because of COVID, could have been saved otherwise.”