Sunday, March 13 marks two years since the first confirmed positive case of COVID-19 was identified in Idaho.

Since then, more than 4,800 people in our state have died from the novel coronavirus, about 60% of them in the last year.

It has been a historic time, altering life in ways many of us had never seen before. That is especially true of frontline workers, who have tirelessly fought the pandemic and cared for patients, whether they had COVID or any sort of need.

St. Luke’s has successfully treated approximately 17,000 people who were COVID positive since March 2020.

Through it all, St. Luke’s frontline workers have seen the extreme highs and lows, the daily realities of a pandemic, unexpected challenges and still, they kept going, hoping to one day return to a sense of normalcy.

The following is a selection of reflections from those team members, thinking about two years of COVID-19.

Dr. Laura McGeorge

We are almost two years into the SARS-CoV-2 pandemic, so it seems a good time to look back through the “retrospectoscope”.

We saw some pretty grim things these past two years, starting with the loss of one of our longstanding volunteers in Wood River and the temporary closing of an entire hospital there. We have so tragically lost a few St. Luke’s employees and their family members along the way. These were mothers, fathers, spouses, adult children, friends and colleagues. We continue to mourn those losses. We also saw the political polarization of health care. So many of us wish that hadn’t happened and it will be revealing to see how history looks back on this pandemic.

I much prefer to focus on so many positive things…

I saw exhausted colleagues rise again and again to take care of patients in the hospital. This included hospitalists, internal medicine hybrid physicians and rural family medicine doctors. There were specialists leaning in for the team to decompress the hospitalist services. I don’t think any of our critical care colleagues ever caught a break. They worked tirelessly, even when beyond exhaustion. Many primary care outpatient doctors, when tapped, said “yes, put me in!” Many of these doctors had not worked inpatient in years. We are indebted to all of them for saving so many lives and helping their colleagues when the call came.

Many of us saw St. Luke’s move it! Incident Command (HICS) got stood up quickly and has continued for nearly two years now. This group of leaders has rotated into HICS every third week, weekend and holiday. Some were on HICS nearly daily for weeks on end. The Medical Operations team mirrored incident command and had a dedicated group of leaders working to move decisions along quickly to support HICS, the providers, our patients and the facilities. As members of Med Ops and the clinical teams, our Infectious Disease colleagues, advised, taught and consulted, helping with our patients and with our system approach to this dreadful virus. Pharmacy, Operations and Supply Chain were there for us at every turn.

Some of the happiest moments were during the earliest vaccine clinics. It was like Christmas morning over and over again! The vaccine was a gift to so many of us and gave us a great sense of relief and joy. Although it has not been the silver bullet, it is still extremely effective in doing what we needed it to do: protect against severe illness.

Through this pandemic, through dim moments and bright spots, we persisted. There is no doubt that we are stronger as a team and as an organization. Nevertheless, we prevail!

Stay safe and well.

Nancy Roberts, Respiratory Therapist

We had never experienced the things we did and endured during this pandemic. Remembering the days that we used our last ventilator or last BPAP with none in storage and hoping that we didn’t need one for a crashing patient. We toed that line too many times but were able to take care of patients with the appropriate medical device. Wearing the same mask for days and feeling the sting on your face from the tightness of the mask so you made sure you were safe from the virus. Worrying about changing clothes and shoes before you went home because you weren’t sure if you could possibly spread it to your family.

I think the unknown and how to properly treat patients was the most challenging thing for respiratory therapists: Do we add more pressure, more volume, higher rate, higher PEEP? Placing patients on 80 L/m high flow heated nasal cannula would have been unheard of before but in the middle of delta, it was normal. 

Each one of our respiratory therapy colleagues took care of patients that were the sickest we have ever seen. We became an integral part of the health care team. We were finally recognized as a profession that made a difference. We pulled together and supported one another. RTs that hadn’t supported the intensive care units for years stepped up and did what they could to support our ICU RTs. We held hands of dying patients. We held mobile devices while families said their final goodbyes. We hugged and cried with each other. 

Looking back, I feel we became closer as a department and team. We had to depend on each other more than ever. Some left the profession and some moved on to different opportunities. We now have an opportunity to look back and feel like we survived, but at what cost? Losing so many patients, seeing some of our own suffer and now finally seeing a glimmer of light at the end of the tunnel. We persevered.

Dr. Frank Johnson

During the COVID-19 pandemic, and especially during our crisis standards of Care activation, there have been moments of heartache, anger, frustration, overwhelming fatigue, self-doubt and countless sleepless nights that impacted me emotionally, spiritually and physically. I’m grateful to have a support system that is helping me work through those feelings and helps me stay healthy.

Thankfully, amidst the dark times, there have also been moments of light, hope and inspiration that have connected me in an even deeper way to the community we serve and to our colleagues and staff. My pandemic memories will, by choice and by circumstance, be colored by these moments, and I am forever grateful to those who have stepped forward and shared their compassion and comfort. As I share some of my own personal nuggets of peace, I hope you recall similar moments from your own journey and reflect on them when you are ready.

Here are some of the moments that I carry with me:

• A member of our community who walked the path around the hospital praying for our staff

• The physicians, nurses and respiratory therapists who held the hands of dying patients so they would not pass alone

• The smiles on faces as we “clapped in” staff one morning

• CRNAs stepping forward to help with critical care nursing

• Administrative leaders taking shifts in Central Laundry, folding scrubs that our teams needed

• Nurses in administrative roles returning to the bedside to help their colleagues and our patients

• Seeing, first-person, the deep well of compassion and caring our palliative medicine team could share in the most difficult of circumstances

• Tater Gems (don’t call them tots) from Simplot one Wednesday afternoon

• Cards from elementary kids sharing their thanks and support

• Thanks and gratitude from those patients and families who were comforted amidst the chaos

• A letter of support from North Carolina sent by someone moved by our crisis standards of care declaration

• Surgeons and specialists taking on additional hospital patient care responsibilities to offload over-worked hospitalists

• Doctors and nurses coming from McCall to take hospital shifts in Boise

• Clinic doctors taking acute care shifts and rolling with the challenges of a skeptical public

• Intensivists sitting with patients and families to provide comfort when a cure was no longer possible

• Emergency medicine teams finding ways to continue to expand their ability to care while keeping people safe

• My colleagues who shouldered the responsibility of leadership alongside me, and in spite of me

There is nothing good about a pandemic, but I am comforted by the reminder that I have a fantastic team alongside me. COVID-19, if nothing else, has strengthened the connection between our St. Luke’s teams. I am humbled by your service and grace.

Ally Komori, DO

My first COVID patient was in early April 2020. The patient was elderly, billed as a chronic obstructive pulmonary disease exacerbation. The patient was my last admission after a long night. I admitted the patient with the usual treatment, went home, and went to bed. Nothing seemed out of the ordinary. But, later, I was woken up by a call. The patient did not have a COPD exacerbation and was found to have COVID pneumonia. I was taken off service and had to quarantine for the next 14 days. Hyperaware of every ache, sniffle, and sneeze, I realized the world would never be the same. My patient’s pneumonia worsened, and within a few days, my patient died. I went back to work.

We quickly tried to learn everything we could about the virus. We talked with peers, sought out studies and medical papers, and listened to as many lectures as we could find. And we learned from our own experiences. The initial trickle of patients we saw in the spring of 2020 became a full-on flood by the fall. I don't think I'll ever forget the eerie quiet of the hospital. I remember the hallways of closed doors with carts of equipment sitting idly outside. There were signs everywhere about new precautions. Each patient, sicker than the last, filled every available bed and room we could find until there was nowhere else to send them. And then, the flood started to swallow us. Emergency room physicians, intensivists and hospitalists were working day and night without any relief in sight. We called in reinforcements and a cavalry arrived. We had outpatient physicians who hadn't worked in the hospital in years and specialists, including surgeons, urologists, cardiologists, who added to their own workloads to allow us to see more patients. 

At one point, I only saw COVID patients. Despite all our efforts, families became more and more volatile and angry as more people died. One day, I had three patients who were incredibly sick and no ICU beds available to send them. I talked to the critical care physician multiple times that day, one ended up going to the ICU and getting intubated, one stayed on the floor on 80 liters of high flow oxygen and the last elected to withdraw treatment. I was on the phone with this patient's devastated spouse and could hear his children screaming in the background about ivermectin, IV vitamin C and that I was responsible for killing their family member.

It was easy to feel defeated and helpless during those times. And often, I did. It was during one of those moments, feeling I had hit a new low, a colleague reached out and pulled me up. I was so angry from a multitude of sick and dying patients and the feeling that it didn’t have to be this way. I walked into the ICU with yet another patient that would need to be intubated. The intensivist recognized my frustration and told me, “It’s okay to have angry days and sad days but try not to make them all your days”. That has stuck with me, even now, and I remember that it’s okay to have a bad day, the next day will be better.

The bravery and collaboration of my colleagues was, and remains, inspiring. I realized that during those trying times I also had seen the best of humanity. It was when a colleague came in for an extra shift, or simply offered an embrace, or exchanged a knowing look while passing one another in a hallway. We endured the darkest days and the roughest waters. And while this pandemic is in no way over, I have faith that we will continue to rise to every challenge. Together, we will weather the storm.

Ann Huntington, MD, FACP, Boise/Meridian Hospitalist Medical Director

Well, here we are: two years into a pandemic that has changed our lives forever. Previously, as some of the most trusted members of our community, we appear to be much less trusted. Interesting information about who we are and what we do has popped up all over social media. The general public has suddenly become knowledgeable about a myriad of medical issues and is even reading research trials, but unfortunately the conclusions seem to lead to what suits them best.

We no longer have as many seasoned nursing colleagues to joke with and solve problems with. We question the tools we have been given to save lives — imperfect as they are, they are all we have. We have not seen our families much, as we repeatedly volunteer for extra shifts. Some of our physician colleagues were not even aware a surge was occurring and other colleagues in our community betrayed us. We have memories of being threatened, watching young people crash into full respiratory failure in a matter of minutes and hours, calling family members with difficult news and receiving the screams of anguish, and signing way too many death certificates. We have whole new social circles — our colleagues and the few friends and neighbors and family in this state who believe in science and in protecting others over their personal comfort. We endure through one wave, only to have another come right on its heels. Fear, doubt, anger, exhaustion, frustration, sadness, compassion, hope and empathy — they have all been there.

Has it been all bad? No. I have learned multiple new skill sets and have grown in ways I previously had not imagined. I have built new relationships with leaders in our system and in our state, as well as with physicians across the country. I have been impressed with the resilience and compassion of my front-line physician colleagues as well as our nurses, therapists, case managers, social workers, EVS members and hospital administrators (among others). My hospitalist colleagues have been the ultimate professionals and have worked tirelessly around the clock to keep the hospitals open and to help our patients at the worst times in their lives. Our nation does not do a pandemic well, but our health system has passed with flying colors in my book, despite the community response. Most of my patients have been grateful, including the patient in the ED who, despite dyspnea, told me “thank you” three separate times, and the patient on Meridian sixth floor who said over and over again “I feel fine; thank you for all you’re doing” while hanging on to 60-80 liters of oxygen for days until ultimately succumbing. Most importantly, my husband and four children have been understanding and cheerful about virtual school, about mask-wearing, and about all my time away from home to serve my group and our community.

What will medicine look like after this pandemic is over? Are the fractures in health care too wide, the cost in dollars and in clinician mental health too great, and will it all break before it heals and is rebuilt? I don’t know.  However, I do know that providers, staff and leaders with compassion and integrity are still needed, and that a supportive community is needed. A COVID-19 pneumonia patient in their 50s on the ventilator in the Intensive Care Unit went into cardiorespiratory arrest a few months ago. Our ICU team successfully resuscitated the patient for a time. The patient’s physician recounted the story in tears, saying that instead of being upset at the team for how sick the patient was, the patient’s family went out and brought in food for the entire ICU team. Instead of thinking of themselves and their impending loss, they thought of others, and they served them. Healing will be an individual and a community effort, and we will all play a critical role.

Cameron Hutchinson, Environmental Services

I am part of the house side, handling linens and laundry. For us, it was a lot of fear early on. We got a lot of laundry from the COVID floors, the bags would rip open and you’d be afraid. You didn’t know. We were touching it all, wondering where it’s from, same thing with trash, handling it twice, collecting it and then tossing it out, you didn’t know if you were possibly being exposed.

It was a strange feeling. I know it was difficult for the housekeepers, they were in the rooms. One of my housekeepers, she was always afraid. She only did COVID rooms. She knew the patients, when she knew one died or got better, it affected her mood and her health. She got to know those patients. I remember she once called in sick after seeing someone die, she was so emotional after seeing that person so many times. I want people to know that every one of us, including in the kitchen, we’re frontline. We were in the hospital all day long, cleaning and being around it, having that risk of exposure.

The best way I describe it is St. Luke’s is the human body, all of us has our own part to be its healthiest – I think of myself as the liver, getting rid of the toxins and the waste, housekeepers are the antibodies, the doctors and nurses, they’re the heart, the brain and the eyes.

The one thing I missed during COVID, I’m a smiler. I always like to say good morning and have patients know someone is there with a smile. Now, going around the hospital, picking up biohazards, I wait for them to pass, I miss being able to smile at them and being able to say hi and good morning. I hope soon we can get to a point where there’s the chance to do that again. I’m also grateful that despite how short we are on people, how hard we work, that things are getting better.

Meghann Bostrom, Nurse Practitioner – Cardiology

When I struggle to find the right words to describe my feelings using the English language, I will turn to other languages. The word watjilpa (in the Pitjantjatjara language) means a deep sorrow that is born of being disconnected from one’s family or social unit. It’s an aboriginal term and I interpret it to mean an emotional disconnection. I suspect most of us have suffered from watjilpa during the pandemic. I would venture to say that health care providers have suffered from this more than most professions. As health care providers, we all took an oath to care for our communities when we began.

We take that oath and responsibility very seriously even today. We have tried our best to protect our vulnerable patients in addition to protecting our families and coworkers. We feared bringing the virus into clinic visits and also feared bringing it home to our families. So, we’ve worn our masks dutifully, we vaccinated ourselves as soon as possible, and we’ve kept our distance as much as we can. To take those precautions doesn’t cause deep sorrow. But to see others in our social circles (our friends, our families, our patients and our communities) attack our efforts of trying to keep one another safe, has brought about extreme sorrow and an emotional disconnection that feels unrepairable at times. At one point during the pandemic when discussing vaccines, I was told, “you are just a cog in a propaganda wheel.” That statement, and many others like it, have left me feeling provoked, fragile and deeply sad. If I give those statements any degree of credibility, then my worth as a health care provider could come crashing to the ground. So, I’m not going to give them any credibility or power over me. I’m going to define my own worth as a health care provider.

I know some of my fragility has been intensified during the pandemic while watching my mentor and friend, Dr. Andrew Chai, fight for his life. There were times when I feared Andy wouldn’t have a hospital bed available if he needed one. I can see now that my love for Andy was a great motivator behind much of my behavior during the pandemic. Losing Andy gives me the feeling of watjilpa, but more in the physical sense like a profound homesick type of feeling. As I try to work through the grief of his loss and the grief the pandemic has brought, I am reminded that love is the only way forward. I’m going to hold moments of love dear to my heart in the weeks to months ahead.

I could easily stay in a feeling of deep sorrow and disconnection given the events of the last two years. But, if I allow myself to focus on different events such as the moments of love and support, then a glimmer of hopefulness finds its way in. I’m reminded anger and hatred will not fix any of this, but love can give us new hope for better days.

• St. Luke's manager of content communications Dave Southorn also contributed to this story