Breen tested positive for COVID-19 in late March. She spent the week of March 22 alone in her apartment, exhausted and sleeping up to 16 hours a day, according to Feist. She was in touch with family, friends, and some coworkers who were also home sick with COVID-19. “At one point approximately 20% of our physicians were out on quarantine,” Mills said of Columbia University’s emergency medicine department, which staffs four of NewYork-Presbyterian’s nine emergency departments.
When Breen’s fever subsided she waited three days, then returned to work on April 1, when local infections—and deaths—were surging. That day, Breen called her sister. “She was saying, ‘It’s like Armageddon,’” recalled Feist. The city’s hospitals were overflowing. The emergency department at the Allen, which served hard-hit communities in upper Manhattan and the Bronx, was treating about three times as many patients as its usual capacity. Breen described supply shortages and staggering deaths.
One of Breen’s colleagues described the stresses of late March and early April as the layers of an onion. Staffing was short and constantly changing. Beds were in short supply. At times, there were lines of ambulances waiting to admit patients. Portable oxygen tanks were frequently deployed. To reduce the risk of accidental exposure, some workers avoided or lived separately from their families. Each stressor layered over the next. At the core was the disease itself, and the inescapable difficulty of treating an illness while experiencing and learning about it for the first time.
On April 4, Gianos texted Breen to ask how she was doing. “I’m doing better, but dealing with the devastation in the ER, struggling a bit,” Breen replied. She had insomnia, which was unusual for her. On April 9, Breen called Feist in despair. “She was saying things to me like, ‘This is the end of my career. I can’t keep up,’” said Feist. She said she wanted to die, a remark so out of character that Feist compared it to hearing someone speak in tongues.
“I hear these stories about pilots,” Feist told me in June. “When they’re in distress, they say, ‘My plane,’ and then they’re in charge. And the cocaptain says, ‘Your plane,’ to acknowledge who’s in charge.”
Feist took control. She arranged for two friends to drive Breen, in a relay, out of the city and to Maryland. Feist drove up from Virginia to meet them. Jennifer’s husband, Corey, called Mills, who offered to check on Breen in person. “It was clear to me that she needed help,” said Mills. “She was not the same Lorna.” That evening, Jennifer Feist brought her sister to the ER at the University of Virginia Medical Center. Breen spent 11 days in the hospital’s in-patient psychiatric unit. Breen’s mother worked in that unit as a psychiatric nurse for two decades until her retirement in 2006.
While she was in the hospital, Breen worried about her career. She texted Flom, who works in human resources, for advice about taking a leave of absence. Jennifer Feist called NewYork-Presbyterian/Columbia University to arrange for one on Breen’s behalf. The process went smoothly, Feist said, but Breen continued to worry.
“When she got out of the hospital, she kept saying, ‘This is a career ender,’” said Feist. Her sister was catastrophizing, which can be a feature of mental illness. But even among doctors, seeking psychiatric care can carry stigma: A number of state medical licensing boards require doctors to disclose their personal psychiatric histories in ways that may not comply with the Americans With Disabilities Act—and which, Feist argues, contributes to a culture that associates seeking help with weakness. “She didn’t want anybody to know what happened,” Feist said of Breen’s mental health crisis. She contrasted that with Breen’s experience, around five years prior, with suffering and treating a pulmonary embolism: “She didn’t hesitate to tell anybody.”