Poet Serena Fox has been an attending physician in the Intensive Care Units of the Mount Sinai Beth Israel Hospital in NYC for the past 10 years. She works night shifts exclusively.

Since the increase in volume and acuity of respiratory failure related to COVID 19 this past month, the ICU beds have been increased 4-5 times usual, and she reports, they we are usually running full. 

Fox worked in a major trauma unit in Washington, DC, until 2007, and launched her career in medicine in the emergency room of New York City’s Bellevue Hospital during the height of the HIV AIDS epidemic. Fox’s experiences there formed the background of poems in her book, Night Shift (Turning Point Books, 2009).

Her poems seem relevant to our historical moment and, with a lot of conversation about the need for ventilators, one poem from her book seems to strike a chord. “All That Separates” is a phrase that is usually associated with the Bible, as in “your iniquities have made a separation between you and your God (Isaiah 59:1-2). In some cases, a ventilator is all that separates a patient from their god.

However, the initial reliance on ventilators to treat patients with Covid-19 has been challenged or at least reconsidered, as moving quickly to ventilation may complicate already existing conditions, further compromising a patient’s health.

And, apparently, intubation and mechanical ventilation may lead to pneumonia because of the invasive nature of their application. A recent study at Rush University Medical Center in Chicago found a promising alternative whereby patients are placed face down on their beds and treated with heated, humidified oxygen for up to sixteen hours.  

Here is Serena Fox’s poem, “All That Separates”:

What about respirators?

I can paralyze you with

an index finger, as effortlessly

as I brush your eyelashes,

making sure you’re down.

I set breaths per minute,

by pressing digits in a square.

Another plunge of my finger

slides you beyond consciousness

and memory. I hope sedation

lets you dream, gloriously

and elusively, beyond pain,

so we can turn you, change

the dressings, where your sternum

is no longer intact. A few

millimeters, all that separates

us, phalanx from pectoral flap,

you from me. A thickness worth

pause. More so, if a finger can

change outcome with the number of

your breath.

—Serena Fox from Night Shift (Turning Point Books, 2009) Used by permission of the author.