Doctor Michael Durso, who works in the emergency center, had some very gloomy days on the front lines in the fight against the coronavirus pandemic in New York City.
Intubated patients sometimes wait days for a bed in overcrowded intensive care units.
The condition of apparently stable patients suddenly worsens.
During a recent shift, 15 of 23 nurses were absent due to illness, many with symptoms of covid-19.
The others were caring for about twenty patients at a time, more than double the normal number.
Such difficult days make Durso even more appreciative of the fact that he finds unique solace in the face of relentless trauma in a conversation with his brother, an identical twin, who does an identical job at an emergency center in Miami, writes Reuters.
For Dennis Durs in Miami, Michael's poignant stories can seem like an unsettling glimpse into the future.
The emergency center where Dennis works is beginning to fill up with Covid-19 patients, while Michael has been fighting for weeks in the hardest-hit American city.
Nearly 168 people in New York have been infected by the new coronavirus, and nearly 18 have died. In Miami-Dade County, nearly 12 people were infected and 324 people died.
"We're getting ready for the surge," says Denis.
Emergency medicine is the family business of the Durses. Their father, James, worked for 35 years as an emergency physician and fascinated his sons with stories of saving lives and diagnosing strange diseases, Michael told Reuters.
Their younger brother, 28-year-old Tom, also works in the emergency room as a technician at a hospital in Salem, Massachusetts.
The twins, who are 31 years old, have been almost inseparable for the past three decades - they graduated from medical school and university together, writes Reuters. Separate specializations were a chance to form separate identities.
Instead, the crisis has created a new kind of closeness as brothers hone their craft on the front lines of the worst pandemic in a hundred years.
“We talk almost every day. We often say to each other, 'Man, I'm having a really bad day,'” says Denis.
Michael says that hospitals and intensive care units are so full that patients sometimes stay in the emergency room for days. Doctors are often too busy to inform them and sometimes relatives call to ask about patients who have died.
Recently, three apparently healthy patients collapsed without warning.
"It's depressing when you work with patients and you don't know how to help them," says Michael.
He told about one case that hit him particularly hard. He intubated an obese patient whose oxygen saturation had dropped to a critically low level of 60 percent. Intubation is expected to stabilize such patients, but in this case it worsened and she died within an hour.
“It was really painful. I put the tube down her throat. At that moment you feel like you are saving a life”.
As he was walking home from work recently at about two past midnight, two men jumped Michael in otherwise sleepy Brooklyn, knocked him to the ground and searched his pockets.
"I am a doctor and I have the coronavirus!" he shouted.
He laughs about it now. He was lying, but it helped. The assailants fled and Michael escaped unharmed.
In Massachusetts, which is also among the hardest hit states, technician Tom Durso is often the first to see emergency room patients.
He checks their vitals and temperature and assigns them to wards.
His hospital has tripled its intensive care capacity to treat Covid-19 patients, Tom says, adding that he sometimes comes to work to find as many as three patients already on ventilators.
An elderly woman whose health was deteriorating begged the doctors to ignore the previous "do not intubate" order.
“She was afraid she was going to die. I saw the fear on her face,” said Tom. He doesn't know if that patient survived.
Listening to the brothers' stories, Denis knows he may soon face similar challenges.
At Jackson Memorial Hospital in Miami, where he works, Covid-19 patients now make up the majority of patients, Dennis says, noting that anxiety is growing.
Several medical workers, including one who is also a resident, have been infected with the coronavirus. Doctors wear protective equipment all the time.
"We introduce ourselves to each other because we don't see who is behind the mask," he says.
Some colleagues are considering covering patients with garbage bags during intubation, making holes where their mouths are, in the hope that they might prevent the spread of infection.
"Everyone is concerned about whether we are safe," he says.
The twins' mother, Linda Durso, shares that fear. She also cares about their mental health. He will get post-traumatic syndrome," he told Reuters by phone.
James, 68, is aware of the risks on a personal level, but he also understands the urge to save patients. He recalled a story from 20 years ago, when he found himself with his face uncovered a few centimeters from a man suffering from meningococcemia, an infectious disease that can be fatal.
"I needed vital information before he passed out," says James, who was sprayed with the patient's saliva and immediately given an antibiotic.
He managed to avoid infection.
James, who worked mostly at night, had no intention of stoking his children's passions when he embellished stories after work, while they were getting ready for school.
"I've seen too many people follow in their father's footsteps, when it wasn't the right career choice," he told Reuters.
As their interests deepened, James made an effort to mention the lives he had failed to save, the frustrations of unprofessional colleagues. On his way home, he would watch the construction crews and tell the boys to maybe consider a career in construction or a trade.
"Electricians and plumbers are doing pretty well," he remembers telling them.
However, it is clear to him why his sons chose medicine. "When it comes to challenge, emergency medicine is second to none." Now he enjoys sharing the experience with them. He likes to question his sons' decisions when they tell him how they treat patients. He says he's impressed with how much they learned in college, and his sons are amazed at how much he remembers.
James knows that his children are taking the risk upon themselves. It reminds him of Michael and Denise's game when they were children, climbing the stair railing and jumping, trying to jump from a higher height.
“On the one hand, you want to prevent them, because it's dangerous. But, on the other hand, you don't want to because your goal is for them to be adventurous in life," said James.
"Together they did things they wouldn't have done alone".
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