Christmas in the ICU: Decorations, lights and many tears

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OPELIKA, Ala. — A Christmas tree stands outside the intensive care room where a man stricken by COVID-19 lies unconscious, a machine breathes for him. A few feet away, a plastic snowman adorns the door of another patient whose face is barely visible behind ventilator tubes.

The decorations are "a way to let family members know that we’re trying, and we love these patients and we want them to feel like it’s Christmas as much as we can," nurse Carla Fallin said, standing just outside one of the rooms at East Alabama Medical Center.

Nurses and medical staff make their way through the seventh floor COVID-19 unit at East Alabama Medical Center Thursday, Dec. 10, 2020, in Opelika, Ala. COVID-19 patients occupy most of the beds in ICU in addition to the non-critical patients on the seventh floor.  (AP Photo/Julie Bennett)

While parades, shopping and Christmas tree lightings go on around them, nurses and doctors who've spent agonizing months caring for the ill are doing what they can to get through the holiday season, which many fear will only spread the disease and add to the U.S. death toll that has surpassed 300,000.

The medical center about 60 miles northeast of Montgomery faces an influx of COVID-19 patients as the pandemic intensifies. That means staff members can hang decorations on patients' doors in the ICU but cannot attend after-work Christmas parties. A cheerful Santa doll stands atop the desk at a nursing station, but big gatherings with relatives are out.

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A nurse for five years, Fallin said Christmas just doesn't feel right this year. She and her husband did not take their two young sons to local Christmas events that drew hundreds of people, many without masks. The decorations in the ICU help lighten the mental load a little, she said, if only until another patient nears death.

The red-brick hospital is near Auburn University in the old railroad town of Opelika, a city of 30,000 that decorated its streetlights and overpasses with green garlands and red ribbons for the season. A huge Christmas tree stands near downtown boutiques, salons and restaurants where hundreds of residents crowded together for a holiday program last weekend.

East Alabama Medical Center draws patients from a mostly rural region. Many people in the city wear masks in compliance with a state order, but fewer health precautions are visible in surrounding areas.

The area was an early hot spot for the virus in the spring. Then cases eased before a summertime spike that health officials blamed on backyard cookouts and lake gatherings around July 4.

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Just as in other places across the country, a surge in infections linked to Thanksgiving is now filling up beds at the hospital. With vaccines not yet available to the general public, hospital officials dread what might happen in January after families board airplanes for the holidays and spend hours gathered around dinner tables or Christmas trees.

Amid so much suffering and after so many tears, any ray of brightness helps, even if it's just a candy cane sticker on a ICU window, said Dr. Meshia Wallace, a pulmonary physician who works in critical care.

"Families come in, and all they're getting for the most part is bad news: 'Your family member is sick, they've moved down from the seventh floor to the ICU,'" she said. "A little bit of Christmas cheer is not going to hurt. It can only help."

Wallace is skipping her usual Christmas gathering of about 30 relatives and hopes to spend the holiday with an aunt who might drive over from Atlanta if neither is symptomatic. Dr. Ricardo Maldonado, who leads the pandemic response team at East Alabama, knows exactly what he will do for the holiday.

"Work," Maldonado said after visiting patients on a hospital floor full of COVID-19 patients. "There is so much work."

The nonprofit hospital has had to bring in nearly 60 traveling nurses to shore up staffing that has been depleted, yet requests to take on additional COVID-19 patients still come in most days from neighboring states, including Mississippi and Tennessee, said chief executive Laura Grill.

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Some workers have been sickened by the virus, she said, and others retired or quit. Many, she said, are simply exhausted, both physically and emotionally, and the Christmas season isn't making things easier.

"I sat in a meeting two days ago with the nurse manager of our ICU and she just cried. She said, ‘We don’t know what else to do. We can look at this patient and know that they are not going to get better,'" Grill said.

Marilynn Waldon has felt the strain.

The veteran nurse oversees COVID-19 patients on a floor that has been decorated for Christmas with strings of white lights and stockings. Waldon had planned to retire this month but with the holidays approaching, she prayed and changed her mind.

"I talked to God about it, and he said, ‘You’re not a quitter. No. These patients got to be taken care of, and that's why you went to nursing school. So you need to stay there, do what you can do, until we get over this crisis that we're in,'" Waldon said.