It was a Tuesday afternoon in mid-December at Beaumont Hospital in Farmington Hills. Inside, dozens of people were alone in rooms with closed doors, hooked up to oxygen tanks and IV medicine, sickened by the virus that came to define 2020.
Every room in the south pavilion of the 20-bed progressive care unit was full. Half of the beds were occupied with coronavirus patients. The other half were filled with people who'd had heart attacks or strokes or other conditions that led them to seek hospital care.
"It's very stressful," said Hassan Beydoun, a registered nurse and assistant manager of the unit, which is filled with patients who aren't quite sick enough to need intensive care, but who need more attention than those in general care units. "It's scary, to be honest with you, because I don't feel like people know what's going on exactly in the hospitals. And I feel like some people just don't care, you know?"
Despite statewide public health orders requiring masks, limiting large gatherings, and prohibiting dine-in eating at restaurants and bars, "people are still gathering," said Beydoun, 43, of Dearborn Heights.
Though all the rooms were full at the hospital, he said the latest surge of Michigan COVID-19 hospitalizations had begun to ease. Still, Beydoun said he worries that the pandemic is far from over, and he and his co-workers could find themselves in crisis mode again — especially in the weeks after Christmas get-togethers and New Year's celebrations.
"Yesterday, I was driving with my wife and we looked at one of the gyms and the parking lot was full. And I'm like, come on. People don't take it serious. And that's why I tell patients, 'Please, if you can talk about your experience on Facebook, tell it to your family members and friends so they can see it how it is' ... because people don't hear the stories."
They don't hear about the people in their 20s, 30s, and 40s who come to the hospital with strokes or kidney failure or difficulty breathing because of COVID-19, Beydoun said. They don't hear about how entire families are getting the virus.
They don't think about the possibility that they could get the very nurses and doctors who care for them sick.
They don't know about Laquawn Milhouse, a Wayne County sheriff's deputy who is 37 and had blood clots in his lungs from the virus. Or Clarence Oliver II, who is 48 and was hospitalized at Beaumont for a second time in less than a month after having COVID-19. Or Debbie Sabo, 68, who was so weak and short of breath from coronavirus, her daughter called for an ambulance to bring her to the hospital.
They don't realize they could die, Beydoun said, just as more than 12,000 Michiganders have already succumbed to the virus. As the new year dawns, the state is now approaching half a million confirmed cases.
"It's bad right now," Beydoun said. "I wish the public would hear about it, see more stories like these stories. ... I wish they could see like what's going on, really. ... We work our butt off over here ... to get people better. And you see people like just going out; people don't care."
Outside each room with a closed door is a cart filled with yellow washable medical gowns. On top are boxes of surgical gloves in a variety of sizes. Before the door opens, the staff must don those gloves and gowns, and put on eye protection. They all wear specially fitted N95 masks that leave deep ruts in their cheeks.
Every time a COVID-19 patient needs medications, or help getting up, or gets a meal tray delivered, the staff must put on a fresh gown and new gloves before they open that door.
For Matthew Taurianen, 27, a certified nursing assistant from Livonia who was hired six weeks ago to work on the hospital's fifth-floor med-surge unit, it's been a revelation.
"After Thanksgiving, like the week after that, it was probably the hardest day I've ever had in this field," he said. "I've never experienced anything like that. ... I had 15 patients. It was just complete chaos.
"You don't realize until you get home how much adrenaline you actually get from this because you're here 12 hours."
He poked Sabo's finger to take her blood sugar level. Since Sabo got to the hospital six days earlier, her sugar has been high. She blamed the dexamethasone, a steroid, used to open up her lungs so she can breathe.
On a Thursday afternoon, it measured in the normal range, 98 milligrams per deciliter. Sabo was relieved.
"I just crawled through the belly of the beast," she said as a nasal cannula pumped oxygen into her nose. "I wouldn't wish this on anybody."
'Lord, never leave me'
Registered nurse Sharon Edwards prayed her way through the COVID-19 surge in the spring, when all of her patients had the virus, and some of them died.
"I always prayed, 'Lord, never leave me or forsake me,' " said Edwards, 59, of Livonia, who has been a nurse for 27 years and teaches at Schoolcraft College.
She carries a smooth gray stone in the pocket of her navy blue scrubs. In gold paint on one side of the rock is a cross, with the words, "I will never leave you." On the other side is an angel.
She held that stone in her ungloved hand outside a patient's room, tears welling in her eyes as she recalled the first person she cared for who perished from coronavirus.
"He went down very quickly," she said. "I mean, he came in with the virus, it attacked his lungs, and then it went to his kidneys. ... We got his wife here just in the nick of time. ... They did allow her to come upstairs, and she just made it in his last moments alive.
"And that was, I think, one of the hardest things. I've been a nurse a long time, but it was very emotional for me."
Soon after, Edwards was given a care package that had been donated to the staff at the hospital.
"People were giving us gifts ... and this is what I got," she said, holding the small stone.
"It was a sign. I prayed myself, and said, 'God, please, please watch over me and help me and help me do the right thing to comfort somebody that may be in distress ... to be a beam of hope to them, and to try to put myself in their spot.'
"I get really emotional when I start talking about it," Edwards said. "When that first one died, it hit me so hard. I was sobbing. ... They were coming in left and right."
The second floor was converted into an intensive care unit, and all the nurses needed a crash course in how to do that work.
Edwards and the other nurses in the progressive care unit already were trained in using ventilators, but they weren't trained to administer some of the medications used in the ICU, said Kimberly Guesman, vice president and chief nursing officer for the Farmington Hills hospital.
"We had educators out here training," she said. "They came up with this class, 'How to be a Critical Care Nurse in 30 Minutes,' and they did it. It was amazing."
Beydoun said it was like working in a war zone.
"We got people from different hospitals, like our sister hospitals, from different departments who never did nursing in their lives, they came here and they pitched in," he said. "And they helped us because it was just very overwhelming. And our staff, some of them got sick and had to stay at home."
As nurses contracted the virus, he said he would go down the list of employees, and start calling them one by one, asking people whether they could pick up extra shifts to fill in the gaps.
Nothing about this pandemic is fake, he said. Edwards agreed.
"In the beginning, it was very rough," she said. "We were all very stressed and it was a scary, scary time for not only nursing, but also for the patients, you know? They were pretty isolated. We were their only contact to the outside world.
"It is a little better now. ... I feel it's a little bit more in control. But it's still ... a very scary time."
Edwards pocketed her prayer stone, put on a yellow gown and stretched the blue surgical gloves over her hands. She knocked on the closed wooden door to Milhouse's room. It is clear, she said, that he misses his sons and their mom.
"He asked, 'Can I have visitors?' And I said, 'No.' ... He's got the COVID."
Milhouse rested on his hospital bed, the television volume turned down low. A nasal cannula was nestled in his nostrils, helping him breathe. On his left foot was a cast, covered by a bright yellow fuzzy hospital-issued sock.
He has been off work from the sheriff's department for weeks because of a ruptured Achilles tendon. He tripped one day at work and it just popped.
"I thought it was just a little sprain," said Milhouse, who lives in Detroit. "I went home, and thought, it will get better later. But then it didn't."
Milhouse had surgery just before Thanksgiving to repair it, and learned the day after the procedure that he had coronavirus.
Initially, his COVID-19 symptoms were fever, loss of appetite and exhaustion. One of his sons contracted the virus, and so did the child's mother, Kamaria Lee, but they recovered quickly.
He hasn't been as fortunate.
"It's been a little rough," said Milhouse. "I've lost about 35 pounds."
A week after his symptoms began, Milhouse said he started feeling much better. His appetite returned, and he thought he had pushed through the worst of it.
But another week passed, and his symptoms returned. Milhouse, who lives in Detroit, started coughing and said he was getting horrible cramps in his stomach.
"I can't walk because of my cast. And so then it became shortness of breath," he said. "Going to the bathroom, I had to catch my breath. Talking to regular people, having conversations, it would become really short, so my conversations had to be brief."
He had night sweats, fever, and then came the pain.
"I start having like a real sharp chest pain," Milhouse said. "I thought it was gas. I didn't think it was one of the symptoms after COVID after your body's done fighting, is over fighting."
He couldn't get comfortable. Lee insisted he needed medical help and drove him to Beaumont.
"So we got down here, and what I was told is there was pneumonia in the bottom of my lungs ... and there were blood clots in there, which I thought was gas," Milhouse said. "So they put me on blood thinners and oxygen and pain killers because I was in pain."
Edwards adjusted his thermostat in his room because Milhouse said he was hot. She replaced the bag of heparin, a blood thinner, on his IV pole.
"He's on a couple liters of oxygen," she said. "We're giving him the steroids. And that's helped him with his breathing. The infectious disease doctor has already been by this morning."
Two days later, Milhouse was being evaluated to go home. A respiratory therapist entered the room, and took off his nasal cannula to see how well his body remained oxygenated on its own when he got up to walk around.
His blood-oxygen levels dipped to 89%, and it was evident Milhouse was tired from that little bit of exertion. But then, his oxygenation began to rebound.
"I was always one of those people that didn't really believe in COVID," he said, coughing a couple times. "I took the precautions and I've seen the deaths, but I guess it didn't hit home until I got sick and how quickly it happened.
"People my age and younger have died. ... It got pretty bad for two or three days. I think the precautions that people are taking as far as the masks and everything is a big deal out here because it's serious."
Fear of dying alone
In late April and early May, registered nurse Lori Mesko, 47, of Howell is certain she had the virus, too.
Though she never got tested, Mesko said she had many of the telltale signs: fever and body aches, incredible fatigue and headache.
"Every part of my body was aching and hurting and I had no energy to do anything," said Mesko, who has worked for 16 years at the Farmington Hills hospital.
Her 90-year-old mother caught it, too.
As her mom grew sicker, and her blood-oxygen levels dipped dangerously low, Mesko had a hard decision to make: try to care for her at home or bring her to the hospital, knowing that if she died while she was there, it would be without Mesko at her bedside.
"I panicked and put her in the car and brought her here," she said. "I got to the emergency department and I saw one of the other nurses that I've worked a long time with. ... We meet face to face, and I made the decision to put her back in the car, contact the doctor and just go home and treat her at home because I did not want ... her to die alone in the hospital."
Mesko's mother has dementia, she said.
"I'm thankful to have her home with me and not in a nursing home where so many losses have happened, you know?" Mesko said. "I took her home and with all the medications and everything, we treated her.
"I was sick myself, and she really was sick," Mesko said. "She essentially should have been hospitalized. But, you know, she would have been alone, and I didn't know if she was going to make it through. I saw what was happening, so I did my best."
Mesko's mother survived the ordeal.
"We were very lucky," she said.
Not everybody is.
"Every single person when they get COVID responds differently," Mesko said. "You just don't know. Are you going to be the one that ends up in multi-system failure? Are you going to be the one that ends up hospitalized on high-flow, and maxing out on oxygen and ending up requiring intubation?"
She saw it all too often in her patients who seemed fine one moment, and then, "within a matter of seconds, things were changing and they were deteriorating," she said.
"It was tough, very difficult, but I don't think we really had time to stop and think about how we were being emotionally impacted by it. You know, we kind of just worked right through it. And then when it started to slow down, I started noticing I would go to bed at night, and I'm like waking up short of breath, and I had to tell myself, calm down, I'm fine.
"We're getting through it. I'm hopeful with the vaccines ... this will just hopefully be gone in the next year or two years. I don't know how long it will take to get everybody immune to it."
She'll get vaccinated when it's her turn, and she hopes others will, too.
"And we've watched it. We've seen it firsthand. ... The public needs to be more aware of what actually is really happening. And everybody needs to do their part."
Longing to walk again
Clarence Oliver II first came to Beaumont Farmington Hills before Thanksgiving because he couldn't breathe.
"My body was aching," he said. "My fever kept going, so the more comfortable I got to be warm, the higher my fever was. The colder I got, the more regular my temperature was. That's COVID."
There were moments, he said, when he didn't know if he'd survive it.
"I know a lot of people, guys my age, who've passed," he said.
After five days on steroids and with supplemental oxygen, Oliver was well enough to go home. But it wasn't long before an infection started to brew in the mastoid area behind his left ear. An abscess developed, and the left side of his face swelled up. Oliver was having difficulty talking and swallowing.
"I ended up going from a doctor's visit to straight back here," he said. "With COVID, you get like an aftermath of different things."
On this third Tuesday in December, he had a bag of IV antibiotics flowing into his veins.
The second wave of the virus in Michigan this fall and winter, he said, "will make a believer out of you. I'm talking about beyond. So really, I'm thanking God first for just being able to get through this because some people don't get through this."
He wants to go home, to have Christmas dinner with his family, and get back to the things he loves — like riding his Harley-Davidson motorcycle.
"I'm always in a rush, but it's going to take a little bit longer," said Oliver, who lives in Detroit. "Often, people think they can get back on their feet in two weeks, three weeks. I'll be back on my feet, but I'll be moving slow. I won't be moving fast because it's not going to let me, and I understand that.
"As long as I can go to work and work and do some things and go home and just sit back down for a while, that's all right."
He said he'll get a coronavirus vaccine when doctors say he should, and then, he said: "with the grace of God, everything will go back to normal. People will be able to go to the movies. People will be able to go bowling. People will be able to just go get ice cream together.
"The simple things are the things that I mostly miss, simple stuff like just being able to take a walk, go to the store, go out in Royal Oak."
'We're doing the best we can'
Dr. Philip Kaplan, an intensive care doctor at the hospital, said more people are surviving this round with COVID-19 because doctors have learned from the first surge what seems to help and what doesn't.
Treatments like the steroid dexamethasone and the antiviral drug Remdesivir seem to help. There's convalescent plasma, too. And they've learned that proning — flipping patients onto their stomachs — has been shown to be beneficial to patients struggling to get enough oxygen.
But, he said, "until we're able to massively vaccinate our population, it's going to continue to be like wildfire. It's so infectious. I think that's the thing that we're concerned about is how infectious is this virus is and how rapidly it affects people that have multiple medical problems.
"What we are seeing is whole groups of families" get infected with the virus, he said. "We have a gentleman that's in the ICU, where now his wife and two of his children actually have the antibody. So I think it's running in families.
"I think a lot of it is everyone's comfortable with their loved ones, and many of these loved ones are asymptomatic carriers. I think that that is a major thing and that's really driving this."
The pandemic also is "changing the face of nursing," said Megan Ostrowski, the charge nurse on the fifth-floor medical-surgical unit, a dedicated COVID-19 unit at Beaumont.
It has pushed many of her coworkers out of the field. Some had underlying health risks and were afraid they wouldn't survive if they contracted coronavirus. For others, the punishing work — both physically and emotionally — was just too much.
"I am interested to see how it's going to be after this kind of settles down," said Ostrowski, a registered nurse who's worked at the hospital for 11 years. "If it's ever going to go away, I don't know."
It's been difficult to keep up morale, she said, when the public doesn't seem willing to do basic things like wear masks and avoid large gatherings to keep themselves and the people they love from getting sick.
"Everybody's frustrated," said Ostrowski, a 34, of Livonia. "And everyone seems angry all the time. Just in general, not just here, but just out in society. They're just frustrated. Everyone's angry. They're sick of it. We're tired of it. This general feeling just bubbling under the surface.
"I think about my patients," she said, tearing up. "I think about the families who can't be with them. At least once a day, I do a video chat. Watching families not being able to hug their family members, that's sad. Patients are scared."
And it's all just overwhelming.
"I cry. I cry every day, and I'm not a sissy, either," Ostrowski said. "It really bothers me that it hits me so much. ... I'm not somebody who is like that.
"Our big thing ... in America is supporting the troops. You support the troops, right? It doesn't matter what the war, what war they're fighting, you give them that reverence because they've earned it.
"And I feel like, with,nursing and health care, it's like, can we get that, too? You may not agree with the governor's orders. You may not believe everything you hear about the virus. You may have some hesitancy about the government, all of that stuff. I get that, but can you at least give some respect to the people who are just working? ... This came out of nowhere. We're doing the best we can. So it would be nice if we felt that support, you know?
"None of us get into it for the glory of it or the attention. We all are here because we love people, and we want to take care of them. So it'd be nice if we got some of that back."
Ostrowski got a dose of the Pfizer coronavirus vaccine the day before she spoke to the Free Press, among the first front-line workers in Michigan to be immunized.
"I hope that it works," she said.
Through all the uncertainty, the waves of emotion and long hours, Edwards returns to the hospital shift after shift, just as she has for almost three decades.
"I feel like I'm here for a reason," she said. "So I just try to make every day count as best as I can. I mean, I'm human, too. You know, you sometimes don't feel like it. But then, I think that could be me laying there, and that's the other side of it, right?"
The Detroit Free Press is teaming up with Michigan Radio and Bridge Michigan to report on the coronavirus pandemic. You can contact Kristen Jordan Shamus at the Free Press at email@example.com; Kate Wells at Michigan Radio at firstname.lastname@example.org, and Robin Erb at Bridge at email@example.com.