On the afternoon of Friday, April 10, at precisely 2 p.m., Madison Smyth sat down with a phone in her hand and resolve in her heart.
For the next 58 minutes, the 26-year-old Erlanger East Hospital nurse, along with members of her family, dialed and re-dailed the phone number of a crisis staffing service called Krucial Staffing. Krucial was funneling health professionals to work at hospitals in New York.
Finally, after nearly an hour, someone answered and took Smyth's nursing license number and contact information. Next, came the urgent question: Could she be in New York City in 24 to 48 hours?
Two days later, Smyth was on a plane.
It wasn't an easy decision, said Smyth, a Girls Preparatory School graduate who is now in a precautionary quarantine at her parents' home on Lookout Mountain.
The Erlanger East emergency department registered nurse said that by the end of March there was a lot of talk among nurses in Chattanooga about volunteering to work in coronavirus hot zones around the United States.
Smyth, who was about to move to Denver, Colorado, for a new hospital nursing job anyway, decided the timing was right to explore a short-term stint in New York, one of the epicenters of the pandemic in America.
"I couldn't help but recognize what a unique opportunity this was in health care, and what a big moment in history this was about to be," she said.
"I thought about some day, if I ever had grandchildren or nieces and nephews that learned about this time in their history or science classes, I would have those almost 'war stories' to share with them."
During the first week in April the war analogy wasn't a stretch, as about 1,000 patients a day were dying in New York state due to complications caused by COVID-19.
Smyth's flight to New York City landed at LaGuardia Airport at 5 p.m. on Sunday, April 12. The Uber ride to her hotel in the Times Square area took only about 20-25 minutes, she says, a distance that can take twice as long during normal rush-hour traffic.
She noticed immediately how eerily empty the city seemed. When Smyth took a walk in Times Square that night, she counted just 18 people on the streets, besides herself. Police officers were tossing a football across a nearly empty Fifth Avenue. People were taking exercise runs down city streets that were usually rivers of cars and taxis.
"There was hardly any traffic on the roads or people walking on the sidewalks," Smyth said.
The next day she would report for her first of 33 straight 7 p.m.-to-7 a.m. shifts at Jacobi Medical Center in the Bronx. The New York Times reported this week that the Bronx has had "the highest rates of coronavirus cases, hospitalizations and deaths in the city."
It's normal for a hospital nurse to work three, 12-hour shifts a week. Working a 12-hour shift nightly for weeks on end, however, would be the mental and physical challenge of her lifetime.
When Smyth arrived at Jacobi Medical Center, she was immediately assigned to the emergency department.
Jacobi is in a Bronx neighborhood called Morris Park, which in the late 19th and early 20th centuries was home to a famous horse race track that hosted such high profile races as the Preakness and the Belmont Stakes.
In a normal year, Jacobi Medical Center, a New York City municipal hospital, might log as many as 100,000 emergency room visits. But 2020 is not a normal year.
On her first night, Smyth was struck by the sight of hospital hallways flooded with patients. Meanwhile, nurses jockeyed for space at computers to update patient charts.
"The place looked almost apocalyptic," Smyth said.
Still, by the time Smyth arrived, the hospital's COVID-19 patient load had begun to crest, she said, and the supply of personal protective equipment was good. She got a fresh N95 respirator mask every night, and there were plenty of eye shields, gowns and gloves, too. The full-time hospital staff told stories about the early days of the pandemic that sounded terrifying, Smyth said.
Day 2 of her work at Jacobi Medical Center would bring an echo of that terror.
Smyth was about 30 minutes into her Day 2 shift when she found herself helping another nurse tend to a younger COVID-19 patient. The young woman, Smyth said, was about her age and seemed to be responding well to treatment.
Then, in an instant, her condition began to spiral downward.
"She was sitting up talking to us, asking us if we could help her to use the bathroom with a bed pan," Smyth said. "Almost as quickly as she said it, suddenly she appeared as if she was having a seizure.
"I immediately felt for a pulse and checked her breathing, and we realized she had gone into cardiopulmonary arrest."
Physicians, residents and other nurses tried to save the young patient's life, but after 45 frantic minutes she was pronounced dead. Doctors believe a virus-induced pulmonary embolism was responsible, Smyth said.
"I think this struck me so much because she was so close to my age and seemed to be responding well to treatment," Smyth said, "but in an instant, everything changed.
"The other nurses told me that this is a lot of what they saw when the pandemic was at its worst in the beginning — people of all ages being struck suddenly and very aggressively."
When she first arrived in New York, Smyth said, the physical demands of her nightly 12-hour shift took a toll. Over time, her body began to adjust.
"After the first week and a half or so, it almost became the new normal, and it got easier to keep going," she said.
Harder to shake were the draining emotions of being around so many gravely ill and dying patients. That never became easy, she said.
"I typically, in my career, have been very good at removing myself emotionally enough from my work so that it does not affect my mental state," she said.
The non-stop work schedule at Jacobi made it impossible to shake the emotions of "so much loss and illness," she said.
Mixed with those darker feelings was the exhilaration of being part of a team working together to save lives, she said.
"I made friends from almost every part of the country," Smyth said, "Louisiana, Idaho, Kansas, Hawaii, Alabama, Georgia, just to name a few [states]. Working together and handling the things we saw every day created a bond that is hard to describe to anyone who wasn't there to see it. We became a family."
This push and pull of emotions has led Smyth to an interesting conclusion about her time in New York: "It is both my favorite and least favorite thing I have ever done in my life."
Back in January and February, Smyth was skeptical of the coronavirus, thinking it was just a "slightly worse" version of the common flu, she said.
Over time, her opinion changed completely.
"I truly saw how scary this virus is," she said.
What's more, she developed a skill that all great nurses aspire to, the ability to read a patient's response to treatment even when they cannot fully express their own needs.
As Smyth and some of the other travel nurses began to prepare to leave New York, she noticed that some of the permanent medical staff members at the hospital had begun to get nervous about their departure.
There is real fear of a second, crippling wave of COVID-19 hitting the city.
"I told them if it did [surge again], I would be back," Smyth said.
"I was worried that this experience, the stress and severity of the work, might cause me to burn out in my career and lose my drive behind wanting to become a nurse in the first place.
"But it did the opposite. I was meant to be in this profession, to help care for people, and I am ready to answer the call again wherever I am needed."
Back in Chattanooga, Smyth was recently notified by the hospital in Colorado that her job offer has been rescinded — at least temporally — due to a low patient count associated with the pandemic.
"So, for now, I'm not sure what is next professionally," she said.
Even for the courageous, the coronavirus is a mighty adversary. And the war is clearly not yet won.
Contact Mark Kennedy at firstname.lastname@example.org.