Abstract
“The First Wave.” National Geographic on Hulu. 2021. Available with Hulu Subscription $6.99/month
A brief warning, this may be a difficult documentary to watch and review to read for frontline workers.
The opening salvo of the documentary “The First Wave” is a barrage of 911 call recordings pleading for help for family members who cannot breathe, followed closely by a cacophony of shouted orders and hospital alarms as we see a hypoxic patient being prepared for intubation while his wife says she loves him over a video call. He codes shortly after intubation and is unable to be resuscitated. The opening scenes plucked me from my relatively comfortable position as an internal medicine PGY-3 and unceremoniously dumped me back into the halfway point of my intern year, the notorious March of 2020.
Some songs can transport you back to a certain part of life, for me, it is the beeping of hypoxia alarms. I and my cointerns had just experienced our first Mardi Gras in New Orleans when COVID-19 patients began to appear in our ED. Our medicine services were alarmingly overrun in the following days. The contamination barriers initially creeped a few rooms at a time, then grew in leaps and bounds to cover entire floors. Ice trucks identical to those used to house frozen beverages two weeks earlier on parade routes were now holding bodies in the parking lot. We were scared and exhausted, and it followed us home. The fear of the unknown was palpable, visible in the face of every nurse, doctor, and ancillary staff in the hospital. “The First Wave” stands out as a raw and accurate accounting of what happened and what it felt like to be there.
The documentary is beautifully respectfully done. We follow Dr. Nathalie Dougé and a team of rapid response nurses as they maneuver the first three months of the initial wave of COVID-19 at a large hospital in New York City. Dr. Dougé is a young internist of Haitian background who like many of us was trying to process the loss of prognostic pattern recognition with a completely new disease. She expresses despair at the disproportionately severe impact COVID-19 has had on communities of color, recognizing that professional distance crumbles when the patient role reminds you of your family. The nurses, again like many of us, attached emotionally to patients in attempts to fill the void left by physically absent family members.
Caregiver fatigue is rampant, seen in the shared shocked silences after discussing the number of intubations and deaths each day. Screen time is split evenly between the hospital and providers' personal lives as they worry about infecting loved ones, celebrate birthdays over Zoom calls, and protest the murder of George Floyd. No emotion is censored—they cry, scream, laugh, and shout. They struggle to bridge the emotional distance caused by a hospital closed to visitors for terribly sick patients.
Death is ever present during code blue after code blue, and so is slow recovery for some. Patients are intubated, code, die, but the documentary does not dwell on the medicine. We instead meet their family members at home, see pictures, and watch videos taken before their hospital stay. More than anything else, “The First Wave” seeks to recognize the mental and emotional effort that the pandemic has demanded of families and workers.
Although Director Matthew Heineman's work is filmed entirely in New York City hospitals, I saw parallels to my experience in New Orleans, which endured its own initial COVID-19 surge around the same time. I am certain that many others will see themselves mirrored in the emotionally exhausted physician, the frustrated nurse, or the distraught family member. “The First Wave” hurt to watch, but the emotional response was one I needed to recognize and acknowledge. It brought back echoes of the fear, anger, and sadness of that time, but also relief that someone was able to accurately document it in a climate of denial and sensationalism.
I have struggled with how to describe and share what I and my coresidents went through with family members and nonmedical friends. As a trainee whose entire residency has revolved around this pandemic, I felt seen in a way that no other COVID-19 media coverage has been able to accomplish. This documentary brought me some healing, and I hope it can do the same for others who need it.
Thank you.