Exclusive

Memphis nurse practitioner serving in NYC on front lines of pandemic

‘I did hospice for 15 years and I’ve never seen this much death’

By , Daily Memphian Updated: April 07, 2020 10:30 AM CT | Published: April 06, 2020 11:23 AM CT

Lately, Charlene Bonner has been thinking about when she was a girl and the family trips to Cedar Point amusement park in Sandusky, Ohio.

She remembers her grandfather always made sure the trips happened, the women in the family cooking and filling coolers, and everybody gathering around the picnic tables for lunch.

It was a festival.

Arrive early, stay until closing, and always observe the family rule that carried across the decades: If one person wanted to ride something, then everyone had to ride – and it didn’t matter if was the kiddies’ merry-go-around or the feared Demon Drop.


In this ‘maybe’ world, all we can do is prepare and stay home


“Takes you up slow, slow, slow,” she said of the 10-story tower ride, “and then, when you have no idea, drops you straight down.

“That’s how this does,” said Bonner, a nurse practitioner from Memphis, after finishing another 15 hours caring for COVID-19 patients at New York City’s Bellevue Hospital.

“One drop straight down.

“You don’t come back up.”

Willing to serve

Bonner saw the text on March 18: A medical staffing company was seeking volunteers to come to New York City and work in a public hospital on the front lines of the novel coronavirus pandemic.

“I called the number and flew out the next morning,” Bonner said.

She left behind her own Memphis medical practice, which includes making house calls and going to assisted living facilities. She discarded any hesitancy and put family life on hold. She has four children, the youngest two a junior and senior at First Assembly Christian School.

Charlene Bonner, 47, decided to walk straight into the epicenter of a catastrophe that, as of Sunday, April 5, had claimed 2,472 lives in NYC alone.

“I’m so used to taking care of people, I don’t think about me,” she said. “I trust God. I don’t walk in fear.

“I get up, I take care of them like any other patient that didn’t have COVID. I pray with them if they need me to, because they’re in those rooms by themselves. They need to have some human interaction – not just a robot.”

Taking care of people started early. When she was a teenager, she used to go with her stepmother on her job working in a nursing home, and with her aunt to her job at a group home for people with intellectual disabilities.

Later, she would work in hospice where every case had a scripted ending. The only variable was time.

Now, they almost seem like the good old days.

“I’ve never seen anything like this,” said Bonner. “I did hospice for 15 years and I’ve never seen this much death.”

Day after day

For the foreseeable future, her home is a room in the New Yorker Hotel. It is a place to take a shower as hot as she can stand it – she figures, why not test the idea that extreme heat might have the power to put down this coronavirus – eat a sandwich or have a bowl of soup, and get a few precious hours of sleep.

By 5 a.m. or so, she and other medical workers are back on a bus and taking the short ride to Bellevue in the “pitch black,” as she describes it. They are traveling eerily quiet streets, perhaps catching sight of the Empire State Building or the Hudson River, the city that never sleeps still tapping the snooze button until that blessed day when, in expert-speak, the curve flattens and normalcy at least finds a narrow window.

But no one knows when that will be.

Which is one thing if, say, you’re working from your laptop in your living room in Memphis; another if you’re a young, frightened nurse practitioner from Georgia on that early-morning bus ride to Bellevue and facing another day of watching the patients you lost being removed from their rooms and replaced by others that may meet the same fate.

On this particular morning, Bonner, too, wasn’t feeling very good. For whatever reason – her own health conditions, including Lupus – or just the cumulative effect of being two weeks into front-line “war zone” duty, she was extra tired.

“Generally, I’m smiley and upbeat, talk to everybody,” she said. “But I was kind of dragging.”

It was then, of course, that the young woman from Georgia started screaming: “I can’t do this! I can’t do this!”

Bonner said next to nothing to the woman. What would be the point, when they both knew what the next 12-plus hours would bring.

“I just gave her a hug,” Bonner said. “And let her process it.”

Whatever it takes

The only constant at Bellevue and the city’s other main hospitals is chaos. As cases and deaths spiked last week Dr. Ashley Bray, a general medicine resident working at public Elmhurst Hospital in Queens, told The New York Times that the scene was “apocalyptic.”

But if that’s true – and Bonner assures that “war zone” is the only apt description for what she experiences each day – then the response from the boots-on-the-ground doctors and nurses is reminiscent of a medic on the open battlefield: do whatever you have to do, however you have to do it, to get the job done.

While Bonner says they have not yet run out of equipment at Bellevue, there is never enough time and they remain short-staffed.

Sometimes, though, necessity really is the mother of invention.

Dr. Nate Link, Bellevue’s chief medical officer, praised staff in an interview with NBC News for “ingenious” workarounds, such as rigging IV lines and medical pumps so personnel would not always have to enter a patient’s room to adjust dosages.

On any given day, Bonner could find herself participating in any number of emergency “code” situations, dispensing medicine, taking in food to patients and even helping them to the bathroom.

“Whatever it is,” she said, “I pitch in.”

Her main job, however, is especially dangerous: She acts as one of the hospital’s primary COVID-19 test-givers.

Not to worry, upon arrival she was trained for the job:

“I got like a five-minute class on how to do the swab on a mannequin.”

One swab at a time

Before she walks into a patient’s room to administer a test, she is already wearing a blue surgical mask, an N95 mask, and a battery-operated air-purifying respirator that takes form as a helmet with a shield.

She looks like she has been called out to clean up a toxic waste spill.

“By the end of the day, my neck is hurting,” she said, explaining that she finds the helmet heavy. “The shields are actually supposed to be changed out after every patient. But because the shields are so hard to come by, I’m cleaning and reusing it.”

It is a reminder that the “war zone” never allows for perfect protocol.

Editor’s Note: The Daily Memphian is making our coronavirus coverage accessible to all readers — no subscription needed. Our journalists continue to work around the clock to provide you with the extensive coverage you need; if you can subscribe, please do

That said, Bonner does all she can do ensure a clean chain of custody as she obtains swab samples from the nostrils and throat, places them in a secure vial, and finally into a bio-hazard bag to be taken to the lab.

When she comes into a patient’s room – wearing three pairs of gloves, plus shoe coverings – she opens up a plastic bag containing a fresh gown that she already knows will be too big.

“So, I have to tear the gown at the neck and then I tie it,” she said.

On the first day, she was essentially conducting solo field experiments; the five minutes with the mannequin were something less than useless.

“You learn by trial and error, but the first day I had it,” she said.

It is well-documented that getting the COVID-19 test is not fun for the patient. After taking his first test, President Trump told reporters: “It’s a medical test. Nothing pleasant about it.”

Nor is it a day at the amusement park for Bonner.

She will say this, though: Women typically handle the long cotton swabs being inserted deep into their nose and throat better than men do.

“The women are stoic, just take it,” she said. “You guys are the worst.”

In any case, Bonner has her system now.

“You have to go all the way back into their nostrils to their septum, twist (the swab) around for about 10 or 15 seconds, and then pull out,” she said. “It’ll make them sneeze.”

After acquiring the sample from the nose, she breaks off the tip of the swab and puts it in a vial labeled with the patient’s name. She then reseals the vial and sticks a separate swab in the patient’s throat: “All the way back, they gag, cough.

“I’m right-handed, so I stand on the right side of the bed and have them tilt their head to the left, so my arm will get most of the cough or sneeze.”

She then secures the throat culture, puts it in the vial – “not too fast, so it won’t splash” – sanitizes the vial, and deposits it in the bio-hazard bag she brought into the room. Next, she sanitizes the bag, removes one pair of gloves, and sanitizes the next layer, and then rolls up the bag with the vial, holds it with a wipe, and knocks on the door.

A second person waiting outside the door is holding another bio-hazard bag in which the first bag, containing the vial, is carefully placed; she watches to make sure the other person closes the outer bag without touching the bag containing the vial.

She’s still not done. She shuts the door, uses the last wipe to sanitize the gloves she’s still wearing, and then removes the gown.

“You do the stripper move and snatch it away from your body,” she said with a laugh, “turn it inside-out.”

She then puts the gown in the trash, sanitizes her gloves again and drops them in the trash.

Next, she puts sanitizer on her bare hands, uses her elbow to the open the door and leave the room, and heads for the nearest sink for a thorough washing with soap and water: “I do the ABCs song more than once.”

If all goes well, and it usually does even when giving the tests to inmates on the Department of Corrections floor, the whole process takes 10 minutes.

Said Bonner: “I have a groove now. It’s smooth – bam, bam, bam.”

One hell of a day

Charlene tries not worry about her own kids, but …

“I’m a mom.”

They in turn try not to worry too much about her.

One of her three sons, Joshua Ward, is a high school junior, 17 going on 40. When his grandparents’ house burned and the insurance company put them up in a hotel, he decided to stay there some and “watch out for them.”

He spent part of last Saturday working at a food pantry through Greater Harvest Church of God in Christ, where his father, Renardo Ward, is the pastor.

Joshua is a polite young man with a quick-draw “Yes, sir” upon hearing any question. As in, “Yes, sir, it’s crazy seeing the virus so bad.

“Yes, sir, I’m just thankful my mom can have a part in helping it get better.

“Yes, sir, I don’t worry too much, because I’m praying for her.”

A few nights ago, Charlene got on the bus to go back to the hotel. All the workers were buzzing about a what a horrible day it had been – so many deaths – and somebody said, “I had 14,” and somebody else said, “I had 11,” and on and on it went, all areas of the hospital, the victims spanning all ages.

It’s like the world’s unluckiest lottery: 21, 35, 45, 56, 63, 78 …

“Gone, just gone,” Charlene said. “We were all giving our numbers.”

Finally, she allowed herself a deep breath – an attempt to let the day, all the days to that point – just float away for a few minutes.

Everything landed on her.

“I just broke down crying, bawling. I’m like, `What is this? What are we going to do about it?’

“There is no rhyme or reason to this. Nothing. It has zero respect for the person.

“Generally, I say the news exaggerates stuff,” she said. “But the news has not scratched the surface of what’s going on inside the hospital walls.”

The night after she broke down, Charlene walked out of the hospital at the end of her shift to the sounds of sirens and honking and cheering. New York City firefighters had come to pay their respects. It happened again the following night.

“After being in there all day, tired, feeling defeated, wondering if I’m doing anything to make a difference, to come out to that … my heart melted,” she said. “And then the residents in high-rises across the street came out on their balconies, were clanking pots and pans, cheering.

“I’m like, `I think I can come back tomorrow.’”

Not science fiction

So far, no one knows how long the tomorrows will keep stacking up one after another. There’s a reason, after all, that refrigerated trailers are parked outside the hospital.

When she was first boots-on-the ground, she was like, “Oh my God, twilight zone. I was like, `This is not real.’ My eyes wide all the time.”

 Now, it’s hard to be shocked.

But she has things she wants folks back here in Memphis to know, not just at head level but all the way through their hearts and down to their toes.

“This thing is real. People are dying. Young. Middle-aged. Old. Healthy people are dying.

“Stay in if you don’t have to go out. If you do go out, cover your nose, ears and eyes with something. Practice social distancing.”

Charlene says many of her patients at Bellevue are Asian and Hispanic. She has seen fewer African-American patients.

She initially was puzzled by this, but now she has a theory: “African-Americans, we don’t go to the hospital very readily. And a lot of them are working in those essential jobs – the grocery store, warehouses, driving the bus … and they’re being exposed, getting it, and being found dead in their homes.”

From her own essential job, she knows the pain of watching people die alone.

She may have a few minutes with patients, but she connects how she can. Last Saturday, a man in his 60s, a cancer patient, clearly was in what she recognized as the end stage of COVID-19.

She could see he was exhausted. He wasn’t up to speaking. She hoped he was listening.

“He had terminal restlessness,” she said. “Before I left, I said, `Fight, don’t give up.’”

Within in the hour, he had coded: Demon Drop.

Charlene also was probably the last person to speak to an elderly woman – ethnicity unknown, “she didn’t speak any English” – that was curled up in the fetal position, hair all a mess, lying in the bed outside the covers.

She covered her up, straightened her hair as best she could, and tried to offer a moment’s comfort.

“I talk to them like they can understand,” Charlene said. “Even if they’re unconscious.”

The woman died within the hour.

Straight down, never came back up.

Survive and advance

No, you can’t wash your hands too well or too often.

Yes, Charlene Bonner – as a front-line medical professional at the COVID-19 epicenter – begs you to take social distancing seriously.

But beyond all that, well, there will be something of a life to follow, right? Eventually?

“The other day, somebody said, `We’ll probably all have PTSD after all this.’ I hadn’t even thought of that,” Bonner said.

So, how best to mitigate that possibility for the doctors, nurses, paramedics and others who, in their own way, keep running into the burning building to try and save as many lives as they can?

“Spiritually, let’s not be mean and ugly to each other, or not speak to each other,” Bonner said. “This can bring people together. We need each other. No one can be on an island and survive. I pray this will help us be better human beings. Just be nice to one another.”

You know, like we were after 9/11.

For a while.

“It was short-lived,” she said. “It went away. People went back to being mean and rude.”

Her hope, then, is that this time it’s different – that we’re different. That maybe we learn a little more, hold it a little deeper, and realize that to fight the COVID-19 pandemic – to survive it – is to embrace a certain responsibility.

“This is history,” she said, a heaviness in her voice as she fixed chicken noodle soup in her hotel room, one more dinner alone before another short night’s sleep and getting up and starting all over again.

“I just hope to make a difference.”

Topics

coronavirus Charlene Bonner Bellevue Hospital New York City
Don Wade

Don Wade

Don Wade has been a Memphis journalist since 1998 and he has won awards for both his sports and news/feature writing. He is originally from Kansas City and is married with three sons.


Comments

Want to comment on our stories or respond to others? Join the conversation by subscribing now. Only paid subscribers can add their thoughts or upvote/downvote comments. Our commenting policy can be viewed here