The intensive care unit (ICU) is somewhere you never imagine you'll go. The maternity ward? Sure. Outpatient surgery? No problem. But the ICU? Nah - not gonna happen.
I didn't think much about the ICU - until life drop-kicked me into its belly. The same hospital where I birthed my first child is where my 48-year-old husband landed with a mystery illness we later learned was necrotising fasciitis. This was in 2009, long before Covid-19, during the H1N1 flu pandemic.
Even then, having a loved one in hospital meant terrible restrictions. Our young children were at times forbidden from entering the facility for fear they could spread infection. It's especially fraught when medical staff tell you your spouse is on the knife-edge of life and death. What if my children never saw their father again?
ICUs can be places of hope and healing. Critical care staff do an amazing job. Yet for me, the ICU was hell. I saw and heard families and patients in pain. Sounds of wailing - primitive keening - are burned into my brain. I used to imagine a sign hanging above the ICU's automatic metal doors with an inscription from Dante's Inferno: "Lasciate ogne speranza, voi ch'intrate," "Abandon hope, all ye who enter here."
You don't abandon the deep desire to see your person walking and well. But it was easy to feel despondent in the loudest, quietest place I had ever been. Machines beeped and whirred continuously. In my husband's room in Spokane, Washington, the heart monitor, ventilator and air mattress played a survival symphony.
Sitting for hours beside someone with an endotracheal tube running through their mouth into their windpipe can crush your soul. They're unconscious and even while awake, they cannot speak.
I sat beside Sean feeling sad, helpless and guilty - I could leave the ICU but he could not. Despite watching hours of television hospital dramas throughout my 20s and 30s, it wasn't until my husband was a resident of the ICU that I digested its purpose: people are there because without the machines, they could die. Even with the machines, they could die. It is still hard to watch dramas featuring ICUs because they flood my mind with memories.
I tell this story for instruction, not sympathy. I tell it because we know that unvaccinated Covid-19 patients are 29 times more likely (according to a recent study of 44,000 people in Los Angeles) to land in a hospital than those who are fully vaccinated. Many of those patients will have trouble breathing, because the Covid infection inflames their lungs, filling them with fluid. They land in the ICU.
When our family was navigating hospital hallways, I wished I had an instruction manual. The internet will suffice. Onhealth.com suggests speaking with a calm, clear voice, realising the patient may still be able to hear you even if they cannot speak. They suggest telling the patient: "You're in the ICU and you have a tube to help you breathe. This is just temporary and we will get the nurse to give you some medication to make you more comfortable, you are doing great and making progress."
Other suggestions include presenting a board so the patient can point to a word such as "pain", using hand gestures and reading favourite stories. I sat for hours, reading Sean messages of encouragement sent by friends, family and strangers via social media.
Enlisting a chaplain was helpful for me. Hospitals have non-denominational clergy who exist to comfort, not to convert. One night, when Sean spiked a fever, a priest friend came to stand with me inside the ICU. He said a prayer. A week later, when my husband was conscious and weaned from the ventilator, he said he remembered hearing last rites - a prayer for someone who's dying.
A social worker, including those specialising in children's issues, may also be available. Setting up a visitation schedule was advisable pre-Covid but may not be of much use now when visits are strictly limited. Write down what staff tell you. I always had a notepad handy. Share information regularly with close family and friends and limit who can ask for information - multiple phone calls to critical care staff are time-consuming. Make sure you get rest, food, water and fresh air. Being in the ICU, even as a visitor, warps your perceptions of space, time, thirst and hunger.
Many people who are vaccine-hesitant think this will never happen to them. They will not need a vaccine or intensive care because they have animal dewormer, magical thinking or vitamins. Too many people who arrived at the ICU with Covid-19 had the same ideas before they died - they were old, young, pregnant, healthy, obese, thin ... the common thread for more than 90 per cent of these patients was their unvaccinated status.
Even if you're hesitant, consider the people who care about you. Getting vaccinated could spare your loved ones anxious hours hoping for a miracle in the ICU.
• For information on the safety of the Covid-19 vaccine and other things you need to know, listen to our podcast Science Digest with Michelle Dickinson: