If someone says the words "Buffalo, New York," odds are that if you do not live here, you think of either snow or the Bills. If someone says they live in Buffalo, one of the first things that comes to your mind to say is "Oh, how's the snow?"
Buffalonians are quick to dismiss such questions because the snow is not usually that bad. Except that every few years...it is. I was born about twelve years too late to see the Blizzard of '77, and came to live in Buffalo the year after the October Storm of 2006. I saw Snowvember (November 2014) peripherally (I took my Step 2 exam that day - in the north towns we had a dusting, and I emerged after an 8-hour exam with no idea that the southern suburbs were buried under seven feet of snow). So I was due for the experience of living through an epic (or "generational") snow storm...and boy, howdy.
I don't generally pay that much attention to Buffalo weather reports on a day-to-day basis, but my wife does, so when they started talking about this generational snow storm during Christmas week, in a week we were both on the inpatient service (at two different hospitals), she made sure I knew about it. The snow and winds were to hit on Friday, so Thursday night we packed an overnight bag each (I thought it was a silly idea at the time. I was wrong). Friday morning dawned rainy, and it was my short day, so I figured I would work to see my patients quickly and maybe write my notes at home.
By noon that looked less likely. The snow was not immense. However, 72-mile-per-hour winds made visibility...also not immense. This is the most Buffalo response, by the way. "The snow wasn't actually that bad, it was just windy!"
So 2:00 PM rolls around and I finish my work for the day. A fellow physician, Q, and two PAs, B and N, are scheduled until 7:00, allowing the rest of us to try and get home. Two other PAs had already driven home and reported it as the "scariest drive of their lives." My closest friend in the group had just driven home from a hospital closer to our homes and we had been encouraging each other that we would be able to get home. As I got into my car and started driving, he called to let me know that he had made it home, but that he only did so through sheer force of will because the visibility was so terrible he had almost turned back. As we finished that conversation, a truck appeared in front of me. Not so suddenly that I was in danger, but enough to make me think. Would my colleagues be able to get home tonight? Would I be able to make it back in the morning when the storm was supposed to continue well into Sunday? Would my three colleagues be stuck handling our 80-100 patient census on their own, save for a resident team that would soon be overextended beyond their duty hours?
I turned around and went back to the hospital. I'd love to say it was out of a sense of duty, but frankly, that drive was not looking promising and I didn't feel like getting stuck in a snow bank.
Not my car. But a good depiction of what it looked like.
As the storm whipped around the hospital, my colleagues/friends and I settled in for the night. We started taking admissions that ordinarily would not have had to come to the hospital, but a travel ban came down and transportation out of the hospital was no longer an option. The nurses, suddenly unofficially mandated to stay (it would soon be official) and even more understaffed than usual, strapped in for some rough ratios. So did the respiratory therapists, nursing assistants, environmental services, transport staff...anyone who had not been able to get home. The cafeteria served up some rather impressive pulled pork quesadillas (while my wife, in the other hospital, made due with a leftover half sandwich and some chips and soda) which was a blessing (even though they didn't have much for my vegetarian colleagues).
It should be noted that Enrique Iglesias's "I Like It" was stuck in my head. The way I moved on the (medical) floor, and all that.
At my hospital, the inpatients are split between two hospitalist groups, a couple of private hospitalists, and the surgeons. 106 of the 259 non-ICU beds were occupied by patients of my group, including 40 patients under resident care.
Incidentally, the residents prepared well for this. The overnight team came in midday on Friday and slept at the hospital to prepare for the night and relieve the day team.
My bosses treat us well and we generally have a census of 10-12 patients each, except for the attendings on the resident service who oversee 16-18 with a resident team. Q and I prepared to take on 10 of our own patients each and then each take one senior resident and see 20 patients with them, since the attendings for the resident services probably would not be able to make it in.
Thankfully, we did not have to be that sacrificial, willing though we were. We took naps in shifts and prepared to see our solo patients in the dawn hours (which would be rude, but desperate times called for desperate measures) and then we would learn the residents' patients. Of course, people who had more sleep than we did had more common sense and the day attendings (snowed into their homes) would be remotely rounding with the residents (again...desperate times).
In addition, some of our providers who lived nearer to the hospital were able to come in and ease the mental burden (some having to abandon their cars in snow drifts, walk to the hospital, and get assistance to pull them out later), even though Q and I remained the two principal attendings in charge.
My brain was still singing "I Like It," complete with Pitbull's weird rap verse that has very little bearing on the rest of the song.
One thing I'll say is that while the nurses (and maybe other staff?) were mandated to stay, at least during the main part of the storm many of the non-clinical staff and even some executive suite folks stayed and did a bit to help. The hospital's chief medical officer, standing in a gift shop T-shirt because he had also needed a change of clothes, handing me a cookie with dinner, was actually a welcome sight, small gesture though it was. Maybe I was just excited for cookies.
You know what got even more old than it already was? People calling us heroes for serving at a time when when...well, we were forced to serve. We heard plenty of that in 2020-2021 as the government half-assed a pandemic response while we tried desperately to convince people (including those in our own ranks) to take a vaccine and use protective measures. Then the government un-did the pandemic response, the CDC tried to oversimplify and overhype vaccine benefits (setting up for a failure in messaging), and anti-vaxxers who know nothing about World War II kept bringing the threat of Nuremberg trials...so administrators and well-meaning folks still trying to call us "heroes" rings hollow, and is frustrating on another level. But I digress.
That last paragraph was heavy. Here's us planking.
Sunday morning dawned: Merry Christmas! As I watched weather reports more frequently than I ever had before, Ashley and I began to strategize between patients. Now that I knew who would be handling all the patients, I could devote some thought to the fact that the storm was letting up in the northern suburbs, but threatening to move back down towards us. At first, we contemplated just waiting out one more day. Q's wife told him their house was inaccessible from the roads, so he would be staying at the hospital. Maybe the roads would be easier on Boxing Day. A friend made it home from ECMC but reported how harrowing it was.
Enrique Goddamned Iglesias was still on loop. Come on and give me some more, hospital.
Ashley started cracking shortly past noon after a paltry burger. The idea of going back into a Monday and its hustle without a reset at home was not at all appealing (a sentiment that quickly spread among staff in both hospitals). So...we made a break for it!
N's husband was braving the roads in his pickup truck to come get her, and they lived near us, so I accepted the ride home. Ashley drove herself home, proving herself, as usual, more badass than she gives herself credit for. Finally getting to shower in our own bathroom and sleep in our own bed? Whew, that felt amazing.
The next day, Ashley drove me back to the hospital and then she went to hers. The atmosphere was similar, but we were refreshed and I felt a second wind as I took on the day's patients. As the nurses I worked with entered their fourth day in a row of mandated work, the camaraderie was still there. We knew we had to be there for each other, because we were all cracking. There was at least one nurse to whom I had to pass on a non-emergent request and I could see her utilizing every single one of her coping mechanisms to restrain herself from snapping at me (which I appreciated). I went back to thank her after she did it and we shared that look - "appreciate the understanding, because this shit sucks."
And it wasn't just the staff who had a terrible time. Patients' families were able to leave (though the driving ban emphasized caution), but few were able to get in to visit or pick up their loved ones. It meant that some of these folks were stuck for multiple days longer than they needed to be, and we ran the risk of hospital-acquired delirium and infections with each passing day.
Even more tragic were those who lived out the ends of their lives in the hospital. Multiple patients passed away during that weekend. All had been expected, they were extremely sick but had discussed their goals of care and were ready for hospice well before the storm...but still. We might have been miserable and stuck in the hospital, but the families of those patients had a far worse Christmas.
Eventually, the storm passed. Monday and Tuesday presented some difficult driving, with main thoroughfares reduced to single lanes as plows could only make that much amid the cars forced to be abandoned in the drifts on both sides of the road. The nurses finally got to go home Monday (one of our most chipper charge nurses, whose smile never left her face the whole weekend, got to her car to find it dead and that was when the tears flowed). Patients finally were able to go home and/or to rehab or nursing facilities. Cars were found and reclaimed by their owners, and by New Year's Eve the temperature was over 50 and you would never know there had been a snowstorm. I'd like to think that some part of us has changed, or at least hospital administrations will be better prepared for such things in the future...but maybe it'll just be a story we tell.
And after a bit of screaming (in frustration and relief) like never before, I finally got a new song stuck in my head.