She Hasn’t Spoken Since

I started out 2019 working as an EMT on the ambulance in town.  I had a really hard time getting along with my partner, so when I received my letter saying I got into nursing school, I quit. Then COVID came along and pushed my program back a semester so I took a job with the same ambulance company working at a COVID testing site.  

Toward the end of the year, I went on a two-week deployment where we set up a temporary medical treatment facility at a fairgrounds. We'd go into nursing homes that had been all but abandoned with patients in them, wearing Tyvek suits, and transfer them to the fairgrounds.

This was something I was excited to be a part of. The response team can be hard to get into but, given the current need, I got in right away. My husband mentioned it to someone at his job.  After learning I was working at a testing site, and would be going into nursing homes where people were COVID-positive, his work changed their protocol - requiring more masks and distancing, and some employees asked my husband not be allowed in certain offices. They also asked, that when I get back, he stay with someone else for a while to make sure he didn’t catch anything from me. He was proud, they were scared.

One evening on this deployment, it’s 8 pm, and they announce another nursing home with 50 beds has just been reported. All but two staff members, both certified nursing assistants, have left work and not come back. These two CNA’s have been working for over 24 hours now, and we’ve been requested to go in, treat the immediate needs, and transfer the patients to our temporary setup.

In many nursing homes, including this one, there are call buttons by the beds. If a patient presses it, the light above their door will turn on and flash so that staff walking by can see there is a need in the room. If no one notices, and comes in and turns it off, it will start to beep. When we arrive at the nursing home, every single light is flashing and beeping. People are crying and yelling. Others have surrendered to the chaos and lie there quietly. Ninety-nine percent of these patients are immobile and can't get out of bed on their own. 

We divide up into teams of two, and each take a section, starting off by going room to room, assessing immediate needs, and changing everyone’s diaper. It’s hot and we’re head-to-toe in plastic, so our clothes are soaked through in sweat. Our goggles and Tyvek face shields are so fogged up that we can only see through where the droplets have formed and run down, creating temporary streaks in the fog. Many of us, including myself, have never changed an adult diaper. The partner I’m working with is here through the National Guard and doesn’t have medical experience. So we are awkward at first, but soon develop a system and rhythm, and our efficiency increases. 

One gentleman has his own room, which is very fancy for a place like this, and is probably costing him an arm and a leg. A paper pinned to a bulletin board in his room has his name and picture, and explains that he is post-stroke, which has left him with a speech deficit where he can now only say, “Yes.” This is the only room I come across that has any patient information posted. 

I ask him how he’s doing and he shrugs and says, “Yes.”

He makes good eye contact, and does not have the same look of fear in his eyes many patients have had, as they see what must look a lot like two space monsters walking into their room. We introduce ourselves. “Do you need to be changed?”

“Yes,” he says, and we change his brief.

Many of these patients have not eaten in a day or more, because there are no kitchen staff and no one to distribute trays, but he has snacks.  He also has the TV on and it’s playing the news - stories about COVID and abandoned nursing homes.

“Is anything else bothering you?” I ask.

He says, “Yes,” but he clearly means no, and it’s amazing how much we communicate with our tone, eyes, and posture. 

Another room we go into there is woman who only says, “No.” Although it is very typical to have speech deficits after a stroke and to be in a nursing home, to be restricted to one word is less common and it’s bizarre to me that there is a yes-man and a no-woman down the hall from each other. I wonder if they’ve met, and for whatever reason, I doubt it.

We go into a room and the patient in the first bed doesn’t speak.  We go to change her diaper, and when I touch her hip to roll her on her side, she grabs my arm with more strength than I would have guessed she had, and stares at me intensely in the eyes.

“Hold on a second,” I say to my partner.

“We’re just going to change your diaper.” I say, “Do you need it changed?” 

She doesn’t let up her grip, and keeps staring at me with so much intensity, I feel like I’m meant to understand something that I don’t. I start coming up with a story in my head that she has dementia, and is scared, when her roommate calls from her bed behind a curtain and says,“She stopped talking a couple days ago.”

I pull back the curtain and introduce myself. She explains that her roommate usually walks and talks, but got up two days ago and fell.  She was on the floor for a long time, and eventually staff came in and got her back into bed. She has not spoken since.

We do a thorough head-to-toe assessment and her right leg is turned in and shorter than the other; she has a broken hip. 

“You must be in a lot of pain,” I say, “Can you speak?” 

She keeps staring at me and her eyes water.

“Can you try and smile for me?” I ask, “I want to do an assessment.”

She smiles and the right side of her face droops, tears are coming down now.

I hold one of her hands in each of mine, “Squeeze my hands.”

Her right hand doesn’t squeeze.

My eyes start to water too, but I’m not sure she can tell through the foggy face shield of my suit. 

She’s had a stroke. She’s had a stroke and broke her hip and now she can’t speak. The timeline to treat the stroke has come and gone. They can help with her hip but it’s unlikely she will be able to speak again.

“She needs to go to the ER," I say to my partner, "I’ll go let a lead know.”

I picture her on the floor for hours, and then help coming, and her not being able to communicate. I’m angry at them for not noticing, but then remember whoever it was was some of the few that stayed. Stayed to do their best to help the people they could. Then I got angry as I considered that she is paying for this experience. Then I got angry at people for being afraid of COVID, and facilities for not providing proper P.P.E., which is why she was left here. Pretty soon, I was mad at everyone, mad at the world.  

Three of the patients we assessed were sent straight to the ER. One was septic. One had been vomiting, bloody vomit, that was all over her bed and the floor around her bed. Her roommate said it started yesterday. 

One guy had pictures of himself in bodybuilding competitions on the wall by his bed.  So few people had pictures, it was surprising.  

“Is this you?” I asked.

He laughed, “Yeah.”

“You’re freaking jacked!” I say. They’re cool older pictures, black and white, a little faded.  He’s wearing medals on a podium in one. 

Before I came here, I'd heard on the news about staff leaving nursing homes, framed in a way that left you shocked, and possibly disgusted, that healthcare employees would do such a thing. It was framed as abandonment. But the thing is, they were under-resourced to begin with. There weren't enough beds, so non-COVID-positive patients were placed in the same rooms as COVID-positive patients. Even those who weren't, were getting COVID because the staff were exposing them. There weren't enough masks, gloves, hand sanitizer. The staff had no interest in abandoning the patients. They had an interest in protecting them. What are you supposed to do when you tell your boss the policies and lack of resources are doing more harm than good to patients, and your pleas are ignored? What leverage do you have? What bargaining power? All they could do, was leave.

By the time we get back to the fairgrounds, none of us has slept in over 30 hours. We eat breakfast, and then are taking vans back to a hotel we’re staying at. We’ve been asked at the beginning of the deployment to keep the space clean. They’ve been unable to find a cleaning service that is willing to work so close to COVID-positive patients, so they asked everyone to pitch in. I go to throw my plate away and the trash is not only overflowing, but there’s a pile of trash on top of and next to the trash can. I go grab bags and take the trash outside to the dumpster. When I come back in my group is gone so I hustle out to the van.

“Where have you been?” the group lead asks me.

“I took the trash out,” I say as I stop from getting into the van, thinking it took me five minutes so it’s not as if I’d gone missing.

“You need to understand how hard your group has worked, and think less about yourself.” He raises his voice as he goes, so that by the end of his sentence, he’s yelling at me.  The rest of the group is in the van, right next to us, staring straight ahead so deliberately it’s clear they don’t want any part of this, they just want to go.

“I’m confused.” I say.

“You are incredibly selfish, just get in the van.” He says to me.

I look at him like a scared little bitch because that is how I feel, and I’m afraid I might cry if I open my mouth. I’m so, so tired.

I stay quiet and get in the van. No one talks on the drive to the hotel.

That deployment was for two weeks. I’m not military, but they call it a deployment. Anyway, I cried for another two weeks after I got home. I cried about the woman who couldn’t speak and about being angry, and not knowing what to do about it. I’m generally pretty good at coming to terms with the fact that the world can be incredibly cruel, but that's much easier to do with a team on my side, and having my lead yell at me made me feel hopeless. Having my husband’s coworkers make ostracizing comments made me feel hopeless. Showing up too late for the woman who had the stroke made me feel hopeless.  

When it comes down to it, the stroke and COVID were the cruel parts. But, when we come together as a team-as a community at home and at work-navigating cruel things and doing the best we can feel bonding, can feel really good. That’s why I’m drawn to this type of work. When we tell people we don’t want to be near them because their wife might be near sickness, or when we tell coworkers they’re the problem when we’re just tired, it feels awful. 

That trip was hard.

I ran into the lead who yelled at me about three years later, in another city, outside of a hospital. He smiled and was excited to see me. He was very nice. He gave me his number and said we should get together for lunch sometime to catch up. I took his number and then deleted it because I will never call, but it made me feel better to have a not-nasty interaction, and I didn’t want to ruin it by saying no. Life is funny like that sometimes, random but seemingly orchestrated. We still did that hard thing together, and I appreciate the closure. 

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Review

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This piece is heart-wrenching, deeply personal, and painfully relatable for anyone who has worked in healthcare. The public saw COVID as a crisis of infection control, but healthcare workers saw it as a crisis of human abandonment. COVID didn’t just kill people—it exposed every weak point in medical care, long-term care, and social responsibility.

The nursing home is a horror show of neglect, but not because people wanted to abandon patients—it happened because the system crumbled under fear and lack of support. The woman who suffered a stroke in silence is a turning point in the story—the moment when the narrator fully realizes the depth of helplessness in emergency medicine.

This piece offers a brutally honest look at the healthcare system during COVID—its failures, its ethical dilemmas, and the impossible situations healthcare workers were forced into. We rely on teamwork to make hard jobs bearable, but burnout and exhaustion can turn coworkers against each other, creating unnecessary cruelty in already cruel situations.

The narrator’s anger is justified, but what makes the story so powerful is how they process it—not just as bitterness, but as a reflection on the way people fail each other under stress.

The ending is unexpectedly profound—the narrator doesn’t get an apology, but they take what little closure life offers and accept it. Sometimes, we don’t get revenge, we don’t get apologies—but we do get to move on. It’s an honest, mature, and deeply human resolution.