‘At the Gates of Hell’: Revisiting an NYC Nurse’s Pandemic Journal, Five Years Later

Patricia Tiu, a nurse, is the Queens-born daughter of immigrants from the Philippines. She was working at New York–Presbyterian/Weill Cornell Medical Center in Manhattan’s East Side when the Covid-19 pandemic hit, five years ago this month; she recorded her observations in video journals that were posted online.

Tiu’s videos and an interview with Jamie Beckenstein of the Queens Memory Project, collected and posted online by the Queens Public Library, were included in When the City Stopped: Stories from New York’s Essential Workers, published by official Manhattan borough historian Robert W. Snyder for the five-year anniversary of the pandemic. Below is an excerpt from her interview.

March 29, 2020

Even though I understand the severity of this virus, I underestimated the impact it would have on the American health care system, for damn sure. I never thought it would get to the point that it is now. It shouldn’t have ever gotten to this point. Everyone needs to know what exactly is happening, because it’s not going to end well.

The week that just passed, we officially all went to the ICU and no longer the ER, because the ERs, they’re flooded. The hospital made every single nurse step up from what they usually are doing. Nurses have to become full-blown ICU nurses. And to become a full-blown ICU nurse you usually need, at least, minimum six months orientation. All of a sudden, a week. It’s like throwing a golfer to go play basketball, in a week they should learn and compete in the NBA.

The FDA was saying because we’re so short of supplies, if you have a patient with the same disease, it’s okay to use the same pair of gloves, which is disgusting. The N95s: we were given one and they said keep it for a week.

I just want to give you a heads up of what it means to be on a ventilator. You need a vent because your lungs get so filled with fluid that you’re drowning in your lungs. The biggest part has been getting people off the vents. When you’re on a vent, it’s usually maybe two or three days depending on how sick you are. When you’re on a vent as a COVID-19 patient, your minimum is two weeks. We’ve had patients on it for a month.

Cuomo has been begging for vents. And you know that the whole thing was the supplies. And then Trump was saying that New York City is exaggerating the amount of vents we need. I really hope so, because pretty soon you are going to have to choose who gets vented and who doesn’t get vented. And what that entails is basically who gets to live and who doesn’t get to live. Does your 65-year-old grandma get to live, or your 40-year-old neighbor?

As an American, born and raised in Queens, it is a f—ing shame that our government can’t get us the supplies that we need.

You can’t say we don’t have the resources. This is not oil that we’re f—ing asking for. This is things that we can find and make on our soil, and it’s absolutely disgusting how they just show that they don’t give a f— about us. Not just the nurses and the health care staff just us in general, like the majority, the working class. And they made that very apparent.

So what does it mean to be a Covid-19 positive patient that’s on a vent? It means that you’re in the room alone. And when we come in and care for you, we’re not trying to be in there long. You’re paralyzed. You’re sleeping. I don’t know if you hear us, maybe you can, maybe you can’t. But you’re just there.

And as for our Covid-19 patients, if you die, you die alone. Your family never gets to see you again. Not at least while you’re breathing. You can’t say goodbye; you can’t even see what’s happening.

Here’s an example. And it’s going to be a lot to hear.

There was an 18-year-old that was Covid-19 positive and vented, and I don’t know what the full story was, but became brain dead. So the doctors need the vent. So they called his mother. They explained that we got to pull the plug. Mother said, “Please no, don’t pull the plug, just put the phone next to him. He will hear me and he’ll wake up.”

Where does that put all of us? Where does that put every single person, the doctors, the mother, the 18-year-old, the staff, the person who’s going to need the vent? Like what do you say to that? How would you handle that? What decision would you make? What if there was another 18-year-old who needs that vent? What are you supposed to do?

I don’t know what you do with a situation like that. And if we run out of vents, that’s what’s going to happen. You’re going to pick and choose. We have no choice but to see who would survive.

Our own staff got hit. We have two doctors and a nurse as well are intubated and they’re Covid-19 positive. As for nurses: None of us are sleeping. I don’t sleep anymore.

Everybody has that high anxiety deep in them. Although I’m proud of our nurses, they’re functioning and they’re fighting through, that high anxiety 24 hours a day, seven days a week is killer. We are not expendable.

So all my nurses, if you do not get the proper gear, your life is not worth losing. You deserve to come home to a family too.

April 6, 2020

The last time I spoke, I said New York City was on fire. Well, welcome to hell. Because we are basically at the gates of hell. We are very close from the tipping point, reaching the peak, we’re almost there. We haven’t reached it yet.

I have accepted the fact that our government, our president, and no one is coming to help. So New York, it’s just us. No one is coming to help us. And working in this ICU, the number-one goal is basically to save as many lives as possible. Everybody’s dying, and you’re just doing your best to keep every single one of these people alive. Every minute that I have gone into work, you are working at like 150%. You don’t even have time to think your own thoughts. You do everything, everything you can to make sure they’re breathing.

The one thing I really feel is anger. And I’m angry. We are in war.

You know New York is in war when we’re by ourselves. And I’ve accepted that. But I’m never going to forget anything that’s happened here.

The nurses are being spread so thin, so thin. What they’re asking for us to do is beyond God’s work. We’re going to keep fighting, it’s our city. So just keep spreading awareness, stay inside.

I stepped out today to do some groceries and errands and it’s amazing to me how many people are still outside walking around even with no mask acting like nothing happened. I just, I don’t understand.

And we are not at the worst yet. These next two weeks are going to be brutal. Like brutal. I’m telling you. And no one is coming. No one is coming to help us. So for all my nurses hang in there. Stay strong. Have each other’s back.

Don’t be afraid. This is a very scary situation. It’s a very anxious situation. Be smart about things but don’t be afraid; if anything, be angry and let that anger fight because I’m angry.

June 11, 2020

My hair is finally growing back, which I wasn’t too worried about. I wasn’t the only one who lost hair due to stress. In terms of mental health I would love to tell all my nurses and essential workers and anyone who’s struggling: please, please reach out to anybody, whether that’s seeing a counselor, a friend, doing an activity. What we went through and what everybody is going through is not easy.

I don’t think I’ve had real time to actually process everything that goes on. I did start seeing the counselor. For the most part I feel okay, but I do have my times where I’m very upset. I could have a beautiful day, the weather was amazing and everything was great — and suddenly I’ll be really upset. Or I could just be sitting here just like this and I’ll just start crying. And I don’t understand why. And I can be completely happy, I can even be with friends, and all of a sudden something just doesn’t feel right.

So for anyone who is struggling, please, I advise you please go speak to somebody, it will only help. What we went through is not normal and what we’re going through is not normal.

Everybody has a different experience. Someone who is stuck working from home has a different experience from me where I’m going in the hospital. Someone that is working in Elmhurst Hospital will have a different experience from someone that is working in, like, Long Island Jewish. There’s so many different experiences, just know that together we could get through it by raising awareness and helping each other.

I still, from time to time, do check up on the patients that I have taken care of. It brings so much joy to see that some of these patients are doing somewhat well, possibly off the ventilator. And then it breaks your heart to see the patients that are still on the ventilator. That have been on the ventilator for more than 40 days and you just know the chances are just getting slimmer and slimmer. And then you have the ones that just didn’t make it.

The nurses that I work with every day, I’m extremely proud of them. Everyone stepped up, every single one of those nurses took initiative and didn’t say no. It makes me so proud to be a nurse. Our nurses acted as not just registered nurses, they acted as doctors, they acted as respiratory therapists. They acted as the nursing assistants. They acted like the cleaning services. We emptied out our own garbage. We cleaned our own floors. Nurses and medical staff are really superheroes.

I’m genuinely proud of all the nurses that have stepped up during this time because it was not easy. They really did the impossible.

The clapping at seven really made me feel good. You may have a nurse who had such a crappy shift, patients might have died on their shift and as they’re walking out, they hear somebody cheering. It makes a difference. It uplifts the spirit.

I’m constantly changing and growing for the better. I’ve definitely become more proactive in politics. I do believe I’m going to be a future leader. I don’t think I’m going to be running for Congress but a leader — if there are young people out there that are looking into the nursing career or who need help with something, I feel like I’d be able to guide people. I’ve had people already talking to me about getting into nursing.

I am in school right now in Hunter College to get my psychiatric nurse practitioner degree. And a main reason I did that was because I wanted to kind of tackle the issues of domestic violence and human trafficking and women’s mental health, as well as public health in general, addressing disparities, helping immigrant families with health care because I feel like they’re very underprivileged.

I really didn’t open my eyes till now and I think that having this knowledge and experience is only just going to make me a better leader. That’s how I feel and hopefully it happens.

Thank you to the Queens Memory Project, Jamie Beckenstein and the Queens Public Library. Excerpt from When the City Stopped: Stories from New York’s Essential Workers, by Robert W. Snyder, a Three Hills book published by Cornell University Press. Copyright (c) 2025 by Robert W. Snyder. Used by permission of the publisher.