April 30, 2020

Stephen Haynes, Poughkeepsie Journal Published 6:00 a.m. | Updated 12:47 p.m. ET April 30, 2020

Mohamed Yasin of Union Vale and his children are registered nurses at Montefiore Medical Center, and are all at work through the pandemic. Rockland/Westchester Journal News

Yasin%20nurses.jpg
Overwhelmed and despondent, Amirah Yasin burst into tears. She, like others, needed a moment to gather herself.

There were more patients than the undermanned staff believed at the time it could manage, as several of their colleagues were out sick. But the stretchers continued to be rolled in.

For the first time, Yasin said, she witnessed the full effect of “pandemic mode” in the intensive care unit. She and the other nurses there were instructed during their 12-hour shift to “triage” the situation, as in, assess which patients were most in dire need of help and make them the priority.

But this was in late March, as COVID-19 began to tear through New York, and her Bronx hospital rapidly was filling with people who contracted the deadly and contagious virus. Each of them required urgent care.

“Usually our role in critical care is to do all we can to stabilize the patient,” said Yasin, an Arlington High School graduate. “We administer so many different treatments. That day, all of them needed so much. The charge nurse was like, ‘Just do what you can to keep them alive. Just keep them alive.’”

The pressure was persistent and the movement almost constant, rushing to each room and scrambling to grab supplies and medication for patients, each seemingly suffering just as much as the last.

The fatigue and sore feet were an afterthought, a distant secondary concern given the circumstances. By the time her shift ended at 7 p.m., she was exhausted and emotionally frayed, buoyed only by the fact that none of her patients succumbed on her watch.

Ismail Yasin knows that story well, and several others like it — some more heartbreaking. His shift begins at 7 p.m., around the time his father, Mohamed, and two sisters, Amirah and Aneesah, are readying to head home.

Mohamed Yasin of Union Vale, N.Y., and his children, Ismail, 27, Aneesah, 22, and Amirah, 25, are all registered nurses at Montefiore Medical Center in the Bronx. Yasin, photographed with his children April 23, 2020, says that while realizing that they are putting themselves at risk of exposure to the coronavirus, he considers them a source of inspiration and is proud of them for the work they are doing through the pandemic. (Photo: Seth Harrison/The Journal News)

Ismail, Amirah and Aneesah all followed in their father's footsteps. The siblings from Union Vale became nurses and joined their dad at Montefiore Medical Center, where he has worked since 1991.

Among the Yasins, family ties are knotted by a tourniquet.

Mohamed%20Yasin.jpg
“I was excited when my first child, Ismail, said he wanted to become a nurse,” said Mohamed, a nurse manager for the general surgery unit. “I think after he chose that path, the other two were influenced. I’ve always been proud of them and it’s easy for me to appreciate what they’re doing.”

That's particularly true at a time like this, when there is nothing easy about what they’re doing. This family serves on the front lines in one of the true danger zones, combating an enemy that can’t be intimidated or overpowered.

New York City, as of Wednesday, had nearly 160,000 confirmed cases of the coronavirus, with more than 17,500 deaths confirmed or believed to be related to COVID-19. The Bronx is one of its hardest-hit areas. Montefiore is the largest hospital in that borough, so it typically is bustling and, during this crisis, many patients are funneled there from smaller facilities.

The days in the intensive care unit often are chaotic, and have been since the middle of March, Ismail said. In addition to the abundance, he said, the condition of COVID-positive patients can change quickly, so rarely can there be a sigh of relief. Their new norm is learning to cope with death in spates and compartmentalizing traumatic scenes.

“There’s only so much you can say to your friends or other people who aren’t experiencing it because they won’t understand entirely, and it can be anxiety-inducing,” said Aneesah, a 22-year-old who graduated nursing school last spring and works in the medical-surgical unit. “I’m fortunate to have my siblings and my dad, who I can speak to about it. They don’t get upset hearing it because they want to vent, too.”

Those sessions in which their stories and emotions are “unleashed on each other” are a form of therapy, Amirah said. They’re grateful to have a ready support system and, in a sense, each is a shoulder to lean on for another.

The Yasin family poses together inside their Union Vale home along with Amirah and Ismael's spouses. (Photo: Submitted)

Ismail, 27, and Amirah, 25, both are married and their spouses chose to continue living with them, even at the risk of contracting the virus. That, Amirah said, is either “the height of romance or extremely foolish.”

Their younger brother, Adam, is a college student and he recently decided that he, too, wants to enter the medical field and become a doctor.

In some ways, the Yasins mirror a military family, insisting a sense of duty quells the concerns for their own safety. And like those families, the Yasins' matriarch exudes strength in support.

“If you worried about it too much, it would take over your thoughts and it would be hard to function,” Safiyah Yasin said of the danger her husband and children face at work. “I’m proud that they’re serving at this time, when the world really is in need of it.”

The siblings and their father expressed similar sentiments and said their devout faith has helped them remain diligent. Amirah said she sometimes repeats to herself the Arabic term, “Alhamdulillah,” during stressful moments.

“It basically means, ‘Thanks to God,’” she said. “God has put us here for a reason and we’re grateful that we’re healthy and in a position to help people. We’re thankful that we’re able to contribute.”

A view from the front lines

The volume of patients began to get “kind of crazy” around March 15, Ismail said. It was then Montefiore opened a new intensive care unit to handle the overflow.

The emergency room was crammed with patients who had tested positive for COVID-19, and others suffering symptoms that suggested they probably soon would test positive.

Preparation began in February, Ismail said. As the headlines were dominated by news of coronavirus sweeping through Europe and Asia, the staff began bracing itself for what seemed inevitable.

“The doctors and nurses were talking about it, saying, ‘You know it’s only a matter of when, not if, we start getting some of the COVID patients,’” said Ismail, who works in the medical intensive care unit. “We ended up getting the first wave of patients in early March. By the following week, our whole unit was COVID.”

He works in a 12-bed unit. Under normal circumstances, he said, they’ll have “two to four” patients who are very ill and the staff will focus its attention on them. Rarely has that been the case in the last two months.

“On most nights now, 12 out of the 12 are very sick,” he said. “Everybody is the sickest patient on the unit. It’s not just one of your patients that might be crashing, it could be several of them at once. It’s hard, but that’s what this virus is.”

By the time he gets home in the morning, there is only enough energy left to shower and rest to prepare for his shift the following night. On an off day, he said, he’ll attempt to unwind by playing video games and watching TV, but the hospital and the indelible image of his patients are never far from his thoughts. It’s nearly impossible to turn that switch off completely.

Mohamed Yasin of Union Vale, N.Y., right, and his children, Ismail, 27, Aneesah, 22, and Amirah, 25, are all registered nurses at Montefiore Medical Center in the Bronx. Yasin, photographed with his children April 23, 2020, says that while realizing that they are putting themselves at risk of exposure to the coronavirus, he considers them a source of inspiration and is proud of them for the work they are doing through the pandemic. (Photo: Seth Harrison/The Journal News)

The “defining moments” in the hospital, though, have come in the show of camaraderie and the all-hands-on-deck teamwork of the staff, Amirah said.

Roles are clearly defined and there is a hierarchy within a unit... under normal circumstances. For the first time in her career, she said, “lines are blurred” and the workers’ uniform colors, which indicate rank, are insignificant.

“The attending physician and physician assistant helped me and a respiratory therapist get a patient prone to help them oxygenate better,” said Amirah, who works in the surgical ICU. “Respiratory therapists are suctioning patients and setting up ventilators, techs are fetching supplies for us as we’re yelling from a room, ‘I need this!’ The perfusionists, who normally work in the operating room, are helping us set up dialysis machines. Housekeeping is helping, residents are doing blood draws for nurses, and nurse managers are putting on scrubs. It’s wonderful to see.”

National Nurses Week runs annually May 6-12, during which their contributions are recognized. But this year, more so than any other in recent memory, will have special meaning. Navy and Air Force jets performed flyovers in New York City on Tuesday in honor of healthcare workers, and there likely will be more tributes in the coming weeks.

More than 9,000 American healthcare workers already have tested positive for COVID-19, according to the Centers for Disease Control and Prevention.

“We’re all human,” Ismail said. “But we can’t be thinking about something bad happening to us. We just do our best, focus on helping the patients, and hope nothing bad happens. That’s how we have to operate if we want to go into rooms and try to be fearless.”

Family matters

After graduating Lehman College in the Bronx, Mohamed began working at nearby Montefiore. Safiyah was a New York City teacher. After starting a family, the couple moved to Dutchess County. 

The Yasin family poses together. From left: Amirah Yasin and her husband, Sameer, Ismail Yasin and his wife Sumaiyah, Safiyah Yasin and her husband Mohamed, Aneesah Yasin and her brother Adam Yasin. (Photo: Submitted)

The children all attended Arlington High School in Freedom Plains, before going on to honors programs at Lehman and Hunter colleges in the city, then landing jobs at the same hospital.

“I remember my dad bringing me there on ‘take your kids to work day’ and I enjoyed the hospital setting,” Aneesah said. “I’d go to volunteer there when I was old enough and there was an affinity for it. Then, seeing my siblings do it and have a passion for it, that convinced me.”

Although she and Amirah work in different units, both have daytime shifts and cross paths occasionally. Before the pandemic sent everything topsy-turvy, the sisters sometimes would schedule their breaks for the same time to meet up and chat. As well, Aneesah said, she often would consult her father or her siblings for advice, usually seeking suggestions on how to appear less like a rookie. 

Now, what often is sought in their conversations is empathy. It sometimes is difficult, Aneesah said, leaving work distraught and seeing civilians oblivious to the deaths and horrors they witnessed. So, the dinner conversations with family do often drift toward the macabre.

Mohamed Yasin of Union Vale, N.Y., right, and his children, Amirah, 25, Ismail, 27, and Aneesah, are all registered nurses at Montefiore Medical Center in the Bronx. Yasin, photographed with his children April 23, 2020, says that while realizing that they are putting themselves at risk of exposure to the coronavirus, he considers them a source of inspiration and is proud of them for the work they are doing through the pandemic. (Photo: Seth Harrison/The Journal News)

The silver lining she has found, though, is that the crisis has brought them closer together — literally, too. Aneesah lives in Union Vale with her parents and Adam, 19, returned home when Lehman College shifted to online classes in March. Amirah has remained in the city. Ismail and his wife live in an apartment building in the Bronx, but are neighbors with his grandparents. With the risk of them being potential asymptomatic carriers of the virus, the couple thought it best to move temporarily to Mohamed and Safiyah’s house.

They make the roughly 65-mile drive before and after each shift, making long days even longer. Sometimes, Mohamed and Aneesah are able to commute together.

The rate of infection does seem to be slowing in New York and the hope, obviously, is that it continues. But the hospital units still are full. The Yasins also began fasting last week, in observance of Ramadan, which continues until May 23.

It is “tiring,” Amirah said of working 12 hours in a hectic environment without food, “but it’s something we’ve been doing for years. We’ve been okay so far.”

The boon in their living situation, Aneesah joked, is that it’s forced her brothers to learn to cook. Ismail smiled proudly when they mentioned his mushroom mozzarella pasta. During Ramadan, observing Muslims have one meal before sunrise called a “suhoor,” so the family counts on Adam to prepare breakfast before they head to work. They raved about his Greek omelets and smoothies.

Being together, even under these circumstances, is welcome. They do all yearn, of course, for a return to normalcy — when most of the illnesses being treated are common and curable, and don’t come with the risk of affecting their loved ones.

“I can’t wait until this pandemic is over because I want the experience of being able to connect with patients,” Aneesah said. “I think seeing us in masks and visors all the time is unnerving to a patient. I’ve almost forgotten what it’s like to go into a room without a mask. I look forward to the day I can go in, calmly talk with a patient and have a big, genuine smile.” 

Stephen Haynes: shaynes@poughkeepsiejournal.com, 845-437-4826, Twitter: @StephenHaynes4