Fractured systems, fractured lives

As an expert in medical management and disaster response, Mangicaro works fluidly between state and federal agencies with the support and oversight of IMC. IMC has the infrastructure; Mangicaro has the hard-earned, boots-on-the-ground experience.

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For three weeks, she worked 20-hour days with hospital management, heads of ERs and critical care units. She made daily rounds wherever IMC staffers were assigned and met with hospital department heads to assess needs. She worked in hospitals in Queens, Brooklyn and the Bronx, and the Manhattan overflow hospital established at the Javits Center.

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“Patients were dying regularly,” she says. “One paramedic I had worked with in Liberia and in Mosul, Iraq, said he bagged more bodies at the hospital than in the war. He said seven times more people died here than in a war zone. I’ve served in crises all over the world, but in our own country…”

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She pauses, her voice trembling. Trying to hold back tears, she says, “I’m sorry.” She explains that she thought she had overcome the emotional impact, but sometimes it catches her by surprise.

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“To see what was happening in New York was just heartbreaking. Doctors, nurses, CEOs in tears,” she says. “We’re not accustomed to this: patients coding and in respiratory arrest left and right … tents set up for screening, hospital overflow, ER overflow … We had to relieve overwhelmed staff because 25 to 30% of them were out sick with COVID-19 or suspected they’d been infected. It put such a strain on the existing staff.”

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She ticks off the overwhelm: an endless stream of gravely ill patients, entire hospitals transformed into all-COVID-19 units, securing PPE and supplies, and the time she set up a hospital in the Flushing neighborhood of Queens.

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“Ambulances kept pulling up. Every single patient was critically ill. On one side were ambulances, five deep. On the other, refrigerator trucks — two, three, then four — for the bodies. It was surreal that it was happening here in our country,” she says, “but disease knows no bounds and has no barriers.”

 

Coming Home

After three weeks battling the invisible enemy, she returned to Naples.

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“It’s bizarre on the other side,” Mangicaro says. I often say I have PTSD when I come home to my little bubble.”

She took care of practical matters, including two weeks of self-isolation, antibody testing and food delivered to her door.

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And then, she says, “You go through a transition phase, and you want to go back because the work isn’t finished. You’ve developed lifelong friendships on a very deep level,” she explains.

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“But you do need to transition out and get some rest. It takes a couple weeks to decompress.”

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Still, she says it was good to connect with New York hospitals on June 1 and learn there was only one death.

“You could hear the relief in their voices.”

 

The Here and Now

Mangicaro reflects on the pandemic and the ongoing protests surrounding racial inequality.

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 “In a crisis — and we’re experiencing that now — you often see the best of humanity. I’m a glass-half-full person. I’ve seen the worst, but I’ve also seen the best. Whenever there’s a crisis in the world, it’s joyful to see people helping other people. It’s a beautiful thing to experience. It’s extremely touching to see and experience firsthand,” she says.

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“I wish humanity would see that. We’d all be better for it.”