Lily Nong: The human side of emergency medicine

In the weeks before Christmas, Lily Nong was working in the emergency room, mostly aiding patients suffering from COVID-19. As yet another patient was put on BiPAP — a machine to help push air into a patient’s lungs — Nong recalled realizing the severity of the situation.

“I was in the ER. We had a patient transported from their home, and they were positive for COVID. We tried additional oxygen, but they were still decompensating, so we switched to BiPAP, which is the last step before you intubate someone,” Nong said.

While this patient was able to use BiPAP, other patients would not be so lucky.

“After the respiratory team came down and switched them to BiPAP, I could hear her from my desk, calling her — I assume — supervisor, and she was saying, ‘I just used the last five BiPAP machines in this hospital. I have one extra here, but I don’t know what to do,’” Nong said. “Hearing the panic in her voice, seeing the patient suffering, trying to breathe, that’s when I was like, COVID is still here.”

Though they didn’t anticipate a pandemic, Nong did anticipate working in the health care field from a young age. While Nong attended grade school, their mother was attending school to become a nurse practitioner.

“I remember seeing [my mom] work hard to obtain various degrees — progressing from an LPN, to an RN, to a nurse practitioner — all while working full time,” Nong said. “I really admired her tenacity, and I knew that I wanted a career that would allow me to impact a lot of people and work hard.”

Watching “Untold Stories of the ER,” a TV show re-enacting emergency room cases, sparked Nong’s interest in health care, specifically emergency medicine. Now a student in Pitt’s Emergency Medicine program, Nong is experiencing the fast-paced nature of the ER firsthand. 

“I definitely remember watching ‘Untold Stories of the ER,’ a TV show, when I was around 10 years old with my mom while on vacation,” Nong said. “I remember thinking how fascinating emergency care was, and I was drawn to the rapid pace.”

Nong decided to join a student organization — Pitt Student Emergency Medical Services — when they arrived at Pitt. After being exposed to EMTs and paramedics, they found that there was something truly special about this line of work.

“One of my favorite things about EMS is that you’re the first line of the health care system,” Nong said. “You get to see the patient in their home setting, and that’s something that not a lot of health care specialities can say.”

Now the chief of education for Pitt Student EMS, Nong organizes lectures and educational events for club members to attend and keep up with the continuing education requirements for EMTs and paramedics. 

But being a health care worker in times of increased racial tension comes with its own set of challenges. A queer Vietnamese American paramedic student, Nong said they have faced racism “every single day” while on the job.

Nong recently spoke at the Stop Asian Hate protest that took place on March 20 in Oakland. Having heard about the protest through social media, Nong originally planned to observe. When the organizer of the protest, Jake B., talked about how they wanted to make the protest a place for Asians and Asian Americans to share their voice, Nong said they made the decision to speak.

“To be honest, I think I blacked out speaking to the crowd. One of my roommates — who I am very grateful for attending the protest with me — filmed what I said, and I haven’t had the courage to rewatch the video,” Nong said.

Nong said attending this protest meant not only seeking support from a community they’re a part of but also learning ways to help.

“Many speakers talked about how racism is societal, and it is up to everyone to call people out for the daily racist acts they see,” Nong said. “I would love to see more people, including myself, aware of other people’s — and their own — racist behavior, and taking the steps to educate more people.”

Though they have faced racism in health care, Nong said something they love about prehospital care and emergency medicine is that “patients will never be turned away.”

Christina Hogg, their peer and president of Pitt Student EMS, said Nong’s dedication to the club and organization has been “phenomenal,” inviting many speakers to speak at club meetings.

“They got amazing people to speak [at SEMS events] — people love [the speakers] so much,” Hogg said. “They had a wide variety, not just people in EMS — people like physicians, people in other areas of medicine to vary the perspectives that we hear from people.”

While Nong will be applying to medical school in hopes of becoming a physician, Hogg said no matter where Nong ends up, they will succeed greatly. This is, in part, due to Nong’s commitment to social justice issues such as the Black Lives Matter movement. 

Referring to #BlackoutTuesday, a collective action to protest racism and police brutality on June 2, 2020, Hogg said Nong was conscientious of how those around them were affected and tried to do more than just “post a black square and [forget] about it.”

“Lily proves that there are people going into medicine who are going to be thoughtful. Being aware of, either with other professionals or on a patient-provider basis, little microaggressions and things like that,” Hogg said. “Knowing that providers like Lily are going in there and they’re going to be cognizant and provide culturally competent health care is amazing.”

Hogg, Nong and others were preparing last summer for this academic year of Pitt Student EMS. Hogg said Nong was eager and prepared to have conversations about Black Lives Matter and justice with the club members. 

“We had extensive discussion among the board of how we would approach it as leadership and what our recommendations for members would be like,” Hogg said. “A lot of them wanted to go to protests and provide medical help. We discussed, from a legal standpoint, can we advise what medical care they should be giving to people?”

Hogg said that Nong has always been thinking about the best way to support their peers, including teaching club members how to add their pronouns to their names on Zoom. 

Nong has been working as an EMT in their home state of New Jersey since the pandemic started. At Pitt, they will graduate as a paramedic, which, according to Nong, provide the highest level of pre-hospital care.

“As a paramedic, you can do advanced life support, which includes starting IVs, giving medications and advanced airway management, like intubation,” Nong said.

Andrew Bober, another classmate of Nong’s, said he found Nong’s dedication to the health care field incredibly inspiring. A fellow New Jerseyan, Bober got to know Nong when they both participated on the competition team at the National Collegiate EMS Conference. 

“They’re very passionate about EMS, but they also want to climb further. I think what inspires me most about Lily is that compared to them I take the lazy route out, and I’ve never thought [in depth] about med school,” Bober, a sophomore emergency medicine major, said. “But they have continually mentioned med school and how they want to be the highest clinician possible and make choices for their patients.” 

Headed to Boston for the National Collegiate Emergency Medical Services Conference one year ago, Nong fondly remembers the “surreal” experience of pre-pandemic preparation. 

“I remember listening, and [conference organizers] were saying, ‘yeah, here’s what you should do to prepare for COVID, but it probably won’t be that bad,’” Nong said. “And then the day I found out Pitt was moving online for the rest of the semester I was at work as an EMT back home.”

Nong used the word “surreal” again, this time to describe the past year as an emergency medicine student working both as an EMT when home in New Jersey as well as working in the clinic at Pitt.

“Especially during paramedic school with having lectures online but working with COVID patients in the ER … it’s like I’ve been thinking about the EM program for the past two or three years but never did I think that I would be doing it during a pandemic,” Nong said.

Bober applauds Nong’s ability to look at a patient beyond their diagnosis. He said Nong cares about pushing medicine forward and eliminating discrimination in medicine. Even when Nong’s preceptors — the people training them and walking them through the process — said Nong did a great job, the preceptors spoke about the patient in a way that made them seem “like a practice dummy instead of a person.”

“[Lily] went on her first ever cardiac arrest recently, where someone stops breathing, their heart stops — it’s the most acute emergency for paramedics in the field,” Bober said. “They did a great job, got an airway to get vascular access. What struck me was afterwards, how they had so much respect for this patient who unfortunately didn’t make it.”

Nong said they’re excited to continue working in the medical field because everyone truly relies on each other and works together. 

“A patient came into the ER, and his heart rate was really slow, which was kind of abnormal, but even with the low heart rate and blood pressure he had no other signs and symptoms,” Nong said. “​We were able to run some immediate tests and discovered that he was in acute renal failure, leading us to stabilize him before quickly sending him up to the ICU.”

With that being the “first true emergency” they got to work on, Nong said seeing that the team had to take steps right away to avoid potential permanent kidney damage was “wild.” Once the patient was stabilized, Nong said the kidney specialists thanked the ER team for the immediate action so that they could continue working to help the patient.

The collaborative facet of health care keeps Nong on their toes. Nong said even though they wake up at 5 a.m. every day to go to clinical, their classmates and surroundings make it a worthwhile experience.

“Yesterday, I was with my preceptor, who graduated from Pitt last year, so I am actually good friends with them,” Nong said. “It’s cool to see you get to pass that knowledge on, and you’re so close in age but each of you is still teaching each other. I’m surviving because of the connections that I have at Pitt.”