After they graduated from high school in North Carolina, Guillermo Vargas and his brother Jonathan wanted to join the Marines. The Mexican immigrants were prepared to serve the U.S. by donning military fatigues and battling enemies overseas.
The Marines turned the Vargas brothers away, Guillermo and Jonathan say, because of their immigration status. Born in Mexico and brought to the U.S. as children without documentation, the brothers were approved for a program that shields kids like them from deportation. But the program doesn’t confer all the rights of citizenship or permanent legal residency.
So today, the brothers serve on a different front line – in the battle against COVID-19. Guillermo, 32, and Jonathan, 30, are both registered nurses in the intensive care unit at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.
Instead of wearing camo and carrying military-grade weapons to battle flesh-and-blood enemies, the brothers don personal protective equipment – disposable gowns, gloves and masks – to protect themselves against the highly transmissible novel coronavirus.
The daily battle they wage while providing treatment to COVID-19 patients in the ICU exacts a heavy emotional and mental toll on the brothers.
Several times, both siblings have cared for patients over a period of weeks, getting to know them and the relatives who call to check on their loved ones. Some COVID-19 patients have briefly improved, only to quickly deteriorate and die. “It does feel like you’re in a never-ending battle, the way the pandemic is going right now,” Jonathan says. “You’re fighting for people’s lives, and patients keep streaming in. We’re exhausted, we’re tired, we’re mentally burned out.”
Jonathan recalls being present as another nurse held an iPad so a COVID-19 patient near death could speak to his relatives one final time. “It was pretty difficult,” he says. “The patient was taking his last breaths surrounded by strangers.” Watching COVID-19 patients die without the company of loved ones “is one of the hardest things we do,” Guillermo says. “The first thing you think about is your family. You think ‘this could be my mom, my dad, my brother.’ It’s very sad.”
In the first weeks of the pandemic, Wake Forest Baptist didn’t allow family members to visit COVID-19 patients because of the highly-transmissible nature of the virus, the brothers say. Forsyth County, where Winston-Salem is located, was then among the handful of counties reporting the highest number of novel coronavirus cases in North Carolina. The rate leveled off, more or less, during the summer. Cases are now rising again: In the medical intensive care unit where the Vargas brothers work, most of the 32 beds for COVID-19 patients have been filled in recent weeks. Overall, the hospital has about 70 beds for COVID-19 patients; officials can increase or decrease the number of COVID-19 beds, depending on the need for them, a Wake Forest Baptist spokeswoman says.
Stressful Immigration Status
The two siblings spent their early years in a poor area in the state of Puebla, Mexico. In 2002, when Guillermo was 14 and Jonathan was 12, they were brought to the U.S. The brothers joined their father, who had immigrated to North Carolina earlier to escape grinding poverty. They learned English in North Carolina public schools.
In 2012, the Obama administration created the Deferred Action for Childhood Arrivals program through an executive order. The immigration policy allows some young people who were in the U.S. without documentation after being brought into the country as children to obtain deferred action from deportation and apply for a work permit. Under the program, DACA recipients – known as “Dreamers” – could renew their status every two years.
After the Marines turned them down, Jonathan persuaded Guillermo to consider a nursing career. Before the advent of DACA, Jonathan initially wanted to go to medical school but couldn’t find a path because of his undocumented status. So he decided to go to college to study nursing and coaxed Guillermo to give it a try. “It was one of those professions where you’re almost guaranteed a job after graduating,” Guillermo says. “I couldn’t afford not to work.”
They both graduated from Guilford Technical Community College with an associate degree in nursing and began working at Wake Forest Baptist in 2016. Despite the strain of treating seriously ill patients during a pandemic, the brothers love their job and are glad they went into nursing.
“It’s a very rewarding career,” Jonathan says. “It can be highly stressful, but when you see patients who were on the brink of death get better and walk out of the hospital a couple weeks later … that’s very satisfying.”
The ICU: Taxing – and Rewarding – Then and Now
Working in the ICU was challenging even before the pandemic. Prior to the arrival of the novel coronavirus, the brothers provided care to patients with a wide array of conditions, including respiratory problems and gastrointestinal bleeding. “Our busy season used to be during the flu season,” Jonathan says. “Now it’s all year long.”
Guillermo echoes his brother. Before and during the pandemic, Guillermo says he’s seen recoveries that he considers miraculous. Over the summer, one COVID-19 patient survived more than three months in the ICU. “He was a very sick man, and he made it out,” Guillermo says. “I’m a Christian, I can’t save people, only God can do that. But it feels good to contribute a tiny bit to helping someone not die.”
Both brothers say they also get satisfaction from helping Spanish-speaking Latino patients and their families. Some patients and their loved ones show their appreciation without saying a word. “They see a Hispanic nurse come in and speak to them in Spanish, and their faces light up,” Guillermo says.
The brothers’ manager, D. Scott West, nurse supervisor at Wake Forest Baptist, praises their work. “They are excellent critical care nurses who are well-respected by their team,” West says. “Jonathan and Guillermo are leaders in the medical ICU, and they have done fantastic work to support the community during the COVID-19 pandemic.”
Immigrants’ Valuable Contribution to Health Care
Immigrants like the Vargas brothers comprise a key component of the nation’s health care workers – and the fight against COVID-19, says Hanna Siegel, managing director of New American Economy, a bipartisan immigration and research advocacy group.
There are more than 2.8 million immigrant health care workers in the U.S., who account for more than 16% of all such employees, according to an NAE report. Of the approximately 660,000 people with Dreamer status, about 62,000 are health care workers, according to another NAE study.
The future of the DACA program – and the Vargas’ brothers ability to stay in the U.S. – is far from certain.
In June, the Supreme Court rejected an effort by the Trump administration to dismantle the program. The narrow ruling said the administration has the right to end the program, just not in the way it was trying to. Some legal and political analysts believe Trump could try to end the program again if he wins a second term. Trump has expressed sympathy for Dreamers, but has not proposed a solution.
Guillermo and Jonathan both worry about the threat of deportation.
“It’s been really hard,” Jonathan says, adding that his mental health has been strained since 2015, when Trump called Mexican immigrants rapists and drug dealers while announcing he was running for president in the Republican primary.
The brothers are very close, bonded by their shared experience as Dreamers, their closeness in age and the fact that they typically work the same shift in the ICU. When they visit their parents, they usually go together. In separate interviews, both brothers said they can tell whether the other is having a particularly stressful work day without talking. They can tell by visual cues, like body language or the look in the other brother’s eyes.
Jonathan, his wife (who is also a nurse at Wake Forest Baptist) and Guillermo often talk with each other and colleagues about the challenges and strains of being a nurse in the pandemic. “We have a pretty good support system,” Guillermo says. “Sometimes you just need to vent.”
Jonathan and his wife, who is an American citizen, are expecting their first baby in January. “That adds extra stress,” he says. “I don’t know if I’m going to be here with family. If I get deported, what am I going to do with my baby, with my family? We can’t plan ahead, we don’t know if we’ll be here (long term).”
To minimize the chances of becoming infected with the virus and bringing it home to his wife, Jonathan is vigilant about his use of personal protective equipment and mostly stays home when he’s not at work or visiting his parents. The couple also uses prodigious amounts of hand sanitizer. “We haven’t been to a restaurant since the pandemic started,” he says.
“We have to cope with it as best we can,” Guillermo says. “We can’t afford to be thinking about this when we’re at work. People’s lives depend on us.”