It feels odd to have family members in the hospital regularly again. My patient’s wife approaches cautiously; for a second I pretend not to see her. She looks like she wants to talk and I’m afraid she wants good news I can’t give, promises I can’t make, and time I don’t feel like I have. She wants time to tell me her loved one’s stories.
Her grip on my hand is tight. Almost as tight as the elastic on the oxygen mask stretched across her face, digging furrows into her thin, sallow skin.
“Every one of these patients should terrify you,” the fellow said. I thought he was just being dramatic.
Thinking back to January 2020, I recalled the whispers throughout the hospital of the first confirmed case of COVID-19 in the United States, mere minutes from my home institution. Aside from my perspective as a pediatrician, I was also forced to confront my own anxieties regarding exposure to this virus as an adult living with repaired congenital heart disease.
The novel coronavirus pandemic (COVID-19) has drastically increased the number of critically ill and dying patients presenting for hospitalized management of dyspnea, acute respiratory failure and other serious complications. The emergence and spread of SARS-CoV-2 has created unprecedented demands on all avenues of inpatient hospitalist medicine. One of the many services in high demand includes palliative care, with increased need for complex end of life planning.
On the morning of January 6, I awoke ecstatic to the news of Reverend Raphael Warnock and Jon Ossoff’s predicted wins in the Georgia run-off elections. To be frank, I have become hesitant to hope while inured by the near-daily attacks on civil rights by the Trump administration via executive orders and federal policies. Over the past four years, I witnessed with pride — but also fear — as community activists tirelessly organized to combat racist policies.
Above all else, do no harm. This is a basic tenet of a physician’s oath, but this oath does not always align with the religious and cultural beliefs of each patient. In cases where beliefs of faith, salvation or religion play a major factor in a patient’s desire to commit suicide, it can be difficult to draw the line between the traditional ethical guidelines of patient autonomy and non-maleficence.
In my home city of Washington, D.C., citizens have taken the changes brought on by COVID-19 very seriously; social distancing, masking and frequent hand hygiene are now routine. These days, I am startled when I see the bottom half of someone’s face out in public. Our homes have become our sanctuaries. In the hospital, however, much of our work continues unabated. Orders are written, notes are signed, lab work is drawn, imaging is performed. Housestaff are on the front lines with nurses, respiratory therapists and patient care technicians taking care of the sickest patients day-in, day-out.
Earlier in February of this year, before COVID-19’s onslaught in London, UK, I was covering service on a respiratory ward when a young medical student made herself known to the physician’s office. “Could I borrow your stethoscope? I’m here to practice my respiratory examinations.”
When the pandemic hit, many psychiatry departments across the United States had to rapidly adapt and respond in innovative ways to serve the needs of their patient population. After an initial struggle, many found a platform best-suited for this need and transitioned to telepsychiatry as a way to see and treat patients.
I first met Ruth in the emergency department when I was a third-year medical student on my psychiatry rotation. She was an “elderly female with psychosis — medical workup negative.” My resident had received a page with a request for her admission and sent me to the ED to speak with her first.
I am a 25-year-old resident physician of anesthesiology /
My sister and I are bonded by genetics, anatomy and biology /
I am a senior in high school at age 18. / My sister and I are bonded by love and everything in between.