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.
My husband was a 53-year-old man who worked full-time as a mental health aide. He was a hardworking man, with shifts from 3:30pm to 12am, and was very dedicated to his patients. He was on the frontline caring for COVID-19 patients. I work as a nurse at the same hospital during the day shift.
This elderly yet jolly gentleman answers our unending questions about his physical health, but it is his question to us that makes me pause. Do I have time for a poem? This busy clinic day, I stop reflecting on why his heart stopped beating and instead what motivates his heart to beat in the first place.
As I enter rooms filled with aerosolized forms of the coronavirus, realizing that I am at high risk of catching this highly contagious disease, I set aside my fears to hold the hands of patients — strangers and friends, all alike. I love what I do.
When I first met Rita, she didn’t make things easy. She fired a barrage of questions at me, punctuating her litany with the dreaded blow to every resident’s ego — “Are you a student?” — before slouching back on her bed, sweat glistening on her gray-streaked temples as though she had run a marathon.
As I check in on my patients each morning, I wonder if some will unexpectedly decompensate and die over the coming weeks. I think about myself and my co-residents who are in the hospital all day swabbing patients for COVID-19 without adequate personal protective equipment. Many of my co-residents are on home isolation as a result of this exposure, waiting for their test results and praying that our government will step up and fund more mask production, or civilians will return the N95s they’ve hoarded, or the set of a TV medical drama will donate their props to us.
Caffeine’s effect waned, stomachs rumbled, attention spans faded after rounding on nine acutely ill patients on university wards. It was nearing lunch. I was the senior resident, so I chose the order in which we saw patients. As we arrived at our last patient’s room, I snapped out of my under-caffeinated daze and realized I had made the rookie mistake of leaving our newest and sickest patient for last.
They said to stop compressions. We all agreed. This baby had no life when she was born, and we had fought for twenty whole minutes with our arsenal of medicine to give her life.
It was 2 a.m. and I was downward-dog in the call room. Earlier during this maternal/child health rotation night shift, I had labored with three other moms in so many different positions that my back felt like it might actually break.
twenty-two nights you kept me awake. i counted / them last night, counted them as i lay on my bed with / eyes propped open, trying everything i could to
Medical training and practice exposes us simultaneously to the beauty and tragedy of life. As a resident, you are thrown into a strange world in which death will often sit as an unwanted companion in the room with you and your patient.