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Showing Original Post only (View all)The heartbreaking view from the front lines: [View all]
https://www.nejm.org/doi/full/10.1056/NEJMp2016293Before I become your doctor, you have been intubated for weeks. I am a point in time, unattached to the greater narrative. I call your husband each afternoon, tell him you are stable. He asks about the medicine that props up your blood pressure. He calls it the levo, acquainted by now with the slang of intensive care. Its true, we have pressors to assist your failing heart, a ventilator to breathe for you, venovenous hemofiltration to do the work of your kidneys. Your wife is very sick, I say, but stably sick. None of this is anything new.
Your name is a poem Im required to keep to myself. Who were you before the virus, before you were this this list of failing organs run in despair by a repurposed trainee neurologist? Do you have children who smile at the sound of your voice? What was the last thing you were allowed to tell them, before you came alone into the hospital, before the breathing tube, the drug-induced coma?
Thirty days before I met you, we didnt wear masks in the streets or in the halls of the hospital. The CDC said they were no use. Back then, the federal government had few plans for facing the pandemic other than sitting still and hoping for the best. True, the masks and antiviral wipes had vanished from the floors, and the residents were told to sanitize our workstations with inch-wide alcohol swabs, and the international news showed helicopter views of mass graves in Italy and Iran. No one, we were told, could have seen this coming.
When the code is called out overhead, your code, I shrink and stall, and move through thick air, slowed as in a dream, nurses and other doctors pushing past me, throwing on respirators and face shields and gowns. By the time I get there, the room is full. With my arms at my sides, I watch through the glass. I have never mattered less in my entire life. I watch your feet kick to the rhythm of compressions. They use a machine the thumper, they call it, a joke, almost, to space us from the horror of it all. Staff in yellow gowns stand around your room, waiting to see if they are called inside. And this is how you die, near no one who ever loved you, a spectacle of futility and fear. Time is called, and someone calls your husband, and it isnt me. I am not the one who hears him cry out in grief. Forgive me if I am grateful.
What else is there to say? You are dead, like so many others, and the rest of us are left to live in the absence of any certainty. We cant go on, and we go on: back to work, back to rounds, back to the next case coming crashing in. It is no use to think about the future, our training, or what happens next. We are all attending now to a historic and global suffering, and learning the limit of the grief our hearts can bear.
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The hospital where my daughter works put a tent up in the parking lot yesterday.
appleannie1
Jul 2020
#9