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Wed Jul 22, 2020, 08:14 AM

The New Stability - a piece by a doctor on watching a patient die

This is heartbreaking.

Before 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. It’s 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 I’m 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 didn’t 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.

There is a hall to the unit that’s lined on both sides with glass-walled family waiting rooms. We used to call walking down it “running the gauntlet.” Family members would call out to us, wanting news, reassurance, certainty. Now the rooms sit empty, except for the rare transport worker, resting with headphones on, waiting to be called off somewhere. Unwitnessed, in the stress of the pandemic, the staff has grown more frank and callous, swearing more on rounds. “You earned this,” I hear a nurse yell as she ties a patient to her bed rails. The delirious woman, post-op from a tumor resection, had tugged at a tube draining the wound in her scalp.
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https://www.nejm.org/doi/full/10.1056/NEJMp2016293

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Reply The New Stability - a piece by a doctor on watching a patient die (Original post)
muriel_volestrangler Jul 2020 OP
Jarqui Jul 2020 #1
Frustratedlady Jul 2020 #2
dalton99a Jul 2020 #3
Miguelito Loveless Jul 2020 #4

Response to muriel_volestrangler (Original post)

Wed Jul 22, 2020, 08:29 AM

1. They should make Trump read that at his next Covid conference

- on second thought, he can't read. Maybe someone could try to read it to him.
But then, he still won't understand.

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Response to muriel_volestrangler (Original post)

Wed Jul 22, 2020, 08:39 AM

2. Damn Trump! He should be the one to stand in the room on a patient's last day.

For these "essential" people to take all our places, day after day after day, with no hope of relief in the near future has to be excruciating.

It would do Trump, Pence and the others, who are so arrogant about this horrible plague, good to witness the final hours of one of the hundreds of thousands of victims and be the one to push them into a refrigerated truck because they've allowed the death rate to get out of hand. Only then would they (hopefully) understand what people are going through. Without a good dose of compassion, they will continue to treat the rest of us as disposable.

Deplorable isn't a strong enough word to label them with.

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Response to muriel_volestrangler (Original post)

Wed Jul 22, 2020, 08:56 AM

3. Kick

This is the day you start to turn. What we suck up from your lungs turns frothy pink and then the frank red of blood. We don’t know if your heart is finally failing or if the virus has destroyed so much tissue that this is necrosis, hemorrhaged in your lungs. There are tests, but no one willing to run them — you are too sick, and you have never cleared the virus. No one would ever want to be what you are now: a hazard, a threat, a frightening object on the edge of death. We try not to touch you. We construct our plans for saving you around staying as far away from you as possible.

I tell your husband about the blood. It’s true that nothing else has changed: your struggling lungs, with help, still take in air, your heart, with help, still brags along. “But she is stable,” he asks, barely a question. Why do I lie? “Yes,” I say, “for now.”

I strip in the doorway when I get home, stand in the shower too tired to think or cry. I sing “Happy Birthday” twice over every part of my body. At work I can’t eat, at night I can’t sleep. The dreams I have now have only three themes: gasping for breath; wiping things down; somehow, by accident, being touched by somebody. Did you ever wake in those last moments, or in your sedation did you ever dream? I still wake some days with a small beat like a held breath before the truth of this new world hits me. “Be safe,” say the families I call on the phone with updates.

The morning you die, I don’t want to be there — like most mornings now, when I rise against my whole will and crawl dejectedly into scrubs. I don’t want to be a plague doctor or a hero on TV. Now on the news, White men hold guns and signs that say “live free or die” to protest the lockdown. I imagine what they will look like dying on vents in ICUs staffed by doctors lacking sleep and proper training, soaked in moral fatigue. I imagine what their wives will sound like on the phone as they cry and say “Do everything.” I wonder if these wives will thank me or tell me to be safe.

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Response to muriel_volestrangler (Original post)

Wed Jul 22, 2020, 11:06 AM

4. Futile

1) He can't read anything without bullet points.

2) He rarely comprehends what he can read.

3) There is serious doubt that he can read beyond a 2nd grade level, if that.

4) He has ZERO empathy.

5) The article mentions that it is mostly minorities who are dying, which he would be thrilled to know, if he doesn't already.

If it were up to me, it would be required reading by ANYONE refusing to wear a mask. If need be, I would wall paper their homes with it.

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