The New Stability - a piece by a doctor on watching a patient die [View all]

[muriel_volestrangler]

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