“She wanted to see his face. She wanted to see where the tubes were going in. She wanted to understand what was being done.”
Palliative care physicians specialize in easing suffering—their job is to support patients and their families as they manage serious illnesses. They know the value of making time for compassion in the midst of a crisis. These days, palliative doctors and nurses are being called into hospital emergency rooms more and more to help the doctors manage the crushing numbers of COVID-19 patients facing intubation on life-support systems and, often, death.
So it’s important that we include as many other members of the team as possible to hear how we have these very difficult conversations. On Sunday I was in a Queens hospital, which is really the epicenter of the epicenter. I was doing a lot of these calls, and I brought in with me the ICU nurses. There are a lot of other physicians rotating through the ICU, like a dermatologist, a surgical oncologist, and a couple of other residents who normally aren’t even in the hospital.
A good way to do [a call] is to first say, “We’re just calling to give an update.” The first thing they think when they see a hospital ID is that their loved one has died, so we want to make sure that we let them know that this is not yet an emergency.
I had another patient who was beginning his dying process. A 52-year-old man, otherwise perfectly healthy. He had a wife and a daughter, and I called the wife to see if she would like to do a telehealth visit with him, and she didn’t. [Then] I did a video visit with the daughter. The dad was paralyzed with the medications and sedated heavily and on a breathing machine, so all she could see was his back and then all these tubes coming out. She asked if I could show her the breathing machine.
It’s hard. It’s really, really hard. We haven’t really had a lot of time to process it. Some of us are together on a Slack chat group. And some of us kind of support each other through WhatsApp. And we debrief and sometimes share how hard things are there. But there hasn’t yet been time for that.
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