When I look at his big blue-gray eyes, I see fear, sadness, resignation, and what only I can recognize as an attempt to reassure me. I can faintly make out small areas of moisture at the corners of his crinkled eyes, while I see him struggling for both words and breath. I can barely hear him over the beeping of machines next to him, screaming an alarm, that some parameter is out of order.
But I am not sitting next to my father, holding his hand, comforting him, as I had imagined this moment would be like when it inevitably arrived. I am looking at him through a telephone video screen. My entire world, at that moment, is behind 4.6 inches, bobbing back and forth, while the physician holding the phone communicates with both my dad and me. This is our “opportunity” to say goodbye, since the prognosis is grim. I’m not able to whisper to him, tell him I love him, tell him that all will be okay while holding his hand, squeezing it as though my life depends on it. No. I am speaking much more loudly than I typically would, yelling practically, via speakerphone, “I love you, Dad! Hang in there! I will see you on the other side of this!” It sounds so unreal, so inhumane.
As an emergency physician myself, I am also acutely aware of the pressured speech of the staff and doctor attending to him – the audible angst and impatience to wrap up this video call and get on with the business at hand – intubating him and placing him on a ventilator. The staff is anxious to get this procedure done as quickly as possible before he deteriorates further. Worsening of his condition would require even more aggressive resuscitative efforts, and therefore, more exposure to this vapid invisible virus.
I feel pressured to end the call, to let them proceed with what needs to be done. I tell my father I love him one last time, blow him kisses, and end the call. I am in despair. I try to console myself that my father has had a tremendous life, full of family, friends, and scholastic achievements. What I cannot accept, however, is how terrified he must be there alone amongst strangers and machines. There is no hand to hold, no cloth to wipe his brow, no whispers in his ear that he is going to be okay, no utterances of reassurance.
This is medicine in 2020. COVID-19 has changed everything. The most affected patients are suffering and dying, alone, and in total isolation. Visitors are not allowed, even at the end of life.
Thankfully, my sweet 82-year-old father is still alive. He is doing well at his senior living facility, where all of the residents are on “lockdown.” I am thankful every day when I hear his voice. With every conversation, I strain to detect any slight cough, any subtle sign of illness. And while I worry for him, he is similarly concerned for me. As an emergency physician on the front lines in a busy emergency department, the threat of exposure and illness is real. I haven’t seen my father in weeks, and I will not until this pandemic is under control for fear of exposing him unknowingly.
I am scared, and I am anxious. I am terrified for my family, my friends, and my professional colleagues. It is unfathomable to me that a patient must die alone. It is inconceivable to me that the demands of the health care system might exceed what it can provide, and that I might be forced to withhold life-saving treatment that I could have easily provided just last month.
There is a great debate happening in our nation today as to how to proceed in these unusual times. Will social distancing help flatten the curve? How do we save lives? How do we save the economy? Do we have to select one over the other? I do not claim to know the answers.
What I do know comes from life experience. I have lost a spouse, a parent, and close friends. With each loss, I have painfully longed for more time with each of them, just one more moment.
Businesses can be rebuilt. Things can be replaced. The economy can recover. Time, however, is not without limit. Time is the one thing we can never get back.
Désirée La Charité is an emergency physician.
Image credit: Shutterstock.com
