How coronavirus took my grandfather’s life [PODCAST]

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“One of the calls you dread making as a doctor is telling a family member their loved one is dying. That was the call I received when my grandfather decompensated. We grow accustomed to making the call as clinicians, but we never expect to get it ourselves.

I felt for his pulse. Slow but faint. As a doctor, you become desensitized over time. You frantically think of the next steps that will save this body’s life, until you realize that body is someone you know.

Death here during this time has no dignity. I’ve experienced a lot in my career by trade. But this one feels particularly brutal. Patients are not allowed to have visitors and often die scared. Someone codes, someone dies, and on you go to save the next life.

A few days later, I prepared to head back to work. I thought about all the patients I treated for COVID, never thinking my grandfather would be one. As I headed into work at around 7 p.m., I hear the sounds of people cheering outside. At that moment, I was no hero. I had just lost a war. And back I went to the battlegrounds that altered my family forever.

Society needs to redirect energy to alleviating the struggles of workers rather than glorifying it. The government faltered, but it is community advocates and organizers of grass-root campaigns that create reproducible change. The fact of the matter is, nobody wants to be a hero right now. We just want to live to see another day.”

Zaki Y. Azam is an internal medicine resident.

He shares his story and discusses his KevinMD article, “How coronavirus took my grandfather’s life.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Zaki Azam. He’s an internal medicine resident, and he wrote the KevinMD article “How coronavirus took my grandfather’s life.” Zaki, welcome to the show.

Zaki Y. Azam: Thank you for having me, Kevin. It’s a pleasure to be here.

Kevin Pho: So we’ll get to the article in a little bit, but first off, can you share your story and your journey to where you are today?

Zaki Y. Azam: Yeah, absolutely. So I’ve always been interested in medicine, for as long as I can remember. I grew up in the Long Island, New York City metro area. That’s where I’ve done most of my training, and that’s where a lot of my focus has been, dealing with people of diverse backgrounds and diverse cases. And I’ve gotten to the point where now I’m a second-year internal medicine resident, and I wouldn’t trade it for the world.

Kevin Pho: We’re speaking in the middle of September. How is the pandemic affecting your training and your practice around you?

Zaki Y. Azam: Yeah, so things are getting, thankfully, a little bit better now. We’re starting to see a little bit more of the diversity of cases that New York City is known for in its training. In the past few months, it’s been COVID only, but now it’s starting to ramp down a little bit, and hopefully, if we don’t have a second spike, it should stay this way.

Kevin Pho: So let’s talk about your KevinMD article, “How coronavirus took my grandfather’s life.” Now, for those who haven’t read your article, can you walk my audience through it and share the story of why you decided to write it?

Zaki Y. Azam: Absolutely. So the inspiration for this stemmed from my training, both as a doctor and then from having it hit home personally for me, at home, where I became a family member and a doctor all at once. So I was doing my training at the peak of the pandemic, in about March of last year. I was working in the emergency room at that time, and that’s the first exposure that you get to these patients. I remember at that time, they were saying there was a cluster in New Rochelle and that it was coming close to us soon. So at any particular point, it wasn’t there yet, but we knew it could walk through the doors. And that sense of uncertainty was something that was mind-boggling to me, because in medicine, there’s uncertainty, but you never expect to be unprepared for it, in a way. I felt unprepared, not just with the materials and the supplies that we were given to combat this, but also just because our knowledge of it was so limited.

And so it started picking up, and we started seeing some of the first cases at our hospital. And it was so interesting and kind of humbling to be a doctor who’s training in this time and in this scenario, where there are so many unknowns, and also to be able to comfort family members who are also dealing with the same unknowns that we are. And so I got to experience that, being at patients’ bedsides. And because the death toll was so high during that time, it kind of struck me as odd: Codes would go off on the loudspeaker in our hospital maybe every 5 to 8 minutes, which was completely unsettling for me.

And I was experiencing so many deaths. One day, I took a moment and I stopped. I was standing next to a patient’s bedside, and I said, “I think it’s time that we take an extra minute or two out of our day to be by the side of these patients who don’t get to have family by their side, who don’t get to have any sort of communication with the outside world, and to be that factor for them, be that family member, or be that loving hand.” And so I started doing that, and I started offering prayers and condolences for whoever may be going through this, because I knew that this was such an unprecedented time.

And then, sadly, it became something that I experienced at home. One day when I was off, my grandfather was also coughing, and I had to put that mental doctor mindset back on, not just from the grandson perspective but also from the doctor perspective. I had to check his pulse ox, had to check his breathing, make sure he was OK. It was, I think, such a unique perspective, to change my understanding of being a doctor in the hospital setting to becoming that same persona as a grandson for my own family. And that’s when it hit home for me.

There were so many emotions that I had to go through, so many trials and so many things that I would have never expected I would have to go through, and I did. And that’s where the inspiration for the article came from. It was my raw emotions, my stream of consciousness of everything that went on, and the peculiarities of dealing with it in such a time. You come home and you want to share your experience of just being with your grandfather and caring for him, but you’re not able to hug other family members, because you have to make sure that they are safe as well. You have to make sure that you are able to clean yourself off in a protective way, make sure you have the protective equipment, and not expose other people.

Kevin Pho: How did you manage that? How did you manage what was going on at the hospital with what was going on with your family at home? That must have been a tremendously difficult time for you.

Zaki Y. Azam: It’s such a delicate balance, honestly, because you have the professional attributes that you kind of have to separate from the personal anxiety and emotions. And I know plenty of my colleagues wouldn’t even have time to cry in the hospital, so they would go home, and that’s when they would let it all out, because it’s so hard to process all of that at work. And so that was the balance for me, dealing with the professional aspects and the personal, and also being able to separate them.

But even in the hospital, in the professional setting, when you’re around patients who aren’t able to see their families, who maybe can only see their families through a 5-inch screen on an iPad or FaceTime, you have to kind of break that barrier a little bit to be that personal side for them. And that’s where that barrier was broken for me at home as well, because not only was it just personal for me, but it was becoming a little bit more professional for me, because I knew I had to do certain things. I knew I couldn’t just keep my grandfather home for a good amount of time. It was time to take him to the hospital, as much as I wanted to keep him away, because I had just seen the horrors of everything that was going on there. And so the lines between the two definitely blurred, and it was a delicate balance, trying to find an appropriate middle ground.

Kevin Pho: What kind of support systems did you have to help you during this time?

Zaki Y. Azam: That’s a great question. So this time was filled with so many unknowns, and people were trying to throw out new things and new support groups that might help. My hospital in particular was trying to throw out mental health resources, trying to highlight some of those resources. I found that some of them were a little bit raw and not really developed, in a sense, and part of that has to do with so many of the unknowns that we were dealing with in that time. But as much as they wanted to throw out resources, and as much as we tried to make resources known, I found that sometimes it was a little bit less organized than you might have hoped during this time. But there were definitely mental health resources, even emotional resources and physical resources, for people going through it. It was just that so much was going on in such a short period of time that it was a little bit unorganized.

Kevin Pho: Can you tell us a little bit about who your grandfather was?

Zaki Y. Azam: Yeah, my grandfather was very humble, very likable. Everyone in the community liked him. He lived his life in the way that he felt was a model for the teachings of our religion. He was a very devout Muslim, and he would live his life based on the Quran and the teachings of the Quran, and everything that he did was modeled on that. He would give to the poor. He would be selfless in every way. On his free Sundays, he would go and help the neighbors landscape their yards. He would be at the mosque helping people, and he lived a very selfless life.

And when he passed away, that was a testament to that, because everyone was kind of shocked, in a way that they were touched by him. They all personally felt close to him, even though they may not have necessarily met him. His teachings and his morals and his values have reached a long way. He wrote books himself. He wrote different treatises and things that people can carry with them, and people may not have personally met him, but his influence and his teachings reach very, very far. And when people found out, they were touched, as if they had personally known him, because that’s the kind of guy he was.

Kevin Pho: We’re talking to Zaki Azam. He’s an internal medicine resident, and he wrote the KevinMD article “How coronavirus took my grandfather’s life.” Zaki, is there something that you’ve learned from this ordeal that you could share with the other clinicians who may be listening to this podcast?

Zaki Y. Azam: Yeah, absolutely. I would say never be afraid to speak your mind. There are so many voices and stories to be shared, and that was my perspective when I wanted to mix my writing abilities with my medical abilities. I always wanted to be a writer. You just need someone to listen. And when you share your voice, people will listen, especially when you share your experiences and the emotion.

Don’t be afraid to share your emotions. Your raw emotions are what make you who you are. Sometimes, as clinicians and professionals, we try to be very stoic and objective and try to hide those emotions, but in a way, that is what makes you unique as a clinician. I think when you share your emotions with your patients or your family or whoever it may be, that’s when you become more personal, as a doctor and as a person. And I think people shouldn’t be afraid to show that.

Also, whatever you may be thinking, you can definitely write about. Writing is a good way to be able to express your emotions and your thoughts and deal with stress, in a way. I remember just coming home the day that my grandfather passed away and just writing everything down, my whole stream of consciousness, thought by thought. It was just crazy, and slowly but surely, that came together, and it became a story that a lot of people wanted to hear. So I would say, don’t be afraid to share that story. There are always people who will be willing to listen.

Kevin Pho: And my final question: Do you have a take-home message that you want to share with the KevinMD audience?

Zaki Y. Azam: Yeah, my take-home message would be just along those lines. Don’t be afraid to be yourself. A lot of times, people have this expectation of what a doctor or clinician may be, or even of you as a person, what they expect of you. But don’t be afraid to share who you are as a person, and to contribute that and involve that in your professional life as well.

I think sometimes people are afraid of retribution and what can happen if they talk about certain things. Especially during the pandemic, a lot of people were afraid to talk about the inner workings of what they saw in the places that they worked at. But at the end of the day, you’re sharing what’s going on. You’re helping family members, you’re helping other people understand what you went through, and you should never shy away from that.

Kevin Pho: Well, thank you so much for sharing your story and insight, and thanks again for being on the show.

Zaki Y. Azam: Absolutely. Thank you so much for having me, Kevin.

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