The desire for human connection is so irrevocably and putatively a tenet of the human condition. The relationships we form with one another are quintessential in adding value to our lives and in fostering loving bonds. And the way we express this connection with one another could be through a multitude of means, whether it is quality time or physical touch.
Moreover, to form human connections is what elevates the work of a physician from solely a job into a profession. The ability for physicians to laugh and cry with our patients, to share in their highs and lows, to hold out our hands to them, to listen to their life story – it is a privilege. These acts build the trust and confidence our patients have in us, supplements how we care for them, and shapes the long-lasting rapport we develop with them. Undoubtedly, the COVID-19 pandemic had affected the way we interact with our patients. From telemedicine to mask-wearing, the way we engage in communication with our patients has changed.
But more than that, the way the COVID-19 pandemic has severed our patient’s personal support network whilst receiving treatment and medical care has been onerous. Ranging from hospital visitor restrictions and physical distancing guidelines, the pandemic has made it harder for patients to have the support they need in both the hospital and clinic setting. Many times, patients are left alone, without their loved ones by their side. They are left feeling isolated in the medical setting, at a time when it is ever so much more needed.
I have witnessed this issue countless times during the pandemic- from a granddaughter not being able to accompany her grandmother to her doctor’s appointment, being asked to wait outside the building; from a wife not being able to be in the ICU to kiss her husband goodbye before the medical team intubating him because his COVID-19 pneumonia was worsening, instead being made aware of the update over the phone; to the son who can’t bring a home-cooked meal for his dad, who is currently hospitalized.
Additionally, the pandemic has made it especially hard for patients receiving cancer treatment. From deferring preventative cancer screenings to delayed detections of cancer diagnoses and adjustments in treatment protocols, COVID-19 restrictions have effectively altered all facets of how cancer patients are cared for. And most importantly, like many other specialties, patient support has been compromised. From what I’ve seen at my hospital, patients can’t have their loved ones with them during their regular outpatient chemotherapy infusions and no visitors are allowed when a patient is admitted for treatment.
I vividly remember a patient I was caring for on the cancer wards service during the peak months of the pandemic. The patient was just diagnosed with gastric cancer within the last month and was being admitted to start neoadjuvant chemotherapy with FLOT (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel). As I was talking to the patient in her room before starting chemotherapy, asking how she felt and if she had any questions, I noticed that she was quiet and terse. She kept looking down at her fingers and twiddling her thumbs. I asked her if anything was wrong.
There was a pause and then she looked up. She told me she was scared. She thought her family would be able to be here with her during her first cycle, but because of the new policy, they could not come into the hospital. She confessed that she considered postponing her admission until the restriction was lifted. To have to face such an ordeal alone was so distressing. After that, she looked down at her hands again.
“I’m so sorry about all this” was what I told her. I told her that I couldn’t imagine how hard this must be and that it was unfair her family couldn’t be here. I told her that if we had it any other way, her family would be here with her right now. And thus, I promised her that I would do all I could to make this process as seamless as I can for her. I would try to find her a tablet that the hospital started loaning out during the beginning of the pandemic so that patients can video conference with their loved ones. I told her that if her family members called to the unit, I would let her know and try to connect them to her room. Even if the physical touch was impossible, I would make sure she still had the comfort and support of her family members by her side through their voices and their faces.
She breathed a sigh of relief, raised her head, and our eyes met again as she said, “alright.”
Aside from the medicine and science, social relationships are inextricably intertwined in patient care. The rapport we foster with our patients is as important as the personal connections our patients have with their loved ones. It impacts the way they approach their illness and their treatments. It affects the confidence they have in fighting their ailments, such is the case in cancer care. The COVID-19 pandemic has strained the ability for patients to have their loved ones alongside them during their medical journey. And so, the medical community has to work with ingenuity to attenuate this issue to improve our patients’ lives and livelihoods.
Nghia Pham is a family medicine physician.
Image credit: Shutterstock.com
