Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How far are you willing to go to survive COVID-19?

Jenny Hartsock, MD
Conditions
April 4, 2020
106 Shares
Share
Tweet
Share

As doctors, we know how this disease progresses. We know the prognosis for patients who need to be on a ventilator. We know that if we have a cardiac arrest during the course of COVID infection, our prognosis gets much grimmer. Faced with this knowledge, how do you decide how far you are willing to go to try and survive?

If you had to be intubated on a ventilator, would you want CPR performed? Would you want intubated at all for that matter? From studies I read out of China, patients with a need for CPR during COVID hospitalization had a mortality rate of 86 percent. That’s bleak. You take that, and add in the fact that in the U.S. we have drastic shortages of personal protective equipment. This means the people we ask to perform CPR on us have a much higher risk of getting infected themselves. Seen in this life, CPR becomes a measure that seems selfish, even reckless. I’d say it even is immoral to ask for CPR under these circumstances.

On the other hand, if you couldn’t wean off the ventilator after let’s say 3 to 4 weeks, but were neurologically intact, without other severe organ failure, would you get a tracheostomy and percutaneous endoscopic gastrostomy? Without even taking COVID into consideration, we’ve all seen our share of tragic patients who’ve been trached and pegged. Not to mention, again, that this also exposes your health care team to more risks. The surgical procedures themselves, and the care of the trach thereafter, mean more people would be at risk for contracting COVID.

I find myself struggling with this decision. I’m a hospitalist doctor, age 38 and obese, but otherwise healthy. Since this is an acute infection, as opposed to a chronic terminal illness, that factors heavily into my decision making. I think that if I had a chance to recover, I’d be willing to take that chance, and I would undergo the trach and peg.

Obviously, this assumes that we have enough vents and resources to treat everyone. That will vary significantly based on where you reside, and the prevalence of COVID in your local community.  Take New York City right now: We know they lack many resources. The severe absence of PPE there is going to play into clinical decisions. Without adequate PPE, how can we ask health care workers to perform CPR? They would be much more likely to acquire the infection themselves by doing so. Not only that, but ventilators are becoming more scarce by the day. Isn’t it morally wrong to continue ventilator treatment if someone isn’t improving as you have more and more new acute cases piling up every day? Many hospitals are developing protocols to help doctors make these difficult decisions.

How much do our belief systems play into these complex choices? I am an atheist myself, and that weighs heavily on me as I contemplate life and death. In my belief system, dead is dead, and for me, that means that I find myself willing to endure more suffering if there is a chance I could survive. But at what cost? If survival means chronic vent dependency, then count me out. If it means chronic debility and inability to continue to practice medicine, then hell no. How much are we willing to sacrifice for a chance at continued life?

I think in general, if I were to be one of the unlucky physicians in need of ICU care, I would put my trust into my fellow doctors. I would ask my husband to defer to their judgment. If they feel a certain measure would be futile, then I would want my husband to follow their recommendations. We need to place our faith in each other as medical professionals and human beings.

Jenny Hartsock is a hospitalist who blogs at Doctor of a Certain Size.

Image credit: Shutterstock.com 

Prev

My uncle's battle against COVID-19

April 4, 2020 Kevin 0
…
Next

From a physician to our leaders

April 4, 2020 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
My uncle's battle against COVID-19
Next Post >
From a physician to our leaders

More by Jenny Hartsock, MD

  • We are all out of ideas for how to convince you to get vaccinated

    Jenny Hartsock, MD
  • Physicians who work themselves into the ground have nothing to be proud of

    Jenny Hartsock, MD
  • We are losing the COVID-19 war. Here’s how we can turn the tide.

    Jenny Hartsock, MD

Related Posts

  • How to get patients vaccinated against COVID-19 [PODCAST]

    The Podcast by KevinMD
  • COVID-19 divides and conquers

    Michele Luckenbaugh
  • State sanctioned executions in the age of COVID-19

    Kasey Johnson, DO
  • A patient’s COVID-19 reflections

    Michele Luckenbaugh
  • Starting medical school in the midst of COVID-19

    Horacio Romero Castillo
  • COVID-19 shows why we need health insurance

    Jingyi Liu, MD

More in Conditions

  • The unjust reality of racial disparities in pediatric kidney transplants

    Lien Morcate
  • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

    Teresella Gondolo, MD
  • The power of coaching for physicians: transforming thoughts, changing lives

    Kim Downey, PT
  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

    Yuliya Malayev, DO, MPH
  • Nose-brain connection: The surprising link between allergies and mental health revealed

    Kara Wada, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Catching the Optimal Amount of Z's May Be Protective Against Long COVID
  • Treating Early Hospitalization Blood Pressure Deemed a No-No for Patient Safety
  • Addressing Burnout in an Invisible Part of the Health Workforce
  • Family-Oriented Sedation Protocol Helps Kids With ASD Manage Routine Healthcare
  • Bariatric Surgery in Kids With Obesity Becoming More Common

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...