I don my PPE in the hallway, while the patient is watching the increased commotion outside of their room. They see me enter their room, introduce myself, and then position myself behind their bed. They are covered with a plastic wrap or an intubation box to protect us from their cough and secretions. They feel a burning sensation in their arm as propofol enters, while the nurse is holding it, so they don’t flail. And then their world goes dark. All in under 10 minutes.
I refuse to continue to function like an emotionless automaton.
After doing numerous intubations in the ICU over the past month, I came to one stark realization that my face is the last face that many of those people will see. And it’s not even my face; it’s my eyes, hidden behind a shield, wrapped in a gown, with a mask over my mouth and nose. I can’t help but feel that I’m the Grim Ripper. Once I show up, their eyes close. No last words to a loved one. No wishes expressed. Just the fear of the end. It’s a familiar sight that I’ve seen many times before, but never has it been so palpable and so pervasive.
Over my four years as an anesthesiologist, I’ve become very adept at winning my patients’ trust in a matter of minutes in the pre-op area. I’ve learned to convince patients and their families that they can depend on me, and I will take care of them while they’re at their most vulnerable. But the current pandemic is putting that skill to a new challenge. When I enter the ICU room now, I’m afraid. I’m afraid of becoming contaminated and spreading the disease. I want to be in there for as little as possible, but I must convince my patients that I will take care of them and that they will see their children and grandchildren again. I am their last stand and the last person to offer them hope. To have any hope of surviving the person must first believe that it is possible. I do not take that responsibility lightly. In fact, it’s an opportunity I treasure and take pride in. Too many of my colleagues are proud of the fact that they can enter the room, intubate from the side with the glideslope and come out, all in less than two minutes. What a shame. What a missed opportunity to offer hope and support to the patient and encouragement to the team.
We are scared people treating scared people. Let’s not forget our humanity amid the hell we’re in. We all have hopes and dreams, and we’re all afraid of the same things. I admit that I’m afraid, but I will not let my fear dictate my actions. I have an opportunity and a responsibility to offer them hope and comfort. I am a physician, and I will heal when I can, but I will always provide hope.
Sergey Moldavskiy is an anesthesiologist.
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