Doctoring in the age of COVID and the possibility of dying in the near future

On January 19, the first case of the coronavirus in the United States was announced. Initially, COVID cases were detected in Washington. As time elapsed, other states did best to prepare for if and when COVID came to our area. As spring break arrived, my husband, an intensivist, debated the best course of action regarding our vacation. We decided we could not take a vacation with heavy hearts while our respective teams stayed to work. The number of cases rose exponentially in California, and New York, San Francisco, announced shelter in place. It was a situation unheard of in modern times, in this country so accustomed to living life moment-to-moment, precisely as we please.

On March 6, the Indiana State Department of Health announced the first confirmed case of COVID-19 within our borders. The fears were becoming a reality, an invisible enemy had invaded our territory. Each day I leave work, not knowing what the next day will bring. The number of new cases is reduced in my state, but the fear of the second wave persists. At home, my husband and I started frequently checking on each other. Workdays begin and end with “stay safe.” We found ourselves hugging our children more, making sure they know how much we love them. Suddenly hugs are with caution, as they could be a weapon of transmission. Kids inquire about being daily late from work. We have weaved a bedtime story around it: Mom and Dad are “ninjas” who save lives. The evening discussions evolve on health policy, medical advances, and emotional well-being. The questions arise on childcare, passing infection, and ultimately, what if we die?

We have processed our living will, and our family is informed of our last wishes and finance details. Our conversations were around early dreams and aspirations. End of life preparations seem to be like superstitions, but they are the actual reality. The responsibility of the kids in no way jeopardizes my passion as a doctor but makes you vulnerable.

The possibility of dying in the near future left me rattled and heartbroken. The perception of youth invincibility was disappearing. My subconscious already envisioned my last rights. Many questions ran through my brain like will they build a pyre for me: What would I say to my family in past times? I have my message prepared for each of them. These emotions were illuminating, although burdensome. The knowledge of my end furnished a sense of control and comfort. Accepting my feelings added a new dimension to my patient care. I considered myself to be a reasonable physician who talked about the end of life care with my patients. My belief in advance planning grew stronger. I strongly urge my patients to plan and prepare. The planned pyre is an accomplishment while you are losing the battle of life. The COVID pandemic taught me the pursuit of living and planning for the afterlife.

Nupur Gupta is a nephrologist.

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