Grief during the pandemic 

With this third surge and our ICUs at zero capacity in Los Angeles, I spent  New Year’s Eve alone at my apartment, recovering from a wards rotation I had completed the night before. No revelry or celebration for me this year.  For months, this virus has been wreaking havoc on our lives and slowly,   then rapidly chipping away at our health care systems. I’ve seen the destruction it leaves in its wake. On my last patient list, sixteen out of twenty patients were COVID positive. Our ward’s census was always at max capacity. 

This December surge laid siege to our hospitals, and consequently, our overall morale. As internal medicine residents, we have become accustomed to getting pulled from scheduled rotations to cover the rapidly expanding list of COVID positive patients in the ICU. We went from two medical ICU teams to three, then four, then five, then six. When I last checked,  only 8 out of 74 patients in our medical ICU did not have COVID. We discuss how exhausted we are, wondering how much more we can take — a shared sentiment of health care providers across the country. It’s been 10 months of this pandemic already, with grim projections for the next few weeks due to holiday gatherings.

I’ve witnessed the grave consequences of this disease both as a physician and a family member. A few months ago, my grandmother was hospitalized with COVID, thirty minutes away from my own hospital, while I was on a wards rotation taking care of other COVID patients. How I wished I could have been there with her, and for her. We didn’t know when she would pass, so we had been FaceTiming her nightly for the past week, sharing stories and saying our goodbyes, unsure if it would be the last time we saw her. 

It’s difficult to face personal family emergencies with the knowledge of a provider. I’ve had multiple conversations with my patients and their families regarding end-of-life care goals and understand the incredibly sensitive situations in which they are placed. You would think it would be easier having had experience in this, but it’s not.

The goal of a physician is to alleviate a patient’s suffering. At the end of life, this sometimes means withdrawing life-sustaining measures and pursuing comfort care, so as to not prolong a patient’s suffering. It’s always a delicate situation when these recommendations are not ready to be heard by families. It’s even more difficult broaching the topic when you know your own family isn’t ready to let go yet. 

One night, towards the end of a 12-hour call shift admitting patients all day,  I got a FaceTime group call from my family, earlier than usual. I knew this one was different. My co-resident came in early so I could drive home to be with my family, socially-distanced and masked. Although we couldn’t comfort each other with hugs, our presence alone was comforting. We Face Timed her for the last time that night — all of her children and grandchildren  — repeating our immense love for her and saying our goodbyes. She passed the next morning. 

I’ve seen so much loss in the past few years during residency, and so much loss in the past year, especially from COVID. When I get a chance to stop and think — a break amidst the toil and mental hardships of working non-stop through a relentless pandemic — the cumulative suffering, both personal and collective, can be unbearable. 

The fear I see in my patients’ eyes, the grief I hear when I tell families their loved one is dying, but no, they cannot come in to see them — it cuts through my soul. Having experienced both sides of this terrible coin — both as a provider and as a family member — neither one is easier. I become robotic to keep moving forward and continue caring for more patients,  sometimes barely caring for myself. Still, when I finally stop, things come crashing down and immobilize me. The weight of human suffering  I’ve been shouldering paralyzes me, and I cry for everyone who’s grieving,  including myself. 

It’s times like these when I incredibly miss my grandmother — the biggest light in my life and the most joyful and benevolent spirit. She always had the most positive outlook on life and knew just the right words to say. I  join all the families who grieve their loved ones, and all the health care providers who grieve their patients. It’s been the most challenging year for humanity in our lifetimes. Grief has been so terribly prevalent in society this year. Let’s take extra care and remember to be kind to ourselves and one another. 

Melissa Chung is an internal medicine resident.

Image credit: Shutterstock.com

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