We liked science and wanted to help people. “I’ll help people,” we said, “I’ll be a doctor. I’ll do no harm and try my best.” We studied and studied and were terrified on our first months on the wards. Finally, we made it. We passed through medical school and residency. So early into the excitement of our careers, the virus has come, and we are scared. Everyone else is staying home and sheltering in place, but we have to continue our lives, working and taking care of patients. We hide our true stories from our families, from our babysitters- so they don’t abandon us. We practice our lines when people ask, “How is the hospital?” so they don’t run away from us. We consider what it would be like to isolate from our kids, and it would be too unbearable for them and us. We take our chances, but we worry every day. The anxiety sets in, bringing us to tears some days, worrying about the night shifts, unsure if our PPE is enough. *** We walk through the COVID ICU watching human suffering. We balk at the racial divide between the COVID and non-COVID ICU. We have seen suffering before, but we have never seen it like this. We have never seen those screaming, yelling at the top of their lungs for water. We have never had to deny water for days to those so thirsty because they would die if they took their breathing masks off to take even one sip. We have never had to let the family and patient know it is time for the tube and know with such certainty that they only will have a 50 percent chance to live. *** What do we say? We want to say you’ll be the lucky one. You are healthy. You are young. You will be lucky. But instead, we say, “I’m sorry, please have your last hug with your mom. We don’t know when and if you will be able to talk again.” You ask how long she will need the tube, we don’t know, but we know it will likely be weeks. We know it will be a long time, and during that time, your mom will be suffering. She won’t be able to move her body or breathe on her own because she is too sick. We have to paralyze her because it is the only way to keep her alive. We have to put her on dialysis because her kidneys don’t work anymore. We pray that another patient does not need the dialysis machine before your mom because we only have one left. We have to talk to you about what the end of her days should look like because this is the virus, and it will take another. *** Some of us ask you, why didn’t your family get vaccinated? You didn’t get vaccinated not because you were angry, not because you wanted to get sick. You didn’t get vaccinated because you were busy working all day long without insurance, without a sick day, without vacation. You didn’t get vaccinated because you and your household of ten are barely scraping by. You didn’t get vaccinated because you can’t read or speak English or use a computer. You didn’t get vaccinated because you are terrified of putting your name into the system, because you are undocumented and you can’t trust anybody. *** Now we ask you to let your mom die peacefully. This is the end, we say. “How do you know?” you ask. We say for certain we know, this is the end, please stop her suffering. You say OK, and we let your mom pass. But then we go home and cry because we don’t know if we did enough. We don’t know if we could have done something differently, and we think about your mom for weeks. *** Sometimes all of us wish we didn’t like biology; we didn’t want to “help people.” Now we feel naïve because we carry a burden we didn’t intend to. We carry the weight of the lives lost; we carry the weight of seeing society’s problems and inequalities on the hospital ward. We carry anger at those who choose not to get vaccinated; we carry anger for those whose life burden is too great even to consider getting vaccinated. We wish we weren’t a doctor for most of the time these days, and we wait for the joy to return to medicine. Jessica Kim is a hospitalist. Source
