IN PERSON

I have a wonderful situation. My boss at the hospital is allowing me to work completely from home for the foreseeable future. There are still some technical quirks. A few of our video calls get dropped, have delays, or I am looking at ceiling or floor (or in one case, the wringing hands of a nervous doctor) not to mention that I cannot seem to get out of my pajamas, but I am not spreading the Corona virus. I have zero physically proximate contact with patients, colleagues, or people on the bus. And for this I am grateful.

In each of my video calls, I am looking into a room with a patient. Most are in-patient, lying in a hospital bed. Some are on oxygen. Most have IV’s and other equipment running. Some have COVID. Some are on the cancer ward. Others are dealing with transplant issues, emergency surgeries such as broken bones, and the usual specialty hospital cases that many people haven’t even heard of, like pulmonary hypertension, or severe pemphigus.

Today, I helped a young mother figure out how to use a breast pump. Her baby is very ill and was already sent by ambulance to our children’s hospital. The nurse talked at length about post-partum depression, and how the sadness can last from a couple weeks to even a year, so make sure and tell your doctor in case you may need some medicine to help you for a while. The mother had been regularly wiping her tears with the edge of her hospital gown, carefully avoiding the breast pump parts attached to her. When the mother found out she will be allowed to be at the children’s hospital with her baby, her whole face lit up. “I thought because of COVID,” she murmured. It sounds like she will be allowed to board with her baby at the children’s hospital in some kind of quarantine. The nurse was very happy for her, and reminded her to take care of herself there, almost as an older sister would.

I helped another young man with bone cancer, whose doctor praised him for handling the treatment so well, although he has had terrible foot cramps lately. The doctor told him that every time his foot cramps up painfully, remember that it is the tumor shrinking that is making his foot adjust to having more space for its healthy tissue. Yay, foot cramps! Woohoo! We are winning! The cancer is shrinking and dying! You are going to make it through! The doctor was exaggerating her gestures to compensate for having to talk through a mask and via remote interpreting, so she was shaking her fist in the air at the tumor and saying things like “Die, tumor, die!” and making punching motions. The patient smiled and then giggled and so did the doctor, and so did I. It was a sweet moment.

My patients typically relate to staff through their family members, but now they are not allowed to have anyone present with them, no matter how sick they are. Even if they are dying. Even if they are birthing. It sounds so terrible, and of course it is for the patients involved. But this state was an epicenter and our trend is going down surprisingly, lower than all our predictors, and lower than all the other states at this time. Many other states are way up off the charts by comparison. We may even have enough hospital beds for our expected peak in mid-April, at least with current calculations. So there is a sense of cautious optimism. But we are doing it by avoiding each other.

Each patient is now an island. And it can be such a lonely, scary place to be ill and alone. Yet what I have been witnessing in the video remote is that our doctors, nurses, assistants, physical and occupational therapists, social workers, spiritual support, respiratory therapists, and others are filling in the gap left by the absent families. Of course staff are worn off their feet, concerned about their own health, and anxious about the future, but it doesn’t show in the encounters I have seen. They are being patient, warm and concerned in all the encounters I have observed.

For most of our patients, it is the first time they have ever been alone at the doctors. Everyone drags someone along – a teenage son, a second cousin, the husband’s aunt, even a neighbor. Going to the doctor simply isn’t something you do on your own. Patients take great comfort in “strength in numbers”. They feel less vulnerable. In a typical visit, the patients often answer a question by first catching the eye of a family member, questioning how and whether to answer, or directing the family member to answer for them. It must be quite scary to suddenly have to confront staff all alone, with everyone masked and cloaked, and the interpreter on a distant screen.

It has been heartwarming to see that now that patients are “trapped” in the hospital alone, with zero family members allowed to visit, much less stay, these patients are finding a new, perhaps unexpected safety net in the caring staff, kind nurses, thoughtful doctors, and general sweetness of care being provided at this time of crisis. I felt so happy to see these smiles and hear these words of comfort while interpreting today. I have never seen a doctor with her fist in the air yelling, “Die, tumor, die!” but it really brought a smile. And I do believe she was trying to make up for the family absence and the fear by revving up and getting dramatic, and it brought a sparkle of joy to the patient.

Back to the doctor who angled the video remote camera so he showed me only the hands he was wringing. I told him several times that I could not see our patient, but he was unable to adjust the angle, so I dropped it. The patient sounded like an elderly lady who was recovering, perhaps from COVID. She had just come out of Intensive Care and off the respirator, seemingly on a path of rapid improvement. After a long and stressful week of uncertainty, something about watching his wringing hands while hearing their disembodied voices was so delightful, and the off-screen patient was the most delightful of all.

So how have you felt since I saw you yesterday?

Fine, thanks be to God!

How is your pain?

It is quite bearable, praise God! But the pain medicines have caused some – stoppage – you know, doctor. The nurses told me it would. I am taking juice, powders and such. God is great, it is all in his hands.

Oh, yes, these heavy narcotics can cause constipation. I will let the nurses decide how best to manage that part of it, so I will leave you in their hands.

Yes, and you leave me in the most capable hands, indeed! May God keep and protect your nurses, dear doctor, because they have treated me like a queen! So attentive, always caring and kind. They treated me as precious as they treat the eyes in their own face! I couldn’t ask for more, so blessed as I have been here! God is great!

The doctor went on talking about weaning her off the oxygen, and continuing some of the medicines to deal with secondary infections, and her latest blood test results. It was not all good news, but the lady was simply exuberant. Off the respirator! Indeed, God is great in his mercy and kindness. Then she gave a prayer beseeching God to keep the doctor and his family safe, so they could continue to do the important work of caring for the community. “May God keep you and protect you in the overwhelming immensity of His Hand, and keep your loved ones safe, dear Doctor!”

The doctor’s hands suddenly stopped moving as he interlaced his fingers. His chin bobbed down into sight momentarily as he nodded his agreement with his elderly patient.

“Yes,” he assented. “Yes, thank you, and you and yours as well, my dear.”

I rendered “my dear” as “my love” in the target language, because it conveyed the actual meaning. These two human beings, so far apart in their usual daily experiences, now alone together on this COVID island bedside, really were exchanging words of love and comfort. And it makes me so happy to see it. I believe these encounters are a healing for all concerned.

Hats off to all the healthcare workers still attending at bedside in person at this time. May they have enough equipment. May they stay healthy. And may they continue to give excellent healthcare along with a much needed dose of comfort, as they meet these isolated patients whose lack of family presence is a constant, aching burden upon them. And wherever we find ourselves upon this lovely, spinning globe we share, may we remember our shared goal: that when we reunite, we will have the absolute minimum of missing faces in our circles of loved ones.