He was struggling to breathe. His oxygen levels kept declining, and he needed to come to the ICU to be placed on a ventilator. He had metastatic cancer, and his upper airway muscles were so weak that he kept inhaling his stomach contents into his lungs.
When I saw him, he was skin and bones. He looked exhausted. And what’s more, it was his birthday. He turned 85 that day. I really didn’t want to give this man — who clearly was dying — a birthday gift of jamming a tube down his throat.
And so, after assessing the patient, I had a conversation with his children, the people who, I was told, wanted “everything done” for their father. I explained to them what “everything done” meant: that if Dad goes on a ventilator, he may never come off of it, and it may only make things worse.
The most important question I asked them was this: “If Dad stood where I stand now and saw himself, what would he say?” The answer was clear: he would not want any of this.
And so, together as a team, we decided not to place him on a ventilator. We would continue to fight for him, but if he became worse, we would focus on making him comfortable. He did not go on a ventilator on his birthday, and he died — peacefully, with his family around him — two days later.
One of my biggest fears — almost two years into this terrible pandemic — is losing my empathy, losing my compassion. With death, after death, after death, it’s become much easier to just “swim down” and say “why bother,” not feeling for my patients and how I care for them. So many of my colleagues have suffered from this, and I’m afraid it will happen to me, too.
And with the exhaustion, the exasperation, and the frank anger we are all experiencing with this latest wave of Covid patients — largely unvaccinated and senselessly getting sick and dying — I am greatly worried I will no longer have any empathy left to give to my patients — whether or not they have Covid — who need my care in the ICU.
This case gave me great relief. Had I not had any empathy left, had I not cared at all, I wouldn’t have taken a step back and talked to his children. I would have just put the tube in his throat, place him on a ventilator, start drugs to put him a deep coma and called it a day.
Had there been no empathy left in my heart, I would have simply said, “whatever,” and tortured this poor man all the way to his inevitable death. But, after just one look at him, there was just no way I could do that.
I immediately said, “There is no way I’m intubating this man on his birthday.” And, thank God, we (myself and his family) were able to give this man dignity at the time of his death; we were able to give this man a good death, and I am so happy for it.
This pandemic has broken a lot of things: it’s broken our sense of invincibility as a nation; it has broken our healthcare system; it has broken our economic system; and most importantly, it has broken the lives of hundreds of thousands of people and their families.
The pandemic has also broken the spirits of so many healthcare professionals; it has left them scarred and hurt, angry and unempathetic. I continually fear that I may be one of those broken spirits. Yet this man, who came to my ICU on his birthday, showed me that Covid has not driven away all of my empty; Covid has not completely broken my spirit.
And for that, Beautiful Lord my God, I am forever grateful.
