Hesham A Hassaballa's COLUMN

We Must Fight The Urge To ‘Just Swim Down’

We must fight the urge to say, "Why bother at all?"

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It’s all the same. It’s the same path. Patients with COVID-19 get admitted to the hospital, and the ones who become critically ill – the ones I end up seeing in the ICU – steadily get worse, fail conservative measures, require invasive mechanical ventilation, and then die. This is the path of most of the COVID patients I see.

This same “lather, rinse, repeat” cycle has played itself out again, and again, and again, and again, and again for the past 18 months. It is exhausting. It is exasperating. And it makes me want to say, when yet another patient follows the same path outlined above, “Why even bother? They’re going to die anyway.”

I am sure many of those on the frontlines – doctors, nurses, respiratory therapists, techs, medical assistants, and others – have asked themselves the exact same question. And perhaps the answer to the question, “Why even bother?”, has led to the dramatic shortage of healthcare professionals across the country.

Yet, when I think about this question, “Why even bother?”, it makes me wonder: would I say that about life itself? I mean, in all reality, the human condition is ultimately fatal: all of us, down to the very last one, is going to die one day. And so, given this fact, would it be right for me to just give up on life and say, “Why even bother? I am going to die one day anyway.”

Absolutely not. It would be criminal of me to do so.

Yes, I am going to die one day. I don’t know when. I don’t know where. I don’t know how. But, one day, I am going to die. But that doesn’t mean that I should just throw up my hands in defeat and not live my life to the fullest, saying “Why even bother?”

On the contrary, I should do my very best to live the very best life possible. I must do my very best to be the best husband I can be, the best father I can be, the best son I can be, the best brother I can be, the best neighbor I can be, the best citizen I can be, and the best believer I can be.

And, yes, I must do my very best to be the best physician I can be: to do all that I can to help alleviate my patients’ suffering as much as possible, even if I know that they will die one day. No where in this equation does the statement, “Why even bother?”, ever even come up.

That would be, in the words of Hamilton, “The moments when you’re in so deep/It feels easier to just swim down.” We must resist – with every cell in our body – the urge to “just swim down.”

Now, for some, the urge to “just swim down” – to give into the hopelessness that is inherent in the question, “Why even bother?” – leads them down a dark path to self-harm and suicide. Dear reader, please, if this is you, please, please, please seek help. Please, please, please talk to someone. Please, please, please don’t follow that dark path.

We must stop focusing on the outcome and start focusing on the path to that outcome. Even if I know this latest patient with COVID-19 will ultimately die, I need to make sure that I do all I can to care for them in the very best manner possible. I need to make sure I do all I can to minimize their suffering as much as possible, and then – if their death is inevitable – I need to make sure that death is a “good death,” one free of suffering, pain, and anguish.

And if I do that, then I should stand tall and feel proud: I did all I could to the very best of my ability.

On so many days, it absolutely “feels easier to just swim down.” It is tiring having to swim upstream all the time. And it is absolutely essential that I do just that. My patients need me to do that; my family needs me to do that; my country needs me to do that; my world needs me to do that. There really can be no other way.

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Dr. Hesham A. Hassaballahttp://drhassaballa.com
Dr. Hesham A. Hassaballa is a NY Times featured Pulmonary and Critical Care Medicine specialist in clinical practice for over 20 years. He is Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine. He is a prolific writer, with dozens of peer-reviewed scientific articles and medical blog posts. He is a Physician Leader and published author. His latest book is "Code Blue," a medical thriller.

4 COMMENTS

  1. Great article Hesham and so timely. Every single human life is worth fighting for, even if the outcome looks predetermined. Every now and then, one survives, against all odds, and it’s thanks to doctors like you that those odds improve for the lucky ones. Every breath we take is to be savored and cherished in our all too short lives.

  2. Great article. Motivation to keep swimming. It is our duty to support each other during this time. Even when things are hard….it does matter.

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DR HESHAM A HASSABLLA

Medika Editor: Cardio and Pulmonary

Dr. Hesham A. Hassaballa is a NY Times featured Pulmonary and Critical Care Medicine specialist in clinical practice for over 20 years. He is Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine.

He is a prolific writer, with dozens of peer-reviewed scientific articles and medical blog posts. He is a Physician Leader and published author. His latest book is "Code Blue," a medical thriller.

Medika are also thrilled to announce Hesham has recently joined our team as an Editor for BeingWell, Medika's publication on Medium

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