Excerpted from an article originally published in the Newark Star Ledger.
As an intensive care physician during the coronavirus pandemic, my most impactful moments have occurred while holding a phone. Health care visitor restriction has fundamentally changed the way physicians and nurses communicate with families.
After spending weeks caring for critically ill patients, I realized that while medical updates are helpful, families are most desperate to see and be near their loved ones. Sitting in the void of their living rooms, families lose the context and reassurance they would typically gain by being at the bedside of loved ones in the intensive care unit (ICU). Their questions for doctors now stray from organ function and clinical status to whether he’s awake? Is he scared? Can I talk to him?
Most of my family meetings now occur at the bedside in the patient’s room via video phone call. I have started using my own cell phone because the ICU device is almost always in use. By holding the phone in this way, health care providers silently witness intense moments of support and love expressed by family members that would normally occur in private.
If families could only see the expression on our faces behind our masks, they would know how much we care. Crying into our goggles while watching video chats is commonplace. In an odd way, I would say that this distorted communication has strengthened the relationship between health care workers and families. We are not just the patient’s nurses and doctors, we are often the only physical connection to their loved ones, sometimes for weeks at a time. When I leave the ICU every night, my cell phone battery is always in the red, but I am certain that each phone call to a patient’s family is the most important “procedure” that I performed that day.
Working as an intensivist during the coronavirus pandemic has brought an incredible sense of belonging, purpose, and extraordinary compassion among health care workers. Seeing my colleagues race to double and triple cover backup shifts despite the fears and social isolation has been one of the biggest inspirations I have seen in medicine. And I still remember the first time I wore a PAPR, a spacesuit style of personal protective equipment, to place a breathing tube. As I stepped out of the room, one of our nurses was waiting with bleach wipes and said, “Don’t move. Let me wipe you down. We need you.”
Many senior medical students have also volunteered for a program to help strengthen communication between families and care teams. The students, who participate remotely at their home, strain to listen to our voices via speakerphone as their virtual patients are discussed on rounds amidst the background noise of the ICU, enabling them to call families right after a care plan is formulated. Many students have been recognized by families for their clear explanations and calming presence, exactly the qualities that should be nurtured in the next generation of physicians.
Finally, like many physicians of his generation, my 70-year-old father will not heed my repetitive pleas to step away from the front lines of clinical work that he has dedicated his life to as a pulmonologist and intensivist. For many veteran physicians like him, personal duty outweighs the concern for contracting a life-threatening infection. Indebted to our mentors and teachers, we would gladly cover their shifts to keep them safe, yet here we are still learning from their example.
This is truly what keeps health care workers up at night: We realize we could just as easily be the mother, daughter, father, son, and partner on the other end of the phone. This connection drives us to put on our masks, goggles, gowns, and gloves every day. So, rest assured we will take care of your family like they are ours.
— Emily K. Damuth ’04, MD, is a critical care intensivist at Cooper University Health Care in Camden, N.J.