From Healthcare Heroes to Healthcare Villains

“So you’re telling me I can’t say goodbye to my husband of 50 years?” says the wife of the patient who is about to pass away from COVID-19 in the ICU.

“Yes, that is what I am telling you. I’m so sorry.” An apology is the only comfort I can offer. “I wish things were different.”

Her tears fill the line. I wait until she hangs up.

I don’t cry until later, when I’m alone, when the numbness that carries me through these conversations wears off.

At the beginning of the pandemic, healthcare workers were regarded as heroes. People yelled out their windows at 7pm every night when the doctors’ and nurses’ shifts were over. We received gifts in the hospital for our service.

Now it has been 18 months since UC Davis treated the first known patient with COVID-19. If we measured the pandemic based on developmental milestones, we are in the awkward toddler phase, finally becoming more sure of our footing. Still learning more every day, but also stubborn enough that we think we know what we are doing.

In truth, we still don’t know. There is discrepancy across the country about whether to intubate these patients early or late. There is nowhere near enough data to have a definitive right answer. At the beginning, I remember being told by an intensivist (ICU doctor) that you should NEVER give steroids to COVID patients because it dampens the immune response. Now, decreasing the damage from the inflammatory process when our body fights infection is literally our goal. So, we give steroids to every COVID patient who walks through the hospital doors. All we know for sure is that we see the same pattern over and over again, and we are pretty powerless in that despite our best efforts (vaccine aside- that is a miraculous feat of science).

Now, 18 months in, instead of bringing us gifts, patients’ families are threatening to sue us, to leave against medical advice (AMA) and take their loved ones to other hospitals. They are calling every day making demands. It is taxing, but I guarantee if I was being treated in the hospital, my family would do the same thing.

I think it is truly cruel that as a healthcare system, we are preventing families from seeing their loved ones as they are taking their last breaths. Especially when doctors, residents, nurses, respiratory therapists, medical students, etc walk into and out of the rooms all day. Especially when we have enough PPE to protect us all. Especially when some of these patients have been in the hospital for so long with COVID that they don’t even test positive for COVID anymore, or the cycle threshold (test that measures the number of times the specimen has to spin around a machine before it comes back positive) is so high that they could never transmit the virus. Especially when these visitors are vaccinated. Especially when sometimes we send COVID patients home on hospice because their families just want them to be home when they die.

On the note of vaccines, mistrust in the medical system is one of the major barriers we face. Then patients get sick and come to our hospitals, and we tell their families that they will never see their loved ones again. What does that do for any sort of trust we are trying to build?

The rules are so inconsistent, and they keep changing. That is why families are so frustrated with us. That is why the message bearers are so burnt out. None of it makes sense. And it is heartbreaking. And it is senseless. The least we could do is admit we don’t know what we are doing.

To the families, I know you can’t be there. That is why I hold their hand for an extra second. I play them a song. I tell them that they are so loved, because I know they are. I tell you, “I’m so sorry. I wish things were different,” because I truly truly do.