The contagion

One of my COVID positive patients, asked me every single day of the four days he was hospitalized, in the step down unit, if he’d be able to return home to his children. He was 49. He had tested positive for COVID-19 2 weeks prior to that. What he or his family didn’t believe in, was in COVID 19 itself. Hence they didn’t feel the need for a vaccination or masking or seeking help earlier in the course of the disease. He told me so, like most of my patients who were hospitalized this time.. as I needed to know, how people were still contracting the virus, despite vaccinations, masking, or if it was time for all of us to receive the booster dose yet, or if there was any specific vaccination that hadn’t provided enough immunity against getting this sick. I was curious to know what had been going on, now with this 3rd, worse than ever wave.
He was one of my several patients placed in isolation, on one of the COVID floors. When he was admitted, I had discharged 2 others on oxygen, transferred 2 to the ICU on ventilators and was wheeling one other patient of mine who was the only one discharged in completely stable condition, but the only one who was unable to speak much, holding back her tears, with a lump in her throat, as she was still shocked to think that her 51 year old husband and she came in together to the ER 5 days ago, he was in the room across from her, that she was moved to a telemetry floor, while he coded, was intubated and admitted to the ICU. He was her family. Her everything. All she ever had. I sought special permission for her to be able to see her husband in the ICU, before she left the hospital building, as after that she couldn’t have been able to visit him, especially in an isolation unit, with COVID cases on a rise- again! Well, and also, I got her the permission, as I felt she’d be able to see him once, as we didn’t know when he’ll be stable enough to talk to her or be home again. In my heart I also knew, that she may be able to say one last goodbye to him this way. That was a bigger reason I asked for allowing me to have her visit him… And she did, on her way out, for one full minute, with tears rolling down her N95, she mentioned that she had worn for the first time during the pandemic, and she walked back to the wheelchair. I saw her off, as she called the cab to go home. And he expired in 2 days.
That same evening, there was a daughter insisting that she would like to see her 82 year old mother just once, for the last time and that she would bring her 85 year old father along, as I had called them earlier in the day, that her breathing had progressively become agonal. She was negative for COVID. Her code status was decided to not resuscitate, after 20 days of being hospitalized due to significant complications with terminal cancer, having fought for the past 3 years, and hours of meetings about goals of care with her loved ones, end of life discussions, suggestions for comfort measures for them to consider in the last week, that finally they came into terms with reality, and accepted that she would be no more, in just a little bit. They came and she expired. But they were able to hold her hands, spend a few moments with her and she took her last breath. But they were thankful that they were able to see her. She had lived a good, long life and had fought till the very end.
Back to my COVID positive patient in the step down unit, his family of 4, were all positive, but stayed asymptomatic. Upon his request, I spoke with his wife from his bedside, facetiming her, to reassure his family that he’ll get better. Everyday. And she would call me asking me about her own symptoms too later in the evening, and enquiring again, if truly he would recover soon. At this point, he had continued to be on the nonrebreather. Every single of my encounters with him would comprise of a promise that he’ll be able to be back home safe, cured and fine. He seemed to be stable, smiling, though a constant impending doom his eyes would be filled with, the only facial features I’d been seeing thankfully on my colleagues or sadly on my patients on oxygen masks and was adapting to this new language I could trust more than words.
He was on intravenous steroids, Remdesivir and all the treatment options we have available at this time for COVID 19. He had also received Regeneron as outpatient at the start of his symptoms. Proning was done intermittently as tolerated. Along with all this we were providing, with tender love and care, each time he begged if he would be ok and be back home, I sat down, prayed with him, for him, as he asked for me to to make him stay optimistic. “Doctor, you promise me that I’ll be able to go back home to my kids?” he asked each time.
His family had my personal cell number, just as many of my patients’ families, especially during this pandemic had, as FaceTime has been the only way to have the loved ones of our patients see them or talk to me about the status or plan of care, and I absolutely had been a fan of it, as it was an excellent way of communication, as if they were at bedside.
But late in the evening of day 4 of his hospitalization, he had a cardiopulmonary arrest, was placed on the ventilator, had to be on pressors as his blood pressure continued to drop.
His sister called me before I could call his wife. She asked as to why this happened to her brother, that COVID was like the flu, people were getting it, but barely anyone was even sick enough to be hospitalized. Why was he so sick that he got transferred to the ICU and that when will he be discharged home. She was explained about the pandemic, that it unfortunately is a very contagious and deadly disease, that it’s airborne, and as it’s viral, we don’t have a cure for it, but masking and vaccinating would’ve been the only ways to prevent it, just like so many other viral illnesses that have been eradicated – smallpox, polio, measles etc. She said that’s not what they’re showing on TV though. Not that’s what their neighbor, who’s a nurse says either. She has been a dear friend who has told them that vaccinations carried a higher risk, as the facts were unknown. She was working at a hospital and suggested to them to think twice before they even considered it. Then I explained to her about the delta variant, which was now prevalent in the US and that if it weren’t that contagious, we wouldn’t be seeing it worldwide, as a “pandemic”. And also that vaccinations work, that’s primarily why, we, healthcare workers are at lower risk for acquiring the illness, despite spending hours everyday in the COVID units, or several times inadvertently getting exposed to other asymptomatic patients we see . She asked me why there was such a disconnect then between the reality we were seeing at the hospitals from what their community for example knew. I told her that I wish I could hold banners, go on every channel and clear the misinformation. It wasn’t political I told her. It was just an airborne viral illness and it was our duty to protect each other, with the bare minimum that we can do is get vaccinated, wear a mask and try and stop it’s spread. While I was explaining this to her, I was intellectuallizing the whole scenario, just making use of the defense mechanism, to protect my heart from falling and breaking into pieces. I could only do it on the phone with her for probably about 8 minutes, when I broke down, and told her that we could’ve prevented her brother from going through what he was now. Her voice sounded like she was beginning to cry too.. and asked me if I was very young, as I sounded too sensitive and caring. I responded that I wasn’t that young, but that I was devastated seeing so many innocent, people getting this sick and the untimely deaths I was seeing, purely because of miscommunication..
The next morning, I walked first to my other COVID patients, who were more stable, atleast at this point, and then to the ICU to see the rest, who were either already on the vent, or almost there.. on high flow oxygen with bipap, etc. Then I went to see this patient of mine, intubated, with an iPad fixed by the bedside as requested to the nurse by the family. The nurse told me that his family had been calling every 5 minutes for an update. As I walked in, I could hear screams of his young kids.. I called his wife, while walking into his room in order to FaceTime with him, but I didn’t realize his kids were able to see him already, unresponsive, to probably his only name called “Daddy” for the past 16 and 10 years, that he had told me about himself, and that’s all I knew about him thus far, that he was a Dad and had desperately wanted to be back home with his kids..And that was all that mattered to me, to be able to get him back..
His children today would keep hollering “Daddy, Daddy, wake up, come home Daddy, will you be ok Daddy?”, moaning and screaming in between these words. As I approached him to examine him, they cried and begged me to make him ok, “please doctor, can you make my Daddy ok, can you please take those things off him, why isn’t he saying anything doctor”.. I felt the doctor in me worthless, the parent in me furious, this world so divided with misinformation. How could I bring this father back to life now? I’d just let him die.. like a million others.. that’s been the fate of so many others who’ve been infected! Who though was responsible for those little children being orphaned? There were mixed emotions. I cried my heart out, barely being able to walk out of that room, where I left behind children who’d never see their father again, a young widow, and broken hopes and promises, one of them being even mine to them, probably their last one..
The 51 year old could’ve lived a bit longer to be with his wife, her only family for maybe even if not all of the rest of her life, for a good majority of it, if it wasn’t for COVID.
The 82 year old may have lived longer, to be with her husband and daughter, but life does come to an end.. She had fought for a while with the cancer. And it was probably her time.. They were all at peace. Not her life, but rather her suffering ended.
But, there were so many more people coming in gasping for air, sick, with the same infection. Actively dying, pleading for help, asking for a vaccination when getting sicker, anxious, troubled, frightened.. COVID 19 is not a joke.. This is the third wave we’re seeing and I saw so many deaths with the first wave too.
But this time it was a different feeling. There was anger in me, I was furious, just as much as heartbroken, which most of my colleagues would relate to, I was frustrated, as I knew this could’ve been prevented this time at least.. We did come a far way since the first wave. We did have a hope after the vaccination. Why would anyone propagate false information then?
These children begging for their Dad was a trauma that left me even more helpless. This young, otherwise healthy man could’ve lived a much longer life.. if it wasn’t for COVID.
Meanwhile we had a 20 something year old die.. A doctor well known to us suffered a massive stroke, as he was scared the vaccination was definitely part of some conspiracy. A nurse had developed altered mental status. There were African Americans, Caucasians, Hispanics, just everyone, liberals and conservatives, young, old, men, women, who had been sick, who were anti-vaccinations and also believed that masks were for a non-American way of living.
Is it at the expense of a life now that we’ll be able to teach a lesson, to one family at a time? Despite the media, the advances in Science, the vaccinations which are the only way known to us to lower the risk of transmission, falling critically ill and decreasing death rate, we question why? We’ve the right to choose freaking freedom, and not to mask, at the cost of people’s lives? Is this fair? It this logical? Is this human?
If seatbelts can help prevent deaths from motor vehicle accidents, condoms prevent STI including HIV, how’s it that masking is a threat to freedom and not someone’s life? Hospitals being at critical capacity, running out of necessary resources, to help our people, our community, who’s unfortunately, sadly brainwashed, with this doctor begging you, kneeling down, asking for your help, to not help actively kill anymore people.. This virus has a high fatality, is the deadliest, most contagious respiratory virus, which is airborne, but can be prevented if we’re together in this.
Just like one gets a pap smear to prevent cervical cancer, colonoscopy to prevent colon cancer, mammogram to prevent breast cancer, or an annual doctor’s visit for a routine checkup- you’re counseled to abstain from smoking to prevent lung cancer and heart disease, you’re encouraged to eat healthy, exercise and make some lifestyle modification to prevent known cardiac risks, that your physicians are trained to educate you about, based on research and advances in Science, on what basis are the political parties interfering in prevention or treatment of a widespread, super contagious, airborne, viral illness? In no time, not surprisingly, it had become a pandemic, and is continuing to mutate with deadlier strains which are more communicable, but now thankfully significantly preventable for those who believe.
Those children’s cries I would not ever be able to get over. Someone’s right to choose for themselves at this unforeseen time of crisis and emergency, is unfortunately taking the same right away from the vulnerable, who may be you and me.. We stand divided today because of our beliefs. And being a doctor, I’ve been taught to believe and learn from what I see.
But I also believe in God, and His/Her ways. There’s probably a reason I am what I am, and what I do, and my encounters with these unfortunate patients of their families aren’t just to break my heart.. I’m not certain, who amongst us is right today, my antivaxer friends, or my mask police militants, or my supervaxers who’ve already received 3-4 vaccinations since their first shot about 8-9 months ago. I’m not sure, if this virus will slowly sweep the world away or there would be survival of the fittest, or if this going to be the new normalcy..
But I want to speak the truth that I see with my own eyes, to share my experiences with you to consider changing your mind, from what I’m witnessing first hand, for it’s only words that I have for you, and I’ll continue to beg for you to wear a mask, to get vaccinated, because apart from words, I am seeing one lesson learnt per family, at the expense of one life, at one time, unfortunately..
And I truly wish, we aren’t at this primitive level still dealing with this contagion, and it doesn’t have to take another death to teach anyone this again!