A typical day in the life of this 47-year-old man started with a morning walk with his dog, a healthy breakfast, and then a busy day at work at a company that he had passionately built over the past decade. “There’s nothing like being your own boss,” he said with a smile, and continued, “And coming back to my loving wife and kids completed my day.”
Now, my patient, this same 47-year-old man, has been in the hospital with COVID-19 for four months. Four months of admission for COVID-19? This patient has had multiple COVID-19 complications, one after the other: respiratory failure requiring intubation, pulmonary fibrosis, deep vein thrombosis, pulmonary embolism, atrial fibrillation, lacunar stroke—all of which I was familiar with from reviewing his medical records when I assumed his care in the medical team.
When I first entered his room, I was struck mostly by how optimistic he was, despite what he has gone through. “This man has a different kind of strength,” I thought. Resilience personified. He was polite, grateful, and warm. I pulled up a chair and sat next to his bed.
“Hi, Mr. J, how are you today?” I started.
“I am great doc, have nothing to complain [about]. Y’all have been so good to me,” he replies. Nothing to complain about? He just lost four months of his life, I thought. “I am alive,” he said and laughed like he just read my perplexed mind.
“Tell me more, Mr. J,” I said. Then, he began narrating his life’s course. His attitude added vibrant colour to the story he painted, which included his days in the hospital. An hour passed by before I interrupted, “What was the most difficult aspect of hospitalization, Mr. J?”
I asked, trying to keep the question open ended.
“The isolation, doc,” he paused and continued, “I wish families were allowed to visit patients with COVID-19. I understand the hospital policy and need to limit contact, but those days when my family was not with me, they were the hardest.” As the rest of the day progressed, I questioned myself repeatedly: How have I not been sensitive to this need of my patients? If I were in his place, I would also have wanted the warmth of my family.
Days passed, and the day of his discharge arrived. We had made arrangements for transfer to a rehabilitation centre. “Hi, Mr. J. Today, we think you can be discharged,” I said with a big smile. “Soon, you can go home to your family.”
Mr. J teared up a little. “This hospital is a family that I am going to miss.” With that, he made me realize how patients view their doctors and medical providers and how special is this doctor-patient relationship.
“This is worth the long hours in PPE, the meals we skip, and sleepless overnight calls we do as residents,” I thought, as I signed his documents: Discharge!
Clinical Practice, COVID-19, Hospital-based Medicine, Medical Education, SGIM, Wellness
Dr. Isaac (firstname.lastname@example.org) is a second-year Internal Medicine resident at the Department of Internal Medicine, North Alabama Medical Center, Florence, Alabama.
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