Care For Each Others’ Bodies, Minds, and Spirits

I’ve been where coronavirus patients now are. The ICU of the Amsterdam hospital in which I lay for six weeks last year — much of that time on a ventilator — is today filled with very sick people fighting for their lives. For those that survive, the challenges will not be over. Many will suffer from long-term physical, cognitive, and emotional problems resulting from being sedated. It’s called post-intensive care syndrome, or post-ICU delirium.

In Erika Edwards’ recent article for NBC News, she quotes Dr. Amy Bellinghausen at the University of California, San Diego, as estimating that up to two-thirds of ventilated patients may be affected by post-ICU syndrome. Symptoms include physical weakness and post-traumatic stress.

I suffered from physical weakness, dropping from 130 to 95 pounds and losing the ability to move during my six weeks in the ICU. Lying still is a wicked thing: your body needs time to recover, but in being quiet it begins to fade away. It took me six more weeks in the hospital to be able to walk gingerly out of there and onto a plane headed for home, where I’ve slowly regained all of my strength and most of my weight.

I also had cognitive and emotional challenges stemming from being sedated. I had very real dreams in which evil nurses were torturing me and telling me horrible things about other patients. I was certain that the hospital clocks were being changed to confuse me. I was frustrated that my family didn’t understand what was really going on.

I was lucky, though. These thoughts and the nightmares faded away in my final weeks in the ICU, and did not return as I continued to recover. They’re just stories now.

Erika Edwards cites doctors’ observations that the best way for patients to avoid post-ICU stress in the first place is to have their family at their side. That’s what made the difference for me. My husband, with whom I was traveling when I suffered the ruptured arterial aneurysm, our daughter, who flew in from Florida, and my sister, who flew in from Colorado, managed to be with me as much as 12 hours a day. The ICU nurses had to chase them out, telling them to take care of themselves, too. But those same nurses cut my family a lot of slack in bending the narrow visiting hours to let them be with me. They held my hands, they stroked my face, they talked with me, they laughed with me. I didn’t see when they cried. I just knew they were there.

The poor souls who are struggling to live as the coronavirus clamps down on them are bereft of family. This virus is robbing them of a crucial life line.

ICU patients need to have humans around to orient them, to calibrate them, to touch them, to look in their eyes and make them understand what’s happening. But that’s exactly what the COVID patients won’t get because they’re all being isolated.

Dr. E. Wesley Ely, Professor of Medicine and Critical Care, Vanderbilt University

These patients are not alone, though. My Dutch doctors and nurses were compassionate, caring, and steadfast. I am imagining them and their medical colleagues in the world’s ICUs today, doing everything they can to care for their coronavirus patients. The Cleveland Clinic is one such place. A patient who survived COVID-19 thanked his caregivers by asking one of them to write a note on the glass wall they’d used to communicate with him. Here’s some of what he said:

Today I leave this ICU a changed person … not only because of your medical healing and God’s direction and kindness, but also with the fact of knowing that there are such wonderful people dedicated to the care and concern of others.” Here’s a Twitter posting with more.

Mr. Brown, COVID-19 survivor, upon discharge from the Cleveland Clinic

I join the millions of people all over the world in clapping for these brave medical soldiers, first responders, grocery deliverers, post office employees, package mailing staff and all others who are our front line in this pandemic war. God speed.

National Doctors’ Day

This Letter to the Editor appeared in The Palm Beach Post on March 29, 2020:

When a healthcare crisis upends our lives, the care of a trusted physician is valuable beyond measure. Now, with COVID-19, physicians are putting themselves at risk without hesitation to save lives, provide testing and reassure patients.

On Monday, National Doctors’ Day, there’s no better time for us all to say thank you.

Tim Stapleton, Florida Medical Association

The doctors and nurses at OLVG Hospital in Amsterdam who saved my life and got me back on my feet over three months last year are now arming for the coronavirus onslaught. Here is what one of them wrote me recently:

It’s a strange and especially unreal situation. Amsterdam is deserted and you know how crowded it can be! I work a lot now, and the pressure is high. All hospital staff are to be available at all times. There is a great sense of togetherness among the nurses and doctors in the OLVG. We will fight this successfully!!!!

AB, Nurse, OLVG7A

The doctors and nurses at the University of Florida Shands Hospital who cleared me to return to our house are girding up for the same battle. Our daughter, a health psychology intern at Shands, is providing support to both patients and staff via telemedicine.

Thank you, Medicare, Medicaid, and private health insurance, for leaping forward this past week to pay for Zoom-facilitated medical appointments. Thank you, Zoom, for being the glue that is helping families and neighborhoods and whole populations to stay connected. Click here to sign up to this free app. Thank you, the world’s medical community, for being in the front lines every day.

Here’s what today’s CBS Sunday Morning Lee Cowan had to say today about doctors, our front line defenders.

We give a nod of gratitude to those bound by an ancient document, with a very modern purpose:  the Hippocratic Oath. It’s a contract more than 2,000 years old, and while it’s evolved over the millennia, it’s perhaps more sacred than ever, especially now that we’re mired in a health crisis that Hippocrates himself could only have feared. One modern version of the oath reads in part: “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”

Today there is no “chemist’s drug” to fight the coronavirus (not yet, anyway), and on top of that, masks, gowns and gloves – those paper-thin barriers between sickness and health – are in impossibly high demand, which makes the oath’s “warmth, care and understanding” promise dangerous to keep.

Our exhausted doctors and nurses are often forced to re-use masks; some are simply going without. That may soon leave many of our healthcare workers unprotected, charging up this viral hill every day, knowing they may die on it.

It’s becoming increasingly possible that the physician you have today could be another physician’s patient tomorrow. There is no greater calling than tending to the sick and suffering. But it doesn’t require an oath; what it requires is courage, selflessness and compassion, all traits seemingly in ample supply in our medical community, thank goodness.

Because these are the souls who are our best hope.

Lee Cowan, CBS Sunday Morning, March 29, 2020
Andy Marlette, Pensacola News Journal