Editor’s Note: Sarah Carlson, MD, MSC, is a surgeon at Boston VA Medical Center and assistant professor of surgery at Boston University. Follow her on Twitter @sarahcarlsonmd. The views expressed here are the author’s. View more opinion on CNN.
Like most Americans, I’ve spent the last several days learning to alter my daily life in the context of this unfamiliar construct of “social distancing.” As a surgeon in the midst of preparing for the challenges of Covid-19, the disease caused by the novel coronavirus, I am beginning to worry about the implications of what I call “patient distancing” –separating families from their loved ones in hospitals and long-term care facilities.
Part of my job, aside from treating patients with vascular diseases, is helping families navigate their loved ones’ illness. When I finish an operation, my first stop is the surgical waiting room where I meet with family and friends of my patient and let them know the surgery is complete. The most common question I’m asked is when the visitors can see their loved one. Beyond hearing the patient is doing well, the family wants to be by his or her side, see for themselves, and offer some comfort of their own.
A few years ago, I was not the doctor but the loved one. I was with my sister Lyn when she took her last breath. At 31 years old, she lost her lifelong battle with cystic fibrosis after years of hospitalizations, intubations, ICU stays and even a double lung transplant. She was my only sibling.
Lyn passed away at a university hospital after receiving top-notch care by a team of experts who, for many years, fought her illness with us as a family. Never did we have to consider that there might not be a ventilator for her when she (frequently) had pneumonia. Never were there too few doctors, nurses or respiratory therapists available to attend to her many needs, day or night. And, perhaps most importantly, there were always sufficient healthcare workers to attend to our family.
Never were we denied the ability to be with my sister in the hospital. My mother, father and I took turns, for countless nights, sleeping in the ICU next to her, with one of us always perched near her bed like a guard dog in a semi-reclining vinyl hospital chair. When she died, she did so peacefully, surrounded by all of us as we rubbed her feet and held her hands. We took comfort in being there together as a family when she passed away.
With hospitals across the nation bracing for an overwhelming number of Covid-19 patients, most have begun scaling back on non-emergent surgeries in an attempt to conserve resources and limit the risk of infection to patients and staff. As part of these efforts, many hospitals and long-term care facilities have dramatically restricted or prohibited visiting hours.
As a health care provider, I am grateful that our hospitals and nursing homes are preparing for the worst. As a family member, I am worried about those patients who will be admitted in the coming days and weeks – whether it be for Covid-19 respiratory illness or any other disease – because many of them will have to do it alone. No visitors means your loved ones may not have the comfort of you being there with them while they fight their illnesses or transition to end-of-life care. No holding their hands, no wiping their tears – comforts delivered by phone or video chat only. Doctors, nurses and other providers will deliver care with compassion and kindness, but that will never be a substitute for the love of family and friends.
Many of our medical colleagues in Italy have relayed harrowing stories about life-or-death choices with scarce resources in over-capacity facilities.
But the tragedies aren’t limited to the decisions about who gets a ventilator and who is left to die. Hospitals and long-term care facilities are already implementing necessary but heart-wrenching policies to remove or restrict visitation. The psychological impact this “patient distancing” may have on our patients and family members cannot be measured. Until we navigate through this pandemic, I remain hopeful that Americans will continue to adopt and practice these new concepts of “social distancing” and “flattening the curve” – if not for our own sake, for the sake of comforting the ones we love.
