COVID-19 has changed the world, the medical profession, and the NHS in ways that we are only beginning to understand.
In my A&E department, we’ve seen patients with lower oxygen saturation than we previously thought possible, treated our own hospital colleagues – some of them went to ITU, spread more bad news on the phone than ever before, and I have the number of patients lost the number of my colleagues who got the virus.
And without a doubt, COVID-19 has changed me as a doctor – how I practice, think, and am at work. Here are just three of the options I noticed.
- A secret that requires presence
One of the most exciting things about being an A&E doctor during the pandemic was the absence of visitors and relatives in the hospital. This meant that many of our patients suffered and, in some cases, died alone with no relatives around. I was really shocked to see so many patients suffering alone as I know from my colleagues.
I was talking to a non-medical friend about this one evening and she made an impromptu comment that changed the way I think. When I told her that so many of my patients suffer alone, she replied: ‘Well at least they have you‘. It was like a lightbulb had gone out in my head. What I realized was that in the absence of friends and family in the hospital, it was difficult for us health professionals to be that precious human presence in the midst of fear and suffering. Prof. John Wyatt often says: ‘Suffering is not a question that requires an answer. It’s not a problem that needs a solution. It’s a secret that requires presence. ‘That is deeply biblical.
in the Romans 12Paul admonishes the Roman Church: ‘Love must be sincere‘(v9) followed by the command, Rejoice with those who rejoice; mourn with those who mourn ‘ (v15). In other words, sincere love enters and connects with the highs of others ‘joys and the lows of others’ sorrows.
From the moment my friend made a comment, I held more hands and asked, ‘Is there anything else I can do?‘Stay in bed more often and just a few seconds longer so as not to add any further treatment, just to be with the patients in their suffering. I have no idea if it made any noticeable difference, especially since I was often covered in protective gear from head to toe. But I know if it were my loved one in the hospital, I would wish their doctors and nurses to be so present in my absence.
- Die well
Just before the pandemic started, it quickly became apparent that COVID patients can worsen very quickly, usually around days 7-10 of the infection. Some patients came in and, despite their low satiety and terrible blood counts, remained reasonably handsome for a few days, but then suddenly got worse and possibly died. Just before the pandemic started, the number of hospital cardiac arrest calls increased noticeably in my hospital.
The progression of the disease through COVID forced all of us in A&E to have routine discussions with patients and / or relatives about end-of-life desires and resuscitation very early on in the hospital trip, knowing that deterioration could suddenly occur. I often had half a dozen or more of these conversations a day.
As emotionally stressful as these conversations are, I found them strangely valuable. As Christians, we have the God-given mandate to cherish all human life until the moment of death. In situations where we clearly cannot win the battle against death, we have a precious opportunity to show a final act of kindness and love by giving patients a peaceful and painless death rather than the trauma and outrage more futile Interventions. In the words of Dame Cicely Saunders, the Christian nurse who pioneered palliative care: “You are important because you are you and you are important until the end of your life. We will do everything we can to not only help you die peacefully, but also live until you die. ‘
- The pain of separation
With hospitals banning most visitors to their buildings, hospital doctors and nurses spend much more time on the phone talking to relatives, especially when patients are older or unable to communicate much on their own. I usually call relatives mainly for informational purposes, for example to find out a collateral history or to determine end-of-life wishes. However, I quickly realized that receiving a call from the doctor was an extremely valuable and desirable thing for loved ones who had sent their loved ones through the closed doors of the hospital.
Hearing the gratitude and relief that relatives express when they receive a call from the hospital has made me much more ready to pick up the phone, not only as an information-gathering exercise, but also as an information-giving exercise. Calling relatives can be time consuming and emotionally stressful, and on a busy shift I tend to avoid doing this whenever possible. But oddly enough, calling relatives also brought out some of the most rewarding moments I had during this pandemic. It is such a strange privilege to be the patient’s voice in their hour of need.
As Christ said “Truly I tell you, whatever you did for one of the least of my brothers and sisters, you did for me.” (Matthew 25:40)
Benjamin Chang is a North London GJ2 doctor, past President of Christians in Science London and a member of the CMF Speakers Track. He recently spoke about the struggles health workers are facing during the COVID-19 crisis Speak life Podcast
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