Beyond Sleep – Physicians Recount “Heartbreak” of COVID Deaths

During a year that has seen non-emergent care (such as sleep medicine) often put to the back burner,  medical subspecialists have adjusted their expectations and bided their time. For all the human suffering wrought by COVID-19, the physicians on the front lines have been experiencing their own misery of long hours, feelings of powerlessness, and a lack of human contact with dying patients.

The stories are emerging, with the Broad Institute recently doing its part by highlighting a remarkable series of first-hand accounts from doctors on the front lines. The following are abbreviated excerpts from each account. 

Deb Hung, core faculty member, co-director of the Infectious Disease and Microbiome Program at Broad, infectious disease physician and attending critical care physician at Brigham and Women’s Hospital:  

“The thing that struck me the most, from the experience of treating COVID-19 patients, was how heartbreakingly dehumanizing it was. Patients weren’t allowed to have visitors, and those intubated and sedated in the ICUs couldn’t talk to you. As a physician, I only knew a name and the medical parameters associated with the individual. During usual times, we get to know a little more about the patient — the personal and human side, with families and friends visiting. But with COVID, it was heartbreaking to see people dying alone, and their families couldn’t come in.” 

Michael Gillette, senior group leader in the Proteomics Platform at Broad, attending physician in pulmonary and critical care medicine at Massachusetts General Hospital (MGH)

“One thing that was striking during the first surge of the pandemic was the number of critically ill patients relative to hospital capacity. At MGH, we got up to about 180 patients requiring ICU-level care. To put that number into perspective, our main medical intensive care unit, where I spent most of my time during the last couple of months, is an 18-bed unit. To accommodate the influx, our medical-surgical intensive care, surgical intensive care, cardiac intensive care, neuro-intensive care, pediatric intensive care, and burn units all were converted to adult COVID-19 intensive care units. There were two general medicine floors in one of our buildings that had the necessary physical infrastructure and also got turned into COVID-19 intensive care units.” 

Pradeep Natarajan, associate member of the Program in Medical and Population Genetics at Broad, director of preventive cardiology at MGH, clinical cardiologist at the MGH Cardiovascular Disease Prevention Center

“During the first COVID-19 surge in Massachusetts, we converted one of our inpatient cardiology units at MGH to a COVID-19-specific cardiology unit. During this time, I was on clinical service, supervising that unit during this first surge of COVID-19. The overwhelmingly large knowledge gap that physicians were dealing with in the face of this public health emergency was immediately apparent as I began treating patients with COVID-19.”  

Marcia Goldberg, associate member of the Infectious Disease and Microbiome Program at Broad, infectious disease physician and Professor of Medicine and of Microbiology at MGH and Harvard Medical School

“I participate in remote analysis of hospitalized patients in two capacities: First, I provide advice to the primary caretakers caring for COVID-19 infected patients. In essence, I respond to specific questions from primary caretakers that may relate to the management, diagnosis, and/or treatment of these patients. Second, I am part of an infectious diseases team that interprets the testing of inpatients who could be infected with COVID-19, including whether an individual is infected and, for infected individuals, when it is safe for them to come out of isolation. What struck me the most with the patients was the rapidity with which they might go from having relatively mild illness to severe and life-threatening illness.” 

Anna Greka, institute member at Broad, director of the Broad’s Kidney Disease Initiative,  associate physician in the Renal Division in the Department of Medicine at Brigham and Women’s Hospital

“I was not scheduled to be on service during the time of COVID-19, but I decided to volunteer in case they needed my help, as either a general physician or kidney expert. It turns out I was needed as a kidney specialist because, in addition to the obviously horrific lung disease, we started seeing an influx in COVID-19 patients facing kidney failure and in need of dialysis machines. The most difficult thing in caring for patients with COVID-19 was the inability to spend a lot of time with them. It was really strange not to be able to touch and communicate with them.” 

Benjamin Gewurz, associate member of the Genetic Perturbation Platform at Broad, infectious disease physician at Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Assistant Professor of Medicine, Harvard Medical School and Associate Director, Virology Program, Harvard Medical School

“During the March through April peak, I volunteered for 10 very busy daytime and overnight shifts on the hospital COVID-19 beeper. These were interesting and challenging shifts, with as many as 80 calls per day coming in from worried nurses, residents, and attending physicians. As testing capabilities and policies on testing and PPE were rapidly developing, many questions came in from all areas of the hospital. For instance, how many tests need to be done and how far apart should they be to clear a patient for surgery that requires general anaesthesia? What to do with a patient admitted from a rehab facility whose roommate was rumored to have COVID-19?” 

Roby Bhattacharyya, associated scientist in the Infectious Disease and Microbiome Program at Broad, and attending infectious disease physician at MGH

“During the two weeks in April that I was on service, the surge was really building in Massachusetts, and by the end, half of our thousand-bed hospital was COVID-19 patients. Which is crazy—that this thing that had infected its first human less than six months earlier was suddenly the majority of what we were caring for. At MGH, we had to create five new ICUs from floors that were normally regular medical wards or perioperative care areas. This was incredible. I don’t think anybody at MGH had seen the need for surge capacity like this before. The hospital had spent months planning for it, and it went off without a hitch from my perspective as a consultant, thanks to the hard work and planning of a lot of people.” 

Source: Broad Institute

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