(Note: This article was written in Dec 2020 when St. Louis COVID hospitalizations peaked in the region)
I’m not a doomsday person, but there is not a lot of great news on the medical front in St. Louis at the moment.
As a hospitalist physician assistant, almost everyday I am having end of life conversations with family who are still in shock that their loved one is dying of an illness which developed only a few days prior to being hospitalized. Unfortunately these conversations are via phone due to COVID restrictions.
Yes, these are most frequently elderly patients. But these were functional people who were living independently until developing COVID 19 multifocal pneumonia. I watch as they slowly suffocate due to worsening hypoxia.
This is not the same as flu season, which also takes a toll on the elderly and the immunocompromised:
Imagine your loved one slowly suffocating to death despite oxygen support. Not just the typical 2 or 4 liters that COPD patients use at home. This is up to 60–(SIXTY!) liters. When that fails to work we move to BiPAP. And if BiPAP fails to provide enough support then we have to move to a ventilator which, as we have found, does not usually lead to a positive outcome.
In the meantime we give patients steroids which often leads to worsening psychosis and confusion and Remdesivir which has questionable efficacy.
I wouldn’t wish this disease on my worst enemy.
I’m not going to follow with a public service announcement. I’m not going to guilt you into something you do not want to do. I just ask that you pray for our medical personnel who are exhausted both physically and mentally.
I’m tired of calling family and telling them that their loved one will soon die. I’m tired of feeling helpless to this disease. I’m tired of the constant media and the shaming of people whether they decide to wear a mask or not. It’s unfortunate that this has also become part of our politics. At the end of the day, I hope we all do what’s best for our fellow man.
Take care of your family. I don’t want the next call to be to you.
