Monday, May 11, 2020

a daunting task




We have been bombarded by commentary related to the Covid-19 pandemic for months now. It is a moving target for speculation, analysis, and judgement. We have experienced a shifting melange of reactions ranging from uncertainty, to fear, to anger, to sorrow. If we have learned anything from this catastrophe, it must be that there is more to illness than the symptoms we observe in our patients, and more than the test results reveal. The emotional, psychological, spiritual, relational, and existential consequences of illness all weigh in.

"No longer were there individual destinies,
only a collective destiny made of
plague and emotions shared by all."
~Albert Camus: "The Plague"~

Healthcare providers who practice narrative medicine know this. They are trained to explore every aspect of the patient's story in order to learn all they can about his illness, not just what caused it, when it started, and what symptoms he has, but how it affects him psychologically and emotionally. This is important because the course of his illness, and the process of recovery are influenced by his expectations, his perceptions, and the nature of his connection with the people closest to him.

Which is what makes this pandemic so difficult. No one knows what to expect.There is no known cure for this infection, and no vaccine, so we are left to practice routines we can only hope will stop its spread. We are required, or at least implored, to wear face masks when we leave our homes, and to keep a safe distance away from every human being we encounter. We have been told to stay in our homes except to get food and medicine. Schools are closed and many small businesses have been shuttered. The future is uncertain. Our connection with family and friends is tenuous, at best. It's no wonder we are lonely, frustrated, and scared, not a healthy emotion among them.

It would be a daunting enough task for our doctors and nurses if all they had to do was administer oxygen, hook up IV lines, and monitor the settings on ventilators. If all they had to do was to bathe and turn patients, and swab their parched lips. But consider this: they are the Covid-19 patients only portal to the outside world. Their only connection to their loved ones...some of whom they will not live to see again. Nurses are manning the ipads and iphones that enable patients to communicate with loved ones remotely. In many cases they are conveying the patient's last words to his or her children, or spouse, or BFF. They are tending to the patient's emotional pain and spiritual needs in addition to everything else.

"The simple act of caring
is heroic."
~Edward Albert~

The EMR that documents the day's activities--the patients' vital signs, medication dosages, vent. settings, and oxygen levels--will not preserve these conversations. It cannot absorb the tears that are shed. It does not reflect the devotion, the energy, or the spirit that binds patients and providers to one another. Which is how healing begins.

"And indeed, it could be said
that once the faintest stirring of hope
became possible,
the dominion of the plague was ended."
~Albert Camus: "The Plague"~
jan










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