The Night I Broke: A Doctor on the Conversations That Never Get Easier

I watched the cardiac monitor of a patient who had a “Do Not Resuscitate” order transform from a sinusoidal rhythm – seen when patients have very high levels of potassium that the kidneys are not working well enough to clear – to asystole, better known as a flat line. The patient was COVID-19 positive, like most, of the patients in the hospital in New York City at the end of March. He presented to the emergency department days earlier with respiratory distress and had required a breathing tube and ventilator support. At that time, he did not have a “Do Not Resuscitate” order, but was rather “Full Code,” indicating that we should do anything in our power to prolong his life. While in the ICU, his condition worsened, leading to kidney failure that dialysis could not fix. We had had a difficult discussion with the family a day earlier regarding his poor prognosis and they decided not to prolong his suffering and not to escalate care, meaning we would keep everything as it was and make him comfortable, but would not do chest compressions if he lost his pulse. I called to deliver the bad news that the patient, their father, had died. As medical students we are trained on how to do this, but that never seems to make it any easier. His daughter started wailing a cry I now know after my year and a half as a doctor is distinct from any cry I had ever heard. It is the cry reserved only for a family member when you tell them their loved o...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Source Type: news