We don't think of dying too often. But when we do, we hope that we pass away peacefully, surrounded by our family, friends and loved ones. However, the global pandemic of the COVID- 19 infection has challenged the very core of this thought.
This threat became clear to me during a painful conversation with a surgeon friend from New York. While he was saving lives on the frontline of the coronavirus epidemic, his father lost his life in a nearby hospital. My friend choked up as he told me all hospitals in the region were utterly overwhelmed with COVID-19 patients and had installed a no-visitor policy. His mother was not allowed to join her husband in the ambulance or visit him in the hospital. His health situation worsened after 24 hours and he was transferred to the ICU. By the second day he was gone.
That my friend couldn't say goodbye to his father adds another layer to his deep grief. As an interventional cardiologist performing life-saving procedures almost every day, I have learned that the moments before we pass away are among the most important of our lives - both for the patient and their families.
When my paternal grandfather was battling cancer and admitted to hospital in the last stages, I took time off from my hectic fellowship in the US and flew down to see him. That one day I spent with him in the hospital by his side and holding his hand are moments I will never forget. To rob patients and their families of the last goodbye is something I wish I never have to do.
If the virus spins further out of control (and I pray it doesn't), we may be heading towards a similar scenario. Due to the nature of the disease, a patient who seemed to be getting better can suddenly get worse, which means they have to be admitted to hospital. If treatment fails, terminally ill patients will be on their deathbeds completely isolated. Usually, doctors-nurses try to be by the patients in these times but given the danger of transferring the infection and the sheer volume of patients, they are unable to do so.
If there were only one single corona patient in my hospital, I would do everything I could to allow family members to visit the patient. Of course, they would have to adhere to strict hygiene standards to prevent further spread of the virus and would have to wear the same protective gear as doctors and nurses and go through the same precautionary measures.
But once beds start to fill up, hospitals won't have the time or the resources to allow any visitors. If cases continue to mount, medical staff won't even have the time to provide emotional support to a sick patient This is what happened to my friend's father in New York City. His family was denied entry to the hospital because of the high rate of infection in the hospital and the risk of spreading the disease further was just too high. When his father was nearing the end, a nurse called the family by video conferencing so they could see him one more time. They had to hang up after only a minute because the nurse had to help another patient who was sick. My friend's father died alone, without anyone to hold his hand.
The bad situation in New York is similar to the chaos and suffering in hospitals elsewhere in the world. European countries like Spain and Italy touted to have some of the best healthcare systems in the world were also overwhelmed with beds filled with terminally ill patients lining up the hallways. Multiple patients died in the hospital. They died without anyone around. Because their national healthcare systems were not prepared to handle the overload, patients and their families members paid the price.
And it is not just the terminally ill, patients with Covid who are asymptomatic, have a mild form of Covid or even exposed to patients with Covid are required to be in quarantine. They are rightfully not allowed to meet or interact with the outside world that many have described as very lonely.
That is why our government's decision to order a full lockdown was the right one. It was a wise decision that few countries dared to make, yet it's paying off. The virus hasn't spread to the extent it has in China, Europe, and the United States. Because of the lockdown, many lives will be saved.
The only reason the extraordinary measures are working is that an overwhelming majority of our people are sticking to the rules. This makes me proud to be Indian. However, we are not bulletproof. If we don't adhere to social distancing, stop washing our hands, or let our guard down in any other way, India will reach the point where many of us will have to face death alone.
Make use of this time of the lockdown say "I love you" to your loved ones a little more frequently and spend meaningful quality time with them. It's all too easy to watch television or get lost in some other mindless activity while the person most dear to you is sitting right next to you. If you are separated from your loved ones, please don't put off a video call to let them know you care about them. And most important of all: have a plan for when one of your family members gets so sick they need to go to the hospital. If possible, make sure they have a phone that supports video calls. Please hug them and wish them well.
We may not be able to be there during the most important moments of their lives, but we can give their lives more meaningful moments until their time comes.
(Dr Sameer Gupta is Director, Umkal Hospital Gurgaon; Interventional Cardiologist and Cardiac Cath Lab Director at Metro Hospitals & Heart Institute, New Delhi/NCR. He is also the co-founder of Voice Of Health, an online health awareness platform.)
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