On death, life, and residency during the COVID-19 pandemic
Saloni Godbole
she/her
2021
“Will you tell me something about her? Anything.” The family stares at us, dumbfounded, tears glistening in their eyes. “What did she love?” My attending wonders out loud. It’s around midnight, 16 hours into my 28-hour call shift in the medical ICU. We have been called to assess an 80-year-old woman with metastatic cancer in the emergency room. As soon as I walk in the room, I know she will need intubation, mechanical ventilation, a central line, and vasopressors if she is to survive the night. The data points jump into view with every refresh of my computer screen, confirming what I already know. pH 7.0, bicarbonate of 10, potassium 8.2, lactic acid 11. The prognosis is grim.
It is a story I have seen play out hundreds of times. Like many of my colleagues, I have grown accustomed to death. During internal medicine residency during the COVID-19 pandemic, death feels like a shadow – lurking behind corners, waiting to seize my patients who are gasping for air while their families watch on Zoom. I expected to become used to death during residency. What I did not expect was to become completely numb to it, cold and entirely unaffected. During medical school, I remember locking myself in a bathroom and sobbing after witnessing my first code. Yet when my own grandfather died of COVID early in my PGY-2 year, I could hardly muster up any tears. I did not take a single day off work. Death no longer touched me. I am not alone in feeling this way. I once asked my co-resident and friend if she was okay after witnessing a patient die by suicide, hanging himself from the ceiling of his room by his telemetry leads. She shrugged and said, “Of course I’m okay. I don’t feel a thing. COVID really f***ed us up, huh?”
So, when my ICU attending asked the children and siblings of our dying patient what she loved, it catapulted me back to my humanity. The very humanity I had been suppressing for over two years. It reminded me of one of my favorite quotes:
“No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend's or of thine own were. Any man's death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bells tolls; it tolls for thee.”
John Donne