To the Editor:
I would like to commend Ammar and colleagues on their article detailing the lessons learned from COVID-19. Their discussion of the psychological implications of restrictive visitation policies during the pandemic was particularly relatable.1 At the height of the pandemic, our intensive care unit (ICU) also did not permit any outside visitors. In addition to being ICU physicians, we also became the eyes and ears for countless families.
As an anesthesiologist, I am used to putting patients to sleep and keeping them safe through the physiological stressors of surgery. Most importantly, I am used to waking them up. One of the most jarring things in the COVID-19 ICU was seeing numerous patients go to sleep without ever waking back up. I would call family members to notify them that I was intubating their loved ones, and that I was not sure when they would come off the ventilator. I could hear the helplessness and the fear in their voices. They wanted to be there by the side of their relatives, but they could not.
My natural physician’s instinct before COVID-19 was to help families navigate through the objective data: Po2, cardiac status, and blood pressure. During my time in the COVID-19 ICU, I focused less on ventilator settings and more on the overall comfort level of my patients when updating their families. I also asked family members how they were coping with the situation. I talked to patients’ children as a fellow son. My formerly sterile tone transformed into a softer one. For myself and for my colleagues, these daily phone updates became a particularly sacred part of the day, when we could relay information and prognoses and, most importantly, make human connections, despite the hecticness of the ICU.
I believe that this crisis has redefined the role of the physician communicator. Before COVID-19, physicians were often objective consultants who filled in the gaps of medical knowledge. In the COVID-19 era, physicians are also therapists, prognosticators, and fellow humans. It is easy to get bogged down by the distractions of modern medicine, and studies have shown the decline of physician empathy.2 The unique circumstances of the COVID-19 pandemic have forced clinicians worldwide to become better communicators. As alluded by Ammar and colleagues, this undoubtedly creates an emotional burden on physicians. However, I believe that it is our duty to take on our newly defined role and continue bettering the lives of our patients and their families both during and after the COVID-19 era.
1. Ammar A, Stock AD, Holland R, Gelfand Y, Altschul D. Managing a specialty service during the COVID-19 crisis: Lessons from a New York City health system. Acad Med. 2020;95:1495–1498.
2. Neumann M, Edelhauser F, Tauschel D, et al. Empathy decline and its reasons: A systematic review of studies with medical students and residents. Acad Med. 2011;86:996–1009.