Mending Broken Hearts

21. Truth

March 2020

Madiha

March 24: Who Should Be Saved First? Experts Offer Ethical Guidance (New York Times)

With hospital beds and ventilators predicted to be in short supply for the expected numbers of COVID-19 patients, experts say that clinicians will be confronted with having to ration care, as doctors in Italy have already had to do. To make such difficult decisions, many ethicists recommend using a utilitarian approach, in which care would be directed toward those most likely to benefit the most from it, according to this article by Austin Frakt, senior research scientist in the Department of Health Policy and Management.

I sat at our breakfast table early in the morning reading the NYT articles that had been the rounds on social media. Physicians were trained to save every life, every time. None of us went into medicine thinking that one day we would have to decide which life is worth saving more than the other. But that was exactly the dilemma facing so many of my colleagues around the world.

Morning rounds at our own hospital were starting to look a lot different too. That entire week we had on average 30 patients on our team's list, every other one had COVID. Chicago was still not as bad as New York where the National Guard (a branch of the US military that is activated in times of federal emergencies) had been called in to set up extra tent hospitals, and morgues were running out of place.

Yet, all week I could feel palpable fear in the air as soon as I stepped into the hospital. The situation with our isolation rooms was especially dire, forcing us to use them only for patients on the ventilator or those receiving breathing treatments that could result in the release of a large number of viral particles in the air. The remaining patients found themselves in standard rooms, a situation that heightened the risk of the virus spreading to hospital staff and non-COVID patients.

I so desperately wanted to talk to Omar about all of this but with Chicago in lockdown all meetings were moved online, including our noon conferences. Everyone not involved in direct patient care was asked to work from home. Even some of those physicians who were taking care of patients were asked to do it remotely via telemedicine. Those of us who did come into the hospital stayed in our designated areas and promptly left after our shift ended.

For a couple that depended on casual run ins, because dating wasn't acceptable in our culture and religion, a lockdown meant zero chances of meeting in-person unless we worked together.

Or lived together...after marriage, an impatient voice reminded me. 

I had started to text him, when I heard Abu come down the stairs. "Assalam Alaikum Abu. You're up early. Is everything ok?" I asked him, noticing the worried expression on his face. 

"Walaikum Asalaam Madi beta. I was just on the phone with Naeem bhai," he sighed. "I am very worried for him."

I poured a cup of chai and served it to him before taking a seat at the opposite end of the table,  six feet away, "What do you mean?"

"He was fired from his job and now the whole country is in lockdown," he shook his head sadly. "Pata nahi kesai guzaara hoi ga un ka. Bhabi's diabetes is out of control and the insulin is so expensive. Plus his youngest is still in school." (I don't know how he will manage everything)

"I am sorry to hear that," I commiserated. 

Though, truth be told I had never paid much attention to Abu's side of the family. We never visited Pakistan growing up, never had the funds to. And their financial situation was worse than ours. It was only in the past few years with smartphones and social media, that Abu had fully connected with his family again giving rise to regrets I knew he felt for leaving them behind.