Published: 12/15/2020 6:20:23 AM
Yesterday, I learned that a patient of mine died of COVID-19. They had been in the emergency department once, diagnosed with the illness, and sent home. However, a few days later, they felt worse and returned to the ED where they were found to need oxygen.
They were admitted to the hospital, transferred to the ICU the next day, and died the following one. From the ED notes, I read that the infection was due to someone at a Thanksgiving gathering testing positive. I did not speak with them or see them since the illness, so I don’t know any details of this. (I am intentionally using gender-neutral pronouns for privacy.)
I have been this patient’s family doctor for almost 15 years. They were 63 years old and had multiple risk factors, including diabetes, obesity, heart disease, and kidney failure requiring dialysis. When I learned of their passing, I wept out of grief and anger. We had been through so much together over these years.
Their medical history follows health care access in many ways: I got to know them when they were part of the working poor, doing clerical work, earning too much for Medicaid, not sick enough for disability, thus uninsured. We struggled for years to get their diabetes and high blood pressure under control, searching through all the limited resources for medications that they could afford.
I know they didn’t always fill prescriptions or take what they did have correctly to make the dollars stretch. Finally, a life-threatening foot infection necessitating hospitalization, intravenous antibiotics, and eventually amputations of several toes made them eligible for Medicare, and increased resources.
Their numbers began to improve but too little, too late. Their kidneys failed and at one point they had a severe heart attack and needed open-heart surgery. They had been on dialysis for over five years.
Life was not easy for this person. On top of everything else, they were hard of hearing, so communication was always a bit challenging, but surmountable.
However, their generally positive attitude and willingness to keep with all appointments and programs helped us both weather the multiple health issues they faced. They remained positive and cheerful, and a vocal advocate for their own needs and issues. They should have lived well for many years to come and go to their mother’s eventual funeral, rather than have their 83-year-old mom attend this one.
But Thanksgiving happened. I have no details of what the gathering was like, if there were people outside of their “bubble” present, or how large the party was.
Did someone test negative a few days before and feel well that day only to have symptoms the following day? Did a younger person know they were infected, but thought they were safe because they didn’t have symptoms? Did a guest feel ill but didn’t think anything of it, and decide to dine with the group anyway? I doubt I will ever know, but I assure you all of these scenarios happen every day.
If this isn’t a cautionary tale, I don’t know what is. Not only was a life snuffed out before its time, when they had fought so hard against many odds, but this illness added one more case to an already stressed hospital staff. I no longer do hospital medicine, but I know this person is just one of many in similar circumstances, and I can’t imagine day after day witnessing the struggle to stay alive and losing so many battles.
So, folks, listen up: Do not be lulled into a sense of security these next few weeks. Someone might test negative for COVID-19 three days before Christmas Eve and fall ill by the New Year. All of our schemes to make gatherings safe have holes in them.
We’ve already seen the devastating surge after Thanksgiving, and must, absolutely must, not repeat that scenario at the end of this month. There are many ways to wrap our love around our families and friends that do not involve being in a physical space together. Send old-fashioned Christmas cards. Be an elf and drop cookies on your neighbor’s doorstep. Find out who is hungry or alone in your faith community and make a call or send a care package.
If we fail now, there will be too many empty places at our tables next year.
(Dr. Laura Fry lives in Bow.)
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