During the pandemic healthcare professionals have often been the only ones present with patients at the end of life. It’s ok if you struggle to find the right words—sitting with a patient so they're not alone is enough.
Donning full PPE, I entered the room and was greeted by the monitor’s alarm, flashing my patient’s oxygen saturation of 80% despite the BiPAP he wore. I knelt by the side of his bed. Stephen had been in our COVID unit for nearly three weeks. Clutching the mask to his face like a child would cling to a blanket, Stephen’s eyes met mine behind my face shield.
“Stephen, I think we’ve reached the end. Even with this mask, I can’t get your oxygen levels up,” I said. “I am so sorry.”
Peeling the BiPAP off his face for a brief moment so I could hear his voice, he asked, “What if we tried the breathing tube?”
“If I put you on a breathing machine, I don’t think you’d ever come off it. You already told me you didn’t want that.”
“No, I don’t want that.” He reached for my hand and held it tight. “Stay with me.”
During the past year of the pandemic, the sheer volume of suffering healthcare professionals have borne witness to on the frontlines is unfathomable. In isolation, with family barred from visiting except via FaceTime, we are the ones present to see, to hear, and to carry forward our patients’ stories.
In the words of Maya Angelou, “There is no greater agony than bearing an untold story inside of you.” Storytelling isn’t a one-way action by the person telling the story, but is the creation of a relationship with the audience.
Whether in hearing a patient’s last words before they’re put on a ventilator or holding their hand as death nears, in bearing witness to the patient’s story, there’s a call to action, to tell the truth of what happened. Their story is never forgotten once shared with us.
Here’s what I’ve learned through the pandemic:
1. Bearing witness requires active and reflective listening skills.
Paraphrase what your patient tells you and ask if you’ve understood correctly. Give affirmations such as reassuring the patient their illness isn’t their fault.
2. Showing up is enough.
We may struggle to find the right words to say or the right actions to take when there’s no further medical treatment available. A silent presence is ok. Sitting with your patient so they’re not alone is enough.
3. Have a self-care plan.
One critical component of taking care of yourself after the loss of your patient is talking about it with a colleague, family member, friend, and/or mental healthcare professional.
This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.