There’s a first time for everything, and today a sweet patient of mine showed up to her appointment, dead.

The secretary clinic called me, stating a cab driver had appeared at the door, asking for help getting the patient out of his yellow cab.

I stepped into the flurry.
The driver had taken out her walker, which was waiting patiently near the car. I peered into the backseat.

She was slumped over, jaw slack. She had no pulse and her eyes were fixed and staring.

I yelled for the driver to call 911 and began 1-handed CPR, cradling her head.
A nurse came out with my stethoscope and I listened to her: silence.

Her physician came out and continued compressions, leaning over my shoulder in the yellow cab backseat while I held her in my arms.

She was a large woman and we couldn’t move her alone.
He stopped to flag down the fire truck that arrived. I took the quiet moment to rub her hands and tell her that she’s ok and sing You Are My Sunshine.

The cab driver, staying warm in the front seat, raised his eyebrows.
Six EMTs got her into a gurney, compressing as they rolled her into the ambulance. They stayed for 15 minutes, coding her. Then they left, sirens off.

I checked on the driver- was he ok? Turns out he was irritated at having his car boxed in because he needed to get back to work.
I shivered and rolled her walker into the clinic.

The patients, whose noses had been pressed against the full-length windows of the clinic, watched soberly as I entered the clinic and sat down to call her son, who the driver said had helped Mom into the car 30 minutes ago.

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More from @MarcusBlimi

9 Dec
I will start sharing resources on the COVID vaccine, as I come across them. Every resource is one that I have vetted.

It is incumbent upon everyone to do their due diligence: read, watch, learn. Do what you must to feel comfortable getting the COVID vaccine to end this
pandemic and the loss of human lives.

It’s not acceptable, during this time particularly, to read a snippet or screenshot or meme or unverified information and make a decision based off that. It is even less acceptable to share misinformation. It will kill.
Here’s your first resource: a 28-minute video on the Pfizer vaccine data.

Read 12 tweets
12 Oct
My client died on Friday night. As an end-of-life provider in my community, I help Orthodox Jewish people die without suffering, and according to Jewish law.

When the family begged me for a timeline weeks ago, I predicted (with the caveat that only God knows) that he’d live
until just after Sukkos. But he progressed rapidly at the end of the week and I wasn’t surprised to receive a call on Friday night. His son called, afraid, that his father didn’t look well at all.

“His oxygen is 72% and he’s on 5 liters,” he said. “And he’s breathing quickly.”
I told him to turn on a timer and count his breaths for 1 minute.

I listened, noting that he counted a breath per second, over 3 times the normal breathing rate.

“Let’s give him morphine,” I suggested gently.

Step by step, the young man did so.

“He will die tonight,” I said
Read 7 tweets
9 Oct
Someone sent me this responsa from R’ Asher Weiss to a young nurse, who had to use old respirators and accidentally applied it wrongly, resulting in the patient’s death. She wrote to him, asking how to atone for killing a patient.

His response made me cry, made my colleagues
cry. To providers who worked through the surge, who ran into infectious disease wards instead of away from them, these words are the most comforting ones I have read recently.

People who lost loved ones, or had hospital stays which were terrible experiences, have accused
us of killing patients, ignoring them, not feeding them, keeping them isolated.

You know nothing. You don’t know the conditions we worked in: surges of patients lining hallways, staff out sick or scared to work, no PPE, and no clue how to treat this disease.
Read 6 tweets
7 Oct
This morning I am sitting at work in numb silence. What happened in my neighborhood last night was painful and unacceptable, and 100% preventable.

A thread.
The choice to see the Governor's words as an attack on religious freedom led many to argue that the treatment of our neighborhoods and zip codes was based on "picking on" the Jews, "anti-semitism," "reminiscient of the Holocaust."
The alt choice would have been to unite the community with safe public health behaviors.

Two rules: wear masks, avoid crowds. That’s all.

It is no secret that from May-Sept my community failed to follow these rules.

Many felt the disease had run its course in our streets.
Read 10 tweets
25 Sep
Make no mistake, what is about to happen in the ultra-Orthodox communities in Brooklyn will be catastrophic. School closures, business closures, synagogue closures and fines to everyone will rock the community and pain them - WITHOUT FIXING THE PROBLEM.
I am all for punitive responses and mandates and fines, but only after an effective, community-centered approach towards education and participation. This has not happened. This hasn’t even pretended to happen.
Instead, clueless methods to improve mask wearing and social distancing were implemented - 2 days ago - and now there are threads to attack the community from all sides by early next week. 3/
Read 5 tweets
15 Sep
"So, the first thing we're going to do is give you 1.5mg of dilaudid in your IV line to get you out of this immediate pain crisis. I already entered the order," I told the patient, crouched at her bedside and holding her hand. She closed her eyes briefly and nodded.
I took her call button and whacked it. We gazed at each other and the unit assistant blared out a "Can I help you?" to which I replied "Yes can we get pain meds please?"
I placed the button back in her hand. "I also placed a consult for our palliative pain team - they will help us get your pain under control with medication. They'll get all the right medications ordered in the right doses so that we keep you comfortable around the clock."
Read 6 tweets

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