1/🧵🎥 The #COVID19 ICU: an Insider’s look behind the curtain of our conversations with patients.
From my vantage point, there are TWO ROADS. Whether we meet depends on which one is chosen…see this video and read a real patient conversation👇
From my vantage point, there are TWO ROADS. Whether we meet depends on which one is chosen…see this video and read a real patient conversation👇
2/ Two Roads:
1. Get a #vaccine & >99% you won’t have me as your doctor.
2. Don’t get a vaccine & #DeltaVariant’s SUPER-VELCRO Spike Protein gets to decide your fate.
1. Get a #vaccine & >99% you won’t have me as your doctor.
2. Don’t get a vaccine & #DeltaVariant’s SUPER-VELCRO Spike Protein gets to decide your fate.
3/ If you don’t get a vaccine and then go to #DisneyWorld or the mall, & get #Delta infection (as multiple people in my life did recently)…
THIS is the conversation we may have…
THIS is the conversation we may have…
4/ Spouse: “Doctor, I’m not willing to throw in the towel. We’ve been married >30 years.”
Me: “I am so sorry. Truly. In seeing 1000s of pts in shock & lung failure at this stage, if we keep her on life support we’ll end up in 1 of 2 two places.”
Spouse: “What places?”
Me: “I am so sorry. Truly. In seeing 1000s of pts in shock & lung failure at this stage, if we keep her on life support we’ll end up in 1 of 2 two places.”
Spouse: “What places?”
5/ Me: “OK. I know this is hard, but I don’t want to rose-color the situation.”
Spouse: “Please be honest. I need to know the truth.”
Me: If we keep him/her on life support w lung failure & shock from #COVID, many days of intense suffering will happen & then death…or…
Spouse: “Please be honest. I need to know the truth.”
Me: If we keep him/her on life support w lung failure & shock from #COVID, many days of intense suffering will happen & then death…or…
6/ Spouse interrupts: “No. What’s the other road?”
Me: “Weeks & months of ICU care followed by gargantuan #PICS and #LongCOVID.”
Spouse: “ok. Survival. I want that road. What’s it look like??”
Me: “Well, my patient & his wife wanted to show you, so watch the 🎥 in tweet #1
Me: “Weeks & months of ICU care followed by gargantuan #PICS and #LongCOVID.”
Spouse: “ok. Survival. I want that road. What’s it look like??”
Me: “Well, my patient & his wife wanted to show you, so watch the 🎥 in tweet #1
7/ Spouse: “Ugh. That is horrible. My spouse would never want that. What’s another way?”
Me: “At this point, to avoid those 2 roads of suffering + death or suffering + #LongCOVID, we only have one option.”
Spouse: “What is that option?”
Me: “At this point, to avoid those 2 roads of suffering + death or suffering + #LongCOVID, we only have one option.”
Spouse: “What is that option?”
8/ Me: “To focus on #PalliativeCare, remove the life support, and make comfortable dying the chief goal.”
Silence.
Me: “I am so very sorry.”
Silence.
Me: “I am so very sorry.”
9/ Spouse: “She/he wouldn’t want prolonged suffering, so let’s keep him comfortable & withdraw the vent.”
The patient dies 5 minutes after vent removed. Immense human suffering by both the family & ICU team.
Spouse: “Doctor, is there anything we could have done differently?”
The patient dies 5 minutes after vent removed. Immense human suffering by both the family & ICU team.
Spouse: “Doctor, is there anything we could have done differently?”
10/ Me: “Well there is, but I’m not sure you want me to say the answer.”
Spouse: “Yes, Sir, I need to know.”
Me: “There is a #vaccine for this disease that has a very high likelihood of stopping you and me from ever meeting.”
Spouse: “Yes, Sir, I need to know.”
Me: “There is a #vaccine for this disease that has a very high likelihood of stopping you and me from ever meeting.”
11/fin
Spouse: “Doctor, we are afraid of a #Vaccine.”
Me: “I know. Fear tricks us. If you want to talk about your fears, I will listen & answer your questions.”
We sit down to talk…later a free 5 min shot is administered in her arm.
Next patient. Next family.
Spouse: “Doctor, we are afraid of a #Vaccine.”
Me: “I know. Fear tricks us. If you want to talk about your fears, I will listen & answer your questions.”
We sit down to talk…later a free 5 min shot is administered in her arm.
Next patient. Next family.
What’s SUPER-VELCRO of #COVID19 #DeltaVariant & why does it matter in your life? 🤷♂️
https://twitter.com/weselymd/status/1424950696114274304
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