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By Anthony Fleg
Story Editor: Diane Guernsey
It was 5:00 pm in the intensive-care unit, and my team and I had just wrapped up our interview with elderly Ms. Armijo, who was in critical condition after emergency abdominal surgery.
Exhausted after a long day, we headed for the door, the ICU machines and monitors beeping their goodbyes.
From behind us, Ms. Armijo called, "You know, the thing I'm really worried about is being all alone!"
I spun on my heel. She was trying to sit up in bed, fright radiating from every inch of her frail, failing body.
I'd thought that we'd covered all of the medical bases in our lengthy interrogation: "Where do you hurt? How do you hurt? Are the pain meds working for you?"
Now, frozen in midstride, I realized that we'd neglected one very important question: connectedness.
COVID had forced our hospital to adopt a no-visitors policy. On every floor, the hand-holding and bedside banter that patients would normally get from their partners, siblings, neighbors and coworkers was gone–replaced by a sickening silence. Even I, a family physician, couldn't visit my own patients who'd been hospitalized for COVID.
I imagined myself lying in that ICU bed, scared for my life, feeling so weak that I couldn't lift a spoon to my mouth–and suffering all of this alone, with no one at my side.
That's what Ms. Armijo is facing, I thought. Not only that, but without her cell phone, she can't even call her family. No wonder she's distraught!
Quietly, my team and I returned to her bedside. This time, we did the listening.
"I have no idea what happened to my cell phone in all of this," Ms. Armijo said.
"Have you been able to talk with your sister and family?" I asked.
"No, and that's what I'm really worried about. My sister takes care of me, and she must be going crazy, not knowing how I'm doing."
Hearing her words, I suddenly felt as if I were the student, and Ms. Armijo my teacher.
"Thank you for sharing," was all I could muster.
"This is not a 'no news is good news' scenario for them," she went on, politely but firmly. "Sitting here, I don't think they even know if I made it out of surgery alive! If it weren't for the pandemic, they would be sitting right here by my side."
I listened, trying to absorb the full meaning of Ms. Armijo's words, as well as what was conveyed by her pauses and facial expressions.
For me, it was a direct, visceral reminder: Asking about her connectedness to her family was as crucial as probing into her abdominal pain or lab results.
Taking it all in, I reflected that connectedness could actually be counted as one of a patient's vital signs–as important, in its way, as any heart rhythm or puff of breath.
In fact, in these extraordinarily difficult times, loneliness can almost be considered a new medical condition–one affecting close to 100 percent of our hospitalized and nursing-home patients, and one that requires its own treatment plan.
In Ms. Armijo's case, the needed treatment was clear. And so, just after we left the ICU, my team contacted Ms. Armijo's sister to ask about her missing cell phone.
They found it at home, where it had lain since the chaos that led to her ambulance ride to the hospital. Over the next few hours, with painstaking effort, the phone was delivered to the hospital–passed like a hot potato to the security guard at curbside, then to a nurse courier, then conveyed past the badge-access checkpoints and, finally, delivered safely into Ms. Armijo's hands.
Although she still had a long way to go in terms of physical healing, now Ms. Armijo was connected once more with her world, and able to benefit by her real-life support system–her family and friends.
And I was left feeling grateful to her for the reminder that you cannot experience full health or healing if you feel disconnected from those you love.
doctor stories, loneliness, COVID-19, coronavirus
Anthony Fleg
Anthony Fleg is a family physician at the University of New Mexico in Albuquerque and with the Native Health Initiative. His work focuses on love as a foundation for health and activism, strength-based approaches to health, and getting communities walking/running for wellness. "Writing has been a part of my life for decades, and even more so during the pandemic, as I write weekly pieces on my blog, Writing to Heal. I often feel that I only fully experience something once I write a piece of poetry or prose about it."
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8 thoughts on "Only Connect"
Mimi Emig
Thank you for your human kindness. I was previously a doctor, now retired early because of my own health problems. I've been hospitalized many times. It's people like you who make a real difference- particularly now in these difficult times. Don't lose sight of the person; they're never simply a medical condition.
Thank you for that insight Mimi. Right you are – it isn't all of the technical stuff (devices, procedures, surgeries, meds, etc.) that heals; only humans heal.
Roger Williams Schauer, MD
Dr Fleg, thank you for sharing your powerful experience. My ICU experience, nearly two years ago, could have mirrorwed Ms. Armijo's had it not been for physical/emotional connectednes with family. Because of complications of heart valve replacement surgery I was intubated for a number of days, and did not fully awaken until my 11th post-op day. During those 11 days, and most of three weeks thereafter, either my spouse or one of our three children were at my side virtually full time. Even though I am a family physician and was aware of the posibility of complications, I am certain I would not have survived wiitihout those connectedness.
Appreciate that testimonial, Roger. To hear it from a physician who has sat on both sides of the ICU conversation is incredible.
Roberta Beary
This happened to me when in ICU a few years ago. Lucky for me a chaplain came by to check on me, and later called my husband for me. The fear of being alone and unable to reach anyone was as bad as my physical symptoms. Thanks for the well-written reminder that the patient's emotions matter too.
Thank you Roberta! "The fear of being alone and unable to reach anyone was as bad as my physical symptoms". That says it all!!!
Pris Campbell
I can't imagine going into a hospital these days and being totally alone and afraid. Thanks for emphasizing this problem. Making that call, finding her cell phone were as essential as treatment per se.
Agree 100% Pris! Sometimes, and maybe I would even say, often times, it is not the medical knowledge elements that make the biggest difference in the care we provide!
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