by Ryan Goetz, MD (PGY-1)

During the COVID19 pandemic, I had the opportunity to care for patients in the Medical Intensive Care Unit (MICU). The MICU has long been one of my favorite areas of the hospital. The level of medical complexity challenges us to learn and grow, and the patient-family interactions give us a look into what it really means to be human. It causes us to face difficult questions about life and death. The COVID19 pandemic caused me to reflect on the important things life. Watching young, previously healthy patients go from living their normal everyday life, to being intubated, sedated, and proned in the blink of an eye. It begs the question, am I next?

The typical social disparities seen practicing medicine in the Southeastern United States were ever-present. Our typical patient was an African American male in his 50s with a limited past medical history. The patient often came to the ICU after being intubated and placed on near-maximal ventilator support. I felt the weight of this pandemic while speaking with the patients' families. The families were quickly having to process the reality of COVID19; going from the constant hum of their television to their immediate reality. The families were attempting to cope with having a young, relatively healthy family member who was critically ill with little warning. The feeling of distress was compounded by visitation regulations designed to help limit the spread of this virulent disease.

Speaking to the families of critically ill patients is one of the greatest privileges in medicine; a situation where compassion can truly shine. One particularly impactful moment came when caring for a patient diagnosed with COVID19 amidst her other health struggles. I spoke with her children daily, and then one night she took a turn for the worse. When the family came to say their goodbyes, the countertransference I felt was overwhelming. I imagined if this were my mother taken so suddenly. The compassion of the bedside nurse shined brightly during this conversation. The nurse assured the family that she would be present with their mom during her last moments and that she would not be alone when she passed on.

I was amazed at the compassion of our community. Driving into and out of the parking garage, there was a message that Birmingham loved UAB. The message also thanked us for coming to work and risking our own wellbeing to help others. I appreciated the various community groups and organizations that sent support via food and personal protective equipment. I am thankful for the opportunity and obligation to care for COVID19 patients, amongst my many colleagues including nurses, respiratory therapists, radiologic technologists, ward clerks, environmental service workers, and others.