Ms. K was one of the oldest patients I’d met. I wanted to sit and hear her stories, to say, “Tell me more,” the way we learned in medical school. But the equipment sustaining her left no room for a chair to sit in. And COVID had stolen her ability to speak in sentences; she puffed out words two or three at a time before inhaling again. Even so, each word was sharp and spirited and made me smile.
Her face was a rich and deeply wrinkled landscape. Ms. K’s gown hung loosely on her, exposing the silhouettes of her ribs and knobby shoulders. I was surprised when I pulled the layers of blankets back from her feet. In contrast to her thin arms, her legs were thick and smooth, due to the accumulation of fluid as a result of her weakly pumping heart. Her heart had been failing for years, yet she had beaten the odds and thrived.
The K family knew this. Over the phone, they wanted to continue the drips that were slowing her heart rate and the oxygen that forced air down her nasal passages into her tired lungs. These interventions had worked before, but I wasn’t sure they were the right thing now. COVID was something new for Ms. K, and all the statistics on who lives and who dies were working against her.
The next day, Ms. K didn’t respond to my voice or my touch. The canister collecting her urine held only a few drops of tea-colored liquid. Her respiratory support was at 100%, delivering pure oxygen through her nose. Inexplicably, on top of that, a mask blew 70% oxygen through her mouth. In the seventeen years I had been a doctor, I had never seen this double oxygen set-up. I didn’t understand the math or the physiology, but maybe no one did.
As the cannula pushed air into the deepest recesses of her lungs, her monitor chimed the decline of her oxygen levels: 86-84-84-82-78-78. It was Sunday, but there was no music in the alarms, no spiritual calling. I put my hand over hers, willing for her to feel the touch.
It was time to talk to her family. They agreed to transition to comfort care. Ms. K passed away, alone, a few hours later.
Ms. K was my first patient to die from COVID-19. I carry her memory, lodged deep within me, to each new patient’s bedside as the pandemic marches on.
Rohini Harvey
Amherst, Massachusetts
