When I get home in Chicago, I get there early and see the bloodstains, the needles, the equipment.
“But this is the way it is. Even the nurses and doctors are just living in fear.” - Mike, resident of Chicago
During the second week of December, the virus is at a peak. The virus is spreading rapidly throughout the hospital and a hospital-wide pandemic has been declared. Patients in need of dialysis are turning to private dialysis clinics for assistance. A few weeks after the first reports of the first kidney infections–people complaining of chronic stomach pain, fever, numbness–reporters ask questions about the problem: “How are they being diagnosed?” “How are you going to get them to dialysis?”. No one explains how they get the money and if the kidney treatments are worth it. “The reason they are spending so much is because they got a bad dose.”
A nurse shares how a patient in a long-term care facility would be unable to pay his bills through dialysis. No one in their right mind would pay for dialysis. If that person dies before he gets on dialysis, his provider doesn’t save a cent. “One guy in a nursing home told me he was too lazy to leave well enough alone to dialysis. They told him to buy the $500 machines and get a free ride to the pharmacy or something like that.” The media are quick to point out that the people who contracted the virus, a family with a small child, had some contact with other people they thought were infected. What’s the big deal, the media ask, if a family with a baby could also contract the virus?
But nobody is telling the tale of a person who contracted the virus from a small child. Because a parent could contract the virus in any way: from sharing needles, sharing food, or giving their baby alcohol–it is easy for the parents to get the virus on their hands and in their breasts. Most of the time they don’t feel they got the infection and assume they were infected with the virus of someone else. “The way I look at it now, [the child] could be infected and the parent should still get the drug. It’s like, well I didn’t know it was in me anyway.”
I get nervous if we talk about the risks of the “blood transfusions.” You’re talking about people giving themselves a blood transfusion, right? Because they’re a blood donor, right? Or because they are a nurse and they might have had other patients give blood to them in the past? There are good reasons not to do a blood transfusion, I don’t think we can all say we can’t make that distinction. But I don’t think there is anywhere near as much worry and confusion. As the nurse in the long-term care facility, I was more concerned for my health than for the child in the home with the flu, and I didn’t want those risks to affect my baby. But that doesn’t mean that I care, either.
If my baby died, the decision to have a blood transfusion would be a difficult one for anyone who could make a medical decision. We are a good people, we believe in good science. We know that we should do things that minimize the risk of death.
One nurse told me that she felt the same way. “Oh well. I can’t help them if they die. I didn’t do it. I have the option not to do it. I’m not the doctor in this. I can’t just make up rules to stop things from going bad in patients that I don’t care about.” I feel lucky that I wasn’t in the situation she was–the same nurse who had a medical license and knew what to do when the situation was life or death. But I am fortunate to not have to worry about whether my future has meaning.
To sum up: I worry that I am a failure because I am a doctor, but I do nothing to save my own child. I worry that I am a failure if I do nothing when a patient does not get better or when it seems my actions are futile. The first thing that I think will happen is to ask if it is even worth my time. In a perfect world, I would always be in a position at the front desk where I had the power to make that decision. In a perfect world, I would never use my power to make a decision about someone else. But right now, I have to put my personal feelings before someone else’s safety. Or else I’ll continue to feel alone.
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