My advice: be thankful for your loved ones. Don't start anything. Let Cousin Fred ramble. But don't let dangerous ideas go unchallenged. And perhaps build a bridge or two.
Such a good piece, Bill. I'm glad you took a break from your break to share this important perspective. You and Terri were a major influence on how Leif and I perceived the pandemic in its early months, as we heard your personal stories of being on the front lines of care. We were able to tell skeptical friends what the reality was, because we knew and trusted you, and you were seeing it with your own eyes.
It's interesting to hear the different perspective you learned from an area that didn't see the deaths caused by the pandemic, but rather the impact of the pandemic on the survivors - economically, mentally, educationally. Great ideas to prepare better for another pandemic.
Outstanding article Bill! Made my day seeing a new Evening Rounds in my inbox. This is really helpful. Have a great Thanksgiving! Hope you are surrounded by family.
Oh man. But just a week ago I had surgical revascularization of one of my carotid arteries, and spent four days in the surgical ICU, from where I was discharged directly to the street and home. It was a very large circular unit that I walked multiple times a day, and saw the truly awful, isolated manner in which we die in this country as a patient, attached to machines and - literally - ten to twelve IV bags hanging on poles surrounding the beds. On several occasions I said to my wife and and other visitors, PLEASE never allow me to end my life in such a fashion, PLEASE. And oddly enough, I also passed the various nursing stations, being given the "thumbs up" with smiles, and messages of "looking good!" encouragement from staff as I walked by. Likewise, I saw staff walking by my room as I was sitting in a chair or standing, looking out the window, becoming familiar - at least by sight - with the daily routine. And then, my surgeon walked in and asked if I was ready to go home, and as he went off to prepare my discharge. I dressed and waited, and so many of the staff that I had only watched pass by came to a halt in my doorway, shocked to see me in street clothes, and asked me, "Are you really going home?" And finally, when I asked why they were so surprised, a few finally told me that "so few actually walk out of here." Wow, I felt quite foolish. Lucky, but foolish. And I couldn't help but think how I need to re-read "Being Mortal: Medicine and What Matters in the End" by Atul Gawandi and the profound impact it originally had on me. I believe I have said on your site previously (or else my memory plays tricks!) of the elderly Russian man who said to me, "When we're young we just can't wait to 'grow up and do all the adult things,' and then suddenly, we would do just about anything to slow down the clock if it were possible!" And so it goes...
first, I’m glad you’re doing well. But your note made me realize just how gloomy my posts are. I should stress that Covid and its death rate was different- even unique in my 35 years. As a rule, more than 90% of my ICU patients survived. It was an exciting and even fun place to work. As I’ve written in the past- the nurses, therapists and pharmacists that work there are great in every way.But that said-I do not plan to go there as a patient unless there is a very fixable reason.
Recall, I walked out of there! Nothing particularly "gloomy" about the reality of the ICU. It is, unfortunately, the way we live & die in the US. I should have clarified that this was the "SICU," surgical a combination of surgical & trauma patients, and some actually transitioned to regular rooms on other floors - though from the look of things, I would imagine 30%... Gawandi's book is highly recommended. By the way - shorter but sweet - it was good to read you!
Such a good piece, Bill. I'm glad you took a break from your break to share this important perspective. You and Terri were a major influence on how Leif and I perceived the pandemic in its early months, as we heard your personal stories of being on the front lines of care. We were able to tell skeptical friends what the reality was, because we knew and trusted you, and you were seeing it with your own eyes.
It's interesting to hear the different perspective you learned from an area that didn't see the deaths caused by the pandemic, but rather the impact of the pandemic on the survivors - economically, mentally, educationally. Great ideas to prepare better for another pandemic.
Outstanding article Bill! Made my day seeing a new Evening Rounds in my inbox. This is really helpful. Have a great Thanksgiving! Hope you are surrounded by family.
Well considered and factual - your examples are so helpful. Thanks!
thanks, Mary- and great to see you in Cambridge!
This article comes at the perfect time, and your insightful reflektion on remembering the true impact of the pandemic truly resonates.
Oh man. But just a week ago I had surgical revascularization of one of my carotid arteries, and spent four days in the surgical ICU, from where I was discharged directly to the street and home. It was a very large circular unit that I walked multiple times a day, and saw the truly awful, isolated manner in which we die in this country as a patient, attached to machines and - literally - ten to twelve IV bags hanging on poles surrounding the beds. On several occasions I said to my wife and and other visitors, PLEASE never allow me to end my life in such a fashion, PLEASE. And oddly enough, I also passed the various nursing stations, being given the "thumbs up" with smiles, and messages of "looking good!" encouragement from staff as I walked by. Likewise, I saw staff walking by my room as I was sitting in a chair or standing, looking out the window, becoming familiar - at least by sight - with the daily routine. And then, my surgeon walked in and asked if I was ready to go home, and as he went off to prepare my discharge. I dressed and waited, and so many of the staff that I had only watched pass by came to a halt in my doorway, shocked to see me in street clothes, and asked me, "Are you really going home?" And finally, when I asked why they were so surprised, a few finally told me that "so few actually walk out of here." Wow, I felt quite foolish. Lucky, but foolish. And I couldn't help but think how I need to re-read "Being Mortal: Medicine and What Matters in the End" by Atul Gawandi and the profound impact it originally had on me. I believe I have said on your site previously (or else my memory plays tricks!) of the elderly Russian man who said to me, "When we're young we just can't wait to 'grow up and do all the adult things,' and then suddenly, we would do just about anything to slow down the clock if it were possible!" And so it goes...
first, I’m glad you’re doing well. But your note made me realize just how gloomy my posts are. I should stress that Covid and its death rate was different- even unique in my 35 years. As a rule, more than 90% of my ICU patients survived. It was an exciting and even fun place to work. As I’ve written in the past- the nurses, therapists and pharmacists that work there are great in every way.But that said-I do not plan to go there as a patient unless there is a very fixable reason.
Recall, I walked out of there! Nothing particularly "gloomy" about the reality of the ICU. It is, unfortunately, the way we live & die in the US. I should have clarified that this was the "SICU," surgical a combination of surgical & trauma patients, and some actually transitioned to regular rooms on other floors - though from the look of things, I would imagine 30%... Gawandi's book is highly recommended. By the way - shorter but sweet - it was good to read you!