My career of treating patients has ended
I don&#x27;t know whether or not this particular story is true, but it&#x27;s within the realm of plausible given what I&#x27;ve heard from my wife who is an ICU physician with a residency in emergency medicine.  The last two years have been difficult and these stories come up a lot, so I figure I might as well share some of our experiences.<p>First, she absolutely has been physically assaulted by a patient as well as family.  This is not new to COVID and was more common when she worked in the ER.  It&#x27;s not an every day sort of thing and the hospitals don&#x27;t put up with patients or family acting violently.  However, I believe it&#x27;s normal for them to have security available for when a patient codes since the families will often act out.  Sometimes they&#x27;re violent.  Sometimes they scream.  Sometimes they roll on the floor.  Sometimes they throw things.  Sometimes they don&#x27;t show up at all and let their family die alone.<p>Second, patients and families will ask for all sorts of things that don&#x27;t make sense normally.  They will demand a COVID vaccine when they&#x27;re about to die from COVID.  They will demand invermectin.  She had one patient that was noncompliant with his oxygen, proning (flipping on the belly), and other treatment who threw a fit, started screaming about how they were trying to kill him, recorded it on video, and posted it on Twitter.  She had another patient on the brink of death, unconscious, intubated, pain controlled, that the girlfriend wanted to bring out of sedation, so they could get married because she was worried about their place in the afterlife (yes, there was in fact a theological consult.)  She had another one where the family kept trying to feed an intubated patient soup.  They will actively accuse you of trying to kill their loved one.  This is particularly difficult emotionally because a lot of my wife&#x27;s life is devoted to helping someone with difficult, long hours.  No one likes to be accused of that.<p>Third, due safety difficulties with patients coming to a COVID filled unit, the ICU physicians started calling the families directly to give them update.  Prior to this, it was more common for the nurse to provide updates and then forward questions to the physicians.  Generally, this is a good thing, but it&#x27;s also not particularly easy.  Nowadays, the patient families not only question, but try to micromanage all elements of the treatment.  For example, there&#x27;s this new trend where the families will ask to see the vent during a video meeting and then demand changes to the treatment protocol.  This is not safe and they are not qualified to make these changes.  Now, generally speaking, if the family has questions, my wife is more than willing to answer them.  However, trying to walk a family through a treatment protocol which they do not have the necessary background to understand is not particularly easy.  Further, she really does not have time to do so either.  Any time spent with the family working through the foundation of pulmonary function is time not spent actively working on patients who are quite literally dying.  It really is hurting other patients and I believe it to be selfish.  And, look, we get that they&#x27;re worried and they want to be involved, but I don&#x27;t think people acknowledge the cost of these demands.  Time is not free.<p>As to how someone can better interact with their physician, I think everyone can achieve better results is they focus on what they want their goals and outcomes to be rather than the exact method to get there.  For example, in end of life care, there are questions like: Do we do everything to keep them alive? Are we DNR?  Are we DNI?  These are hard questions, so it&#x27;s easier to frame them as: What do we want life to look like after our hospital stay?  If your goal is to be able to speak with family, hold your kids, and read books, then having the hospital do everything in their power to keep you alive while simultaneously ending up neurologically devastated in an LTAC (long term acute care) probably isn&#x27;t a good outcome.  I can assure you that the medical staff will work harder if you tell them, &quot;Hey, I really appreciate what you&#x27;re doing for my wife.  She&#x27;s really important to us and this has been really difficult to everyone.  Our primary goal is to have her come home in a situation where we can have a conservation together.  If that is not possible, we&#x27;d really like to be there with her and to have her pass in peace.  Please keep us informed if there&#x27;s anything that we can do to support her or if her status changes.&quot;  Then, make sure to check in everyday, so that the hospital, nurses, and physician know that the family is involved.<p>I will also mention to the &quot;this-is-the-new-normal&quot; COVID crowd, it literally can&#x27;t be.  To me, new normal means that we&#x27;ve achieved a new stable point of operating in our everyday lives.  However, the hospitals have not reached that point.  Physicians, nurses, and other medical staff really are leaving.  The units are not fully staffed and they have not been for months.  Attrition is high.  This affects all of us whether or not you believe in COVID or vaccinations because I can assure you that regardless of ailment, the level of care now is not the same as it was prior to COVID and it is getting worse.  Please be safe.