Do You Really Want Me to “Do Everything”?
With COVID-19 ravaging the nation, we need to articulate to our doctors what our goals of care are
In my last post, I shared my experiences taking care of patients suffering from COVID-19. One of my reflections had to do with articulating goals of care, and I want to expand further about what this means.
Thankfully, most people — about 80% — who get COVID-19 will have a mild illness and recover without complication. About 20% will get sick enough to require hospitalization, and of those, about 20% will require intensive care unit admission.
It is that small percentage of patients that have occupied most of my waking — and sometimes sleeping — hours working in the Intensive Care Unit. These patients are sick…very sick, and we are doing everything humanly possible to support them through their critical illness and avoid further complications. We give them IV fluids, we give them oxygen, we give them antibiotics and other treatments. We have them sleep on their stomachs if they can tolerate it. We have them breathe through a tight-fitting mask called CPAP or BiPAP (similar to what is used to treat sleep apnea). And when all else fails, we sometimes need to put them on a ventilator. When this happens, we pause and ask the question: “Do you want me to do…
