Opinion | We Can’t Become Numb After 1 Million COVID Deaths

*All names have been changed to protect patient privacy

The U.S. recently passed a grim milestone: one million COVID-19 deaths. The growing death toll has become so common that people are starting to lose a sense of the degree of suffering and despair this illness has caused, not only for patients but for their loved ones. As a palliative care doctor, I have intimately experienced the pain of the victims of COVID-19 and the accompanying grief.

We all remember where we were when the world shut down more than 2 years ago as the never-ending barrage of news, death, and despair surged. At that point, my caseload became overwhelming. And while COVID-19 is still here and very real, I can breathe again. But there’s one message I will forever hold close to my heart: we must maintain the capacity to recognize and ease other people’s suffering. We must remain compassionate.

It is my duty, my badge of honor, to listen to and support those making hard, unfair decisions. While working long shifts in the COVID hospital units we all thought might never shut down, I developed three methods to remain compassionate, which we must continue to practice even as we enter a new phase of this pandemic.

First, listen.

Everyone wants to be heard, particularly during times of crisis like this pandemic. As a geriatrician and a palliative medicine physician, most of my patients are going through a crisis, facing life-threatening situations, or confronting the challenging decisions of advanced illnesses. How do they feel? What is going through their minds? How are they suffering? Listening is the only tool to get an answer to these questions. It is my job first to listen so I can understand the patient’s suffering — a fundamental part of having compassion.

Some doctors, while empathetic, may not take enough time to understand a patient’s unique suffering. To do this effectively, you must force yourself to stop — stop moving, stop thinking about the other patients or that email you need to send — and just listen.

The second step is to assess.

After you have listened and gained an understanding of what is driving their suffering, you need to take a step back, personalize their feedback, process what they’ve shared, and then react. Here, new solutions may come to light.

A case I remember well from the first COVID-19 surge in New York is that of Maria, who did not get the virus, but whose story prepared me for what was to come. An undocumented single mother with three young kids, Maria came to the U.S. looking for better opportunities for herself and her children, whom she had left with her family in South America. After a few months of living here, she started to have vision problems. After diagnosis, surgeries, and some complications, she developed an infection in her brain. I was called to try to help her family make difficult decisions regarding her care. Their desires and goals changed along the way, from additional surgeries to eventually, end of life.

The family decided they wanted to bring Maria back to her home country so she could spend her last Christmas with her children and family. At that point, there was no time to waste. Thinking outside the box and working with the neurocritical care team, nursing, social workers, her physical therapist, one of our volunteers, and many other people, we were able to stabilize Maria’s condition and collect enough money and resources so she could fly home just in time to celebrate those last holidays. By thoroughly assessing the situation and the options available, we came up with the best solution for Maria and her family, despite the difficulty of the circumstances.

My final lesson is to always respond with kindness. It sounds like a bumper sticker, right? It is easy to say but hard to do. However, this is fundamental when providing compassionate care.

During those horrible, painful early months of the COVID-19 pandemic, I was frustrated. I refused to believe we couldn’t do more. I was disappointed we didn’t have strong enough tools in our toolbox to prevent the pain I saw spread across so many patients’ and loved ones’ faces. But it is in those times of anger that you need to respond with kindness.

One patient who stands out was an elderly gentleman, Alex, who had the usual chronic medical issues many 98-year-olds have: diabetes, hypertension, and other issues that were all red flags for a bad outcome. Amazingly, this patient was able to survive his COVID-19 diagnosis.

Two weeks later, I was called in because a 50-year-old man, Jose, was on a mechanical ventilator due to COVID-19. When I called Jose’s family, it was the daughter (Rita) of my other patient, Alex, who answered the phone — it turned out that Jose was her husband and Alex was her father, and COVID-19 had spread throughout the family. Rita was hopeful that I could successfully care for Jose as I had done for Alex. Unfortunately, Jose’s lungs were badly damaged, and though our care team did everything possible, he died on a ventilator. During that crisis, my job was to be kind and to work with my team, Rita, and her family to support them emotionally, providing compassionate care.

COVID-19 has been unfair to many people. It is as much a mental pandemic as a physical one. As we emerge from what were hopefully our darkest days, I encourage you to always listen, assess, and then respond with kindness and compassion.

Santiago Lopez, MD, is a geriatric and palliative care doctor. He is the associate chief of Geriatrics and Palliative Medicine (GaP) at Northwell Health, site director of GaP at North Shore University Hospital, and a researcher at the Feinstein Institutes for Medical Research.