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News of death should not come by phone. Doctors struggle to adapt to coronavirus reality

Meredith Blake, Los Angeles Times on

Published in News & Features

NEW YORK -- Matt Kaufman is accustomed to death. He knows well the task of telling people that someone they love is gone -- from a stroke, an overdose, a car accident, or any of the dire scenarios he often sees at the urban New Jersey hospital where he works.

Usually, says the emergency room doctor, he can find a way to honor the gravity of the moment with small, but meaningful gestures of compassion -- waiting while a family member cries, touching them gently on the shoulder, or simply looking them in the eye to give them words nobody wants to hear.

He had never broken such news over the phone. Until now.

COVID-19 has changed things for many people, and so it has for him. Sometimes these days, while muffled by the N95 protective mask he wears throughout his shift, he shouts over the din of the ER. He recently told a woman her daughter had died.

"It is awful," said Kafuman, a director of medicine at Jersey City Medical Center in Jersey City. Like many other hospitals in and around New York City, the epicenter of the pandemic, it has seen a dramatic influx of seriously ill patients over the last three weeks.

"The overall acuity, how sick people are, has ramped up in a tremendous way," he said. "I have never seen so many people dying. You walk into the room and it's cardiac arrest here and cardiac arrest there. That is what is unbelievably shocking to me and disturbing."

 

Most hospitals in the region have barred anyone other than patients and medical staff from the emergency room in an effort to halt the spread of the coronavirus that causes COVID-19. This means parents, spouses, children and siblings who would typically be waiting in the emergency room are at home, unable to say goodbye.

Kaufman is one of hundreds of doctors who have had to change how they practice medicine because of COVID-19, particularly the delicate burden of bearing news of death.

Kaufman said the calls are often met with disbelief: "'How did this happen?' 'Wait, what? Are you sure it's the right person?' This happens when you can't do it in person. It's obviously distressing. And you feel pretty impotent about being able to help or do the right thing. It's heartbreaking."

It is perhaps the most painful act of social distancing, another cruel detachment in this strange time. Many doctors, already struggling to connect with patients on a personal level through alienating layers of personal protective equipment, are attempting to mitigate these difficulties by using FaceTime to at least put a human face on the interaction.

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