The coronavirus has upended the world of palliative care teams -- the nurses, doctors, social workers and chaplains whose job it is to support patients and families in times of serious illness and death.
Gary Blunt is a palliative care coordinator at Providence Cedars-Sinai Tarzana Medical Center. As a palliative care nurse, he has been present at hundreds of deaths when he could hold a patient's hand and comfort bereft family members.
But he has been "taken aback at times" by the end-of-life scenes wrought by the coronavirus.
The hospital converted a cardiac unit into a COVID-19 ward. Large, zippered sheets of heavy, opaque plastic seal the hallways and the open doors of each patient's room. A small window of clear plastic provides a view of the bed.
No visitors are allowed in the rooms. To limit exposure, even the palliative staff avoids entering, meaning that the patient's primary contact is with a bedside nurse cloaked in a gown, face shield, mask and gloves.
When death is near, the hospital will let one family member -- wearing full protective gear -- stand in the hallway and look through the window for a short period of time.
Late last month, Blunt's team tried to prepare a woman for what she would experience if she came for a final glimpse of her dying husband.
He was confused and had been restrained so he couldn't dislodge his oxygen mask and tubes. He would not be able to recognize her, garbed in gown and mask, peering through a small plastic window several feet from the bed. He would not be able to hear her against the hum of the room's medical equipment.
In the end, she decided not to come. Instead, the family asked Blunt to play Neil Diamond songs on a Bluetooth speaker in the room and said goodbye on FaceTime.
A nurse held an iPad over the man's face for about 15 minutes while his sobbing wife and son uttered their final endearments.