Parallel Pandemics Mind of Medicine (Wellstar Health System)

The COVID-19 pandemic has stretched hospital resources and staffing to their breaking point. Even before the pandemic hit, there were vulnerabilities, but the pandemic has exposed them. Fifteen months after the first COVID patients began filling hospital beds, frontline healthcare clinicians were showing increased signs of exhaustion and compassion fatigue – symptoms of burnout. At that time, an undocumented, COVID-positive man was transferred to the Wellstar Kennestone Intensive Care Unit. It quickly became evident that there was something special about this patient.  
 
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During the third wave of COVID-19, frontline clinicians are struggling to manage the accumulation of stress of the prior 15 months and keep burnout at bay. Whereas their initial efforts to protect the community were met with enthusiasm, many of those shows of support have waned. Vaccinations bring an element of hope but also new tensions. Meanwhile, inside hospital ICUs, patients are younger, usually unvaccinated, and sicker than ever before. After months of caring for intubated and unresponsive patients, the Wellstar Kennestone ICU team begins caring for Carlos, an unvaccinated man who is "wide awake." Through his charisma, Carlos begins lifting the spirits of the caregivers.
 
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With restrictions on visitations due to the high COVID-19 infection rates, hospitals look for creative ways to connect patients with their family members. Despite the innovation, frontline clinicians have often found themselves struggling with the realities of the pandemic – communicating virtually with families and sitting at the bedside holding the hands of dying patients. Despite his dependency on ECMO, Carlos makes daily progress over a 3-week stretch and surpasses the expectations of the Kennestone team. His determination and fighting spirit are reciprocated by a team in desperate need of hope.

Following Independence Day 2021, COVID infectivity rates surge again, once again increasing the demand for ECMO machines and staffing resources. With optimism on the decline, Carlos continues to demonstrate his desire to live – exhibiting the fight and determination that the Kennestone ICU team has come to know so well. Nonetheless, his condition has deteriorated, and the team recognizes the need to consult the Ethics service. Difficult conversations are made even more challenging in light of the strong emotional attachments between Carlos and his caregivers.

When Carlos was admitted to the Kennestone ICU in May 2021, the accumulation of stress and fatigue experienced by healthcare clinicians over the prior 18 months of COVID-19 had led to concerns that compassion was eroding on the frontlines. But seventy-plus days after he was transferred to Kennestone, Carlos’ care team continues to lean into adversity and ensure that he doesn’t face his illness alone. Carlos reciprocates their gifts of care by accessing the courage that has defined him and inspired the team throughout his hospitalization.  His bravery is a catalyst that deconstructs the narrative of emotional hardening and helps expose the magnitude and authenticity of his caregivers’ feelings.