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Gabrielle Dawn Luna sees her father in every patient she treats.
As an emergency room nurse at the same hospital where her father was dying of Covid last March, Ms Luna knows firsthand what it’s like for a family to hang on to every new information. She has become acutely aware of the need to take more time to explain developments to a patient’s loved ones who are often in desperate need of updates.
And Ms Luna has agreed to share her personal loss if it helps, as she recently did with a patient whose husband has passed away. But she also learned to hold it back to respect each person’s distinct grief, as she did when a colleague’s father also succumbed to the disease.
It’s hard, she says, to allow yourself to cry enough to help patients without feeling overwhelmed.
“Sometimes I think that’s too much of a responsibility,” she said. “But that’s the job I signed up for, isn’t it?”
The Lunas are a family of nurses. His father, Tom Omaña Luna, was also an emergency nurse and was proud when Ms Luna joined him in the field. When he died on April 9, Ms Luna, who also had mild symptoms of Covid-19, took about a week off. Her mother, a nurse at a long-term care facility, then spent about six weeks at home.
“She didn’t want me to go back to work for fear that something would happen to me too,” Ms. Luna said. “But I had to go home. They needed me.
When her hospital in Teaneck, New Jersey, swelled with patients infected with the virus, she battled stress, burnout and a nagging fear that left her grief an open sore: ” that I gave it to him? I don’t want to think about it, but it’s a possibility.
Like the Lunas, many of those who have treated the millions of coronavirus patients in the United States over the past year have come from families defined by medicine. It is a call handed down from generation to generation, which binds spouses and connects siblings who are separate states.
It’s a bond that brings relief from a shared experience, but for many, the pandemic has also introduced a host of fears and stresses. Many worry about the risks they take and the risks their loved ones face every day. They worry about the invisible scars left behind.
And for those like Ms. Luna, the care they give to coronavirus patients has come to be shaped by the beloved healer they lost to the virus.
Working through grief
For Dr Nadia Zuabi, the loss is so new that it still refers to her father, a colleague in the emergency room, in the present tense.
His father, Dr Shawki Zuabi, spent his last days at his hospital, UCI Health in Orange County, California, before dying of Covid on January 8. The youngest Dr Zuabi returned to work almost immediately, hoping to continue living. purpose and the camaraderie of his colleagues.
She had expected working alongside those who had cared for her father to deepen her commitment to her own patients, and to some extent. Most importantly, she realized how important it is to balance this grueling emotional availability with her own well-being.
“I try to always be as empathetic and compassionate as possible,” said Dr Zuabi. “There’s a part of you that, as a survival mechanism, maybe has to build a wall because to feel that way all the time, I don’t think it’s lasting.
The work is filled with reminders. When she saw a patient’s fingertips, she recalled how her colleagues had also pricked her father’s to check insulin levels.
“He had all these bruises on his fingertips,” she says. “It broke my heart.”
The two had always been close, but they found a special bond when she went to medical school. Doctors are often descended from doctors. About 20% in Sweden have parents with medical degrees, and researchers believe the rate is similar in the United States.
The older Dr Zuabi was a conversationalist and loved talking medicine with his daughter while he sat in his lounge chair with his feet propped up. She is still in residency training and throughout the last year she was asking him for advice on the difficult Covid cases she was working on and he was dispelling her doubts. “You have to trust yourself,” he told her.
When he caught the virus, she took time to be by his bedside every day and continued their conversations. Even when he was intubated, she claimed they were still talking.
She still does. After difficult changes, she turns to her memories, the part of him that stays with her. “He really thought I was going to be a great doctor,” she said. “If my dad thought that about me, then it must be true. I can do it, even though sometimes I don’t feel like it.
Love tempered by risk and horror
Just as medicine is often a passion that stems from a set of values passed down from generation to generation, it is also shared by siblings and brings healers together in marriage.
About 14% of doctors in the United States have siblings who also have medical degrees, according to an estimate provided by Maria Polyakova, professor of health policy at Stanford University. And a quarter of them are married to another doctor, according to a study published in the Annals of Internal Medicine.
In interviews with a dozen doctors and nurses, they described how useful it has long been to have a loved one who knows the rigors of work. But the pandemic has also revealed how frightening it can be to have a loved one in danger.
A nurse’s brother looked after her when she contracted the virus before volunteering at another virus hotspot. A doctor had an invigorating conversation with her children about what would happen if she and her husband both died from the virus. And others have described silent tears in a conversation about wills after putting their children to bed.
Dr. Fred E. Kency Jr., a doctor with two emergency departments in Jackson, Mississippi, realized he was surrounded by danger while serving in the Navy. He did not expect that he would face such a threat in civilian life, nor that his wife, an internist and pediatrician, would also face the same dangers.
“It is scary knowing that my wife, every day, has to enter the rooms of patients who have Covid,” said Dr Kency, before he and his wife are vaccinated. “But it’s gratifying to know that not only one of us, the two of us, are doing everything in our power to save lives in this pandemic.”
The vaccine allayed fears of being infected at work for medical workers who were vaccinated, but some say they are deeply concerned about the toll that working through a year of horrors has taken for their closest relatives .
“I worry about the amount of suffering and death she’s seeing,” said Dr. Adesuwa I. Akhetuamhen, an emergency room doctor at Northwestern Medicine in Chicago, of her sister, who is a doctor at the Mayo Clinic in Chicago. Rochester, Minn. I feel like it’s something I learned to deal with, working in the emergency department before Covid started, but it’s not something that’s supposed to happen in his specialty as a neurologist .
She and her sister, Dr Eseosa T. Ighodaro, spoke regularly on the phone to compare notes on the precautions they take, provide updates on their family and support each other. “She fully understands what I am going through and gives me encouragement,” said Dr Ighodaro.
The seemingly endless intensity of the work, increasing deaths and the cavalier attitude of some Americans towards safety measures have caused anxiety, fatigue and burnout among a growing number of workers. of health. Nearly 25% of them are very likely to have PTSD, according to a survey released by the Yale School of Medicine in February. And many have left the field or are considering doing so.
Donna Quinn, a midwife at NYU Health in Manhattan, fears her son’s experience as an emergency room doctor in Chicago may lead him to leave the field he only recently joined. He was in his final year of residency when the pandemic began and he volunteered to be part of the intubation team.
“I’m worried about the toll this is inflicting on her emotionally,” she said. “There have been nights when we are in tears talking about what we have encountered.”
She still has nightmares that are sometimes so terrifying that she falls out of bed. Some speak of her son or of patients she cannot help. In one, a patient’s sheets transform into a towering monster who chases her out of the room.
The purpose of a nurse
When Ms Luna first returned to her emergency room at Holy Name Medical Center in Teaneck, NJ, after her father died, she felt like something was missing. She had gotten used to having him there. It had been scary because every urgent intercom call for resuscitation made her wonder: “Is this my father?” But she could at least stop every now and then to see how he was doing.
Besides, she had never known what it was like to be a nurse without him. She remembered that he was studying to enter the field when she was in elementary school, coloring almost every line in his large textbooks with a yellow highlighter.
At breakfast last March, Ms Luna told her father how shaken she was after holding an iPad for a dying patient to say goodbye to a family who couldn’t get into the hospital.
“It’s our job,” she recalled Mr. Luna, saying. “We are here to act as a family when the family cannot be there. It’s a difficult role. It’s going to be tough, and there will be more times you have to do it.
Kitty bennett contributed to the research.
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