Reflections: Doctor On Life And Death With COVID

For the past year, Dr. Lauren Graham has been the COVID-19 coordinator at the Grinnell Regional Medical Center in Grinnell, Iowa. She spoke to Side Effects Public Media’s Natalie Krebs about what she’s learned one year into the pandemic.

The following transcript has been edited and condensed for clarity.

I think in April, I was anticipating this awful wave of terribleness that thankfully did not come, and that's good. But I think I underestimated that this would be an ongoing, always stressful issue, and what was stressful then — lack of PPE, some certainty about testing protocols — those things have largely gotten better replaced with new issues, which is just going to be how this process goes.

We've had four nursing home outbreaks in our county. You know, I think every time one of those happens, that is a pretty serious moment. There's these little pictures on the chart that shows the person and you look at those little pictures, and you just know, some of them are not going to make it through this.

And the truth is, you know, we are getting better. And we are having, you have more tools. And we know the illness better. There are less fatalities. And that is we're grateful for that. But for every family member, I have to call and say, 'You know, look, your loved one that you haven't been able to see for months because the nursing home has not allowed any visitors to prevent infection has COVID-19, and they're not doing so well. And here's what we have to do. And they're going to come to the hospital, and you still aren't going to be able to see them, and they may pass away, you might have seen them on a Zoom call.' That feels awful for so many reasons.

As awful as the outbreaks in the nursing home have been, sometimes caring for those patients and talking to grateful family members who are so glad you are coming to see their loved one have been the highlights. There was a patient who had been my patient for years actually, and most recently now in a nursing home, who unfortunately passed away from COVID-19. But I got to be with her as she passed, and her family got to be outside her window. This was thankfully in nice weather. And, you know, that was just a pretty touching moment that I got to be part of that and got to be there for her in a way that her family really couldn't be without putting themselves at risk.

It's been hard on my family, just not being there very often. I have 7-year-old twin boys, and they had a birthday just a couple of weeks ago. And you know, we were coming up to their birthday and asking them what they wanted for their birthday. And request number one was a vacation to somewhere warm, we said, 'That's not going to happen.' And request number two was, ‘Mom, we want you to not work on our birthday.’ But the fact that that was the number two request before any particular toy or other 7-year-old-appropriate item was just kind of a sign that, yeah, I've been working too much and my family knows.

You know, the truth is, the next year is going to be a lot the same as the last, although better. I think there was a time when I really thought it would be gone soon. And then soon kept stretching a little further and further and further. I do think as more people get vaccinated, and as we have more developed treatment options, that that this will become more routine, but I don't think it will completely go away.

And I think the harder thing will be rebuilding all of the other pieces of our lives that have kind of been neglected as we do, as we kind of get back to normal, and I know what we see outside of COVID in the hospital and in our clinics is lots of anxiety, lots of chronic conditions that have not been optimally cared for because people don't have the energy to do what they need to do. They've been afraid to come to the doctor. And you know, we see more folks dying from cardiovascular disease and strokes and other things because they haven't been getting the care that they need. And, you know, I think it's going to take a while to recover from all of that. And that will put a toll on folks too.

This story was produced by Side Effects Public Media, a news collaborative covering public health.