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Tuesday, January 12, 2021

74 Brazos County residents hospitalized for COVID-19, ICU occupancy at 127%

Folks, we are stretched past the limit of usual capacity and care. As some other communities in this situation have been forced to triage care to those most likely to revive, we may be in the same position. Once a covid infected individual in intubated and placed on mechanical ventilation, death takes 2-4 weeks. This means resources are tied up for a long, long time while more and more and coming in. Consider your advanced care directives (ACD). Write it down and state your wishes to your surrogate decision-maker. We have had instances where such surrogate decision-maker has not honored their loved one's wishes and have wilfully kept the existence of an ACD from the healthcare team. What a breach of trust on all accounts! Certainly, it is an unethical thing to do to a loved one who entrusted that individual. So, please do ask your surrogate if he/she feels comfortable filling that role. If he/she cannot fill that role, select someone else. If medical benefit can no longer be afforded, a do not resuscitate (DNR) status is reasonable. If a covid infected patient has a cardiac arrest while on a ventilator, doing chest compressions and shocks is futile. We have saved no one under such conditions. Doctor, do everything! When people say "do everything," what they often mean is do everything that may help and don't do those things which may hurt. Few would desire to spend their last days in medical torture. It takes a toll on us, the healthcare team, to be forced to commit medical torture. Remember we, all of us, have a capacity for compassion and to offer it to the suffering. We are so gifted by our maker. We are not like animals who simply step over the body of a fallen member and move on. Let's not forget, our uniquely human gift and practice this compassion. When cure is not possible nor further medical betterment may be afforded, we have the capacity to alleviate preserve dignity and to alleviate suffering.
from Rajesh Harrykissoon, MD

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