What felt like closure.

Niloy Jafar Iqbal

Albert Einstein College of Medicine, MD/PhD MS4


April 21, 2020

I have been a volunteer sub-intern at Jacobi since the first week of April. I did not think twice about volunteering; I had spent the entirety of my third year at Jacobi for clerkships and felt it an honor and privilege to give back to all the residents and attendings who had spent the past year training me. Now, two weeks in, I remain grateful for having this opportunity to support my colleagues and community. I am a fully integrated member of an amazing, multi-disciplinary team. Our attending is an OB/Gyn. Our residents are pulled from radiology and GI. It is truly "all hands on deck" as we all try our very best to combat a disease that we sometimes feel like we barely understand.

After two weeks on service, as the management of my patients becomes more algorithmic, I am beginning to re-accumulate enough bandwidth to start thinking about what comes next. Namely, I have started wondering how I am going to deal with all the death I have seen in the past two weeks. I think about one of my first patients, who passed away six hours after I first saw her. Although she was DNR/DNI, and the family was aware of her grim prognosis, I remember trying to find the words on the phone to explain why they could not see her or be with her in her final moments. I think about how, in my second week, an incredibly young patient of mine went into cardiac arrest, and the physician running the code did not think it either feasible nor safe to intubate him; he was pronounced dead as I performed chest compressions. I have seen more people die in the last two weeks than I have in the entire year preceding them. Everyone on my team feels strangely desensitized, compartmentalizing each death for the sake of the patients who are still alive and need our care.

As I head back to Jacobi for another two weeks, I fear that I will accumulate more memories of tragedy and death, and I am unsure as to how they will shape me in the future. But, among all the sadness, I look forward to the small reminders of the good we are doing for our patients. At the end of last week, I discharged an older COVID patient home. As I finished talking to his daughter (through a Spanish translator, no less), she asked if it was okay if we prayed together over the phone. I have never been a religious person, but this was an incredibly spiritual experience for me. As we prayed together, for both my patients and my colleagues, I felt some measure of what felt like closure for all of the patients I had lost in the past few weeks. I only hope that I have more moments like this.


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