A Harvard doctor has described the difficulties loved ones face as they mourn the loss of a coronavirus victim.
Strict restrictions mean many hospitals, both in the UK and US, have put limits on friends and family visiting patients.
While this may help stem the spread of the coronavirus, Dr Amrapali Maitra argues medics have been left “struggling to accompany patients who die alone and support families who cannot follow the usual customs of grief”.
In England, funerals can only be attended by 30 mourners, with some having to pay their respects via a Zoom ceremony.
Having said goodbye to some of her own relatives virtually, Dr Maitra “would not wish distance grieving on anyone”, with the pandemic making people “contend with loss in new and unexpected forms”.
“During the long months of COVID-19 [the disease caused by the coronavirus], our tally of losses has accumulated,” Dr Maitra wrote in the journal JAMA Internal Medicine.
“First, we lost the intimacy of holding hands or hugging our children after work, fearful of skin teeming with invisible harm.
“We lost the ability to walk into a patient’s room without fretting about the risk hanging in the shared air.
“And we have lost hundreds of thousands of people to an illness we cannot yet contain.”
Read more: Nurses absorb the emotions when patients die
Dr Maitra is well accustomed to departures.
Her family left their native Kolkata, India, when she was a baby, emigrating to Wellington, New Zealand. Ten years later, they settled in Houston, Texas.
“With each flight, I said goodbye to people and places I knew and loved,” wrote Dr Maitra.
“There were some goodbyes we could not bring ourselves to say, the dangling ties to our lives back home.”
“Having a conversation about your loved one’s wishes at the end of life is an act of love.” True, timely, and poignant words from cancer surgeon and humanist @khickscourant (cc: @A_Schwa) https://t.co/4uu1IXOrys
— Amrapali Maitra (@amrapalimaitra) October 5, 2020
Feeling “unmoored”, Dr Maitra was just a child when she threw herself into pursing a career in medicine, where patient deaths are inevitable.
“Dare I say, I have gotten better at goodbyes over time,” she wrote.
“I have had the chance to ‘practice losing farther, losing faster’.
“I have been harried by residency training. Lost a first patient, heartbreak for a young physician, then a second and a third.”
Thousands of miles from her native India, Dr Maitra has said goodbye to relatives via FaceTime and watched Skype burials, allowing her to empathise with loved ones who cannot be with family members as they die with COVID.
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“I would not wish distance grieving on anyone,” she wrote.
“The pandemic has made us contend with loss in new and unexpected forms.
“Calling primary care patients for virtual appointments, I walk into sudden eruptions of grief, like minefield.
“Entire families who succumbed to COVID-19 infection, elderly adults confined in isolation and fear, and patients whose treatments for other illnesses have been deferred to disastrous effect.”
Dr Maitra has adopted her own “private rituals” to help her “bear witness to these casualties”.
“Whether a post-shift shower to wash away the enormity of pain or a moment of stunned reflection after hanging up the telephone,” she wrote.
“Ultimately, we must make peace with the volatility of grief and its messy presence.
“In medicine, the art of losing is still the hardest one to master.”
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