A Doctor’s Letter

This First Person article is a letter to an unvaccinated patient on life support from Raiyan Chowdhury, an intensive care doctor at Edmonton's Royal Alexandra Hospital for the CBC’s “First Person Stories”.

“Can you hear that?

The rhythm filling the silence. The hiss representing your gasp for breath. The ventilator struggling to meet your inhale and exhale. It reminds me of the ocean. The crash of the tide hitting the beach and then slowly retreating.

It's almost peaceful if it weren't so mechanical. It's almost soothing if it didn't mean your life was so fragile. This ventilator and its cadence being the only thing that separates your life here and now from what lies beyond. 

How did it come to this? Was it fear of the vaccine? Or narcissism? Or are you simply another victim of misinformation? We want to scream. We want to shout. If it would make a difference.

But we feel as silent as you.

For you, the tube connecting your lungs to the ventilator means that air can't pass over your vocal cords, resulting in utter silence. And after 16 months, it seems Albertans are tired of hearing from us. 

Different sides of the war

You are a mystery to me. I don't mean your age, your occupation, or your past medical history. That's all clear on the chart. I want to know you. I want to know the soul behind those eyes that are so clouded. You lie here in front of me exposed, but you remain a mirage. Perhaps it's the anesthesia, but I feel it's a strange disconnect for a job that's intimate in every other way.

My colleague looked you directly in the eyes as she slipped the endotracheal tube into your exhausted, listless body. She said you were kind. Sitting here, I wonder, what are your hopes and dreams? Will they go unfulfilled?

My only glimpse of the real you are the photos that your family has brought in. They serve as reminders of happier times. They are a shrine to your legacy as a person and father. In them, I see someone boisterous, warm and happy. You look loved. You've clearly done something right with your life.

The pain of the pandemic was captured in this photo, from November 2020, of Calgary ICU physician Dr. Simon Demers-Marcil calling a family to tell them their loved one had died of COVID-19. (Submitted by AHS/Leah Hennel)

In another time and place, I feel that I would have wanted to be your friend. That you could perhaps teach me about what's important in life and family.

So why does it feel right now that we are so different? Now that we are on different sides of a war — one vaccinated and one not.  

'Why was your dad not vaccinated?'

I spoke to your son by phone. He's far too young to lose his dad. I didn't know he lost his mom a few years ago. Without you, he'll have no one.

I shouldn't have asked, but I couldn't help it. "Why was your dad not vaccinated?"

Silence interrupted his tears for a second. He tells me that he begged you to get your shot, but you never did. He regrets not pushing you harder. The regret is so deep that I fear it may come to define his young adult life. It was your decision, but I wonder who is paying the price. It seems harshly unfair.

He cried the whole time I was on the phone with him. It was heartbreaking. I don't think I will forget it anytime soon.

I've always considered myself a strong individual. You don't do this type of work if you aren't. But I couldn't help my eyes from watering.

He wanted me to promise that you'll make it through this. I wanted to respond with a well-practised doctor line establishing the gravity of the situation while offering some hope.

But I couldn't do that to him.

"I promise."

If not for yourself, then why not for him?

What kind of society have we become when charlatans on social media have good people willing to risk everything based solely on their manipulative words? 

Frustration and sympathy

Anger isn't the right word for what I feel. Maybe frustration is. The nurse in your room is named Isabelle. She's a fairly new grad. She's doing this job for all the right reasons — like most of the nurses and respiratory therapists here. Not for the pay, social media recognition or the lifestyle, but to make an impact.

I wonder to myself if she will still be doing this job a year from now. After 16 months, gestures of gratitude for frontline workers have been replaced by jeers from protesters greeting nurses on their way to work.

Albertans are done with COVID even if COVID isn't done with them. 

There was a viral quote making the rounds on the internet from a doctor at his wit's end with the unvaccinated. He said that empathy wasn't an unlimited resource. 

Maybe that's the case, but not here.

ICU staff at the Peter Lougheed Centre in Calgary on April 17, 2020. After 16 months of the COVID-19 pandemic, Chowdhury says health-care workers are still doing their best to help their COVID-19 patients. (Leah Hennel/AHS)

My friend Cara is your respiratory therapist today — the brunette who takes the time to hold your hand while deep suctioning your lungs, clearing secretions that are slowly drowning you. She's one of the most empathetic people I know. 

After 16 months of this, she should be empty of sympathy. How much more can she give? But she isn't. I see her come in here and give you her best, day in and day out. It inspires me to do the same. 

Help me keep my promise to your son

I wish I could understand and rationalize your hesitancy or refusal, but maybe that's too much to ask of me. Instead, you'll get my best. 

When I see your listless body, I don't see politics. I see someone who needs my help. That's the reason we all chose to do this job. Let the protesters outside jeer and the haters online hate, and we'll meet them with a Ted Lasso-like kindness and unbreakable dedication to our patients — vaccinated or not. 

Can you hear that? The faint beeps down the hall. The nurse practitioner is intubating another one of your unvaccinated brethren. I should go.

Can I ask you a favour before I do? Please help me keep my promise to your son. “