A doctor learns how to connect with others in an era of distance.
It’s 6:45 a.m., and I’ve arrived early to see my patients on the COVID floor of the 10th floor at Hillcrest. Two minutes on the floor and I am already paged that my patient, who I had admitted less than 24-hours ago, is having more and more difficulty breathing. As a hospitalist who works on the COVID team, I have learned how quickly the condition of our patients can worsen. I rapidly put on my mask, face shield, gloves, and gown to see my patient. She and I have a difficult conversation. I tell her that the intensive care team will be called because her respiratory symptoms had progressed to the point where she requires intubation. I had spoken to her family on the phone the day I admitted her to the hospital and knew I would need to update them about her current situation.
Breaking bad news to patients and their families is typically done in-person. It is much easier to convey empathy when looking into the eyes of your patients and their loved ones. Face-to-face conversations also let me pick up on body language, to determine when I should slow down, or pause to allow the listener time to digest the information, and even a gentle touch on the hand if it feels appropriate. We commonly try to avoid breaking bad news over the phone. But in this era of visitor restrictions and social distancing, I don’t have a choice. I have had to adapt my approach to breaking bad news and try to convey empathy and respect as much as possible. Just like I would in-person, I try to find a quiet place to make my calls. A place free from distractions and the background sounds of the hospital—the beeping telemetry monitors, the nurse’s station call-bells, and conversations carrying in the background. I have even found it helpful to spend the first few minutes of the conversation getting to learn more about my patient from their family. It lets me feel more connected to them and helps build that bridge of trust and rapport.
This pandemic has changed the way we practice medicine and interact with our patients and their loved ones. Whether my phone call to them is bad or good news or even a simple update, that regular communication with them lets them be part of their care. Although we are practicing medicine in an era of less human contact, that doesn’t mean there has to be less human connection.
Dr. Ali Farkhondehpour ’07 is an internal medicine physician/hospitalist at UC San Diego Health. He graduated from UC San Diego’s Warren College with degrees in human biology and psychology. He has worked at both the UC San Diego Medical Center in Hillcrest and Jacobs Medical Center in La Jolla since 2013.