Coming to terms a year into the pandemic

Dr. Alexandra Kharazi is a cardiothoracic surgeon affiliated with Sharp Grossmont Hospital. A version of this essay was published in The San Diego Union-Tribune.

A leaky valve. Tight coronary arteries. While challenging, these problems have concrete solutions, which are readily described and learned. This is why I became a surgeon. 2019 was an exciting year for me, personally and professionally — giving birth to my daughter, Harper, in March and moving back home to San Diego in August to begin practice.

The first few months I did just what I was trained to do. Most cases went well, and even after a long or difficult operation, I was usually able to give families reassurance immediately afterward. I could hear the sighs of relief and I could see their faces soften markedly during our conversations in the waiting room.

Several months into my practice, I met Anna* in January 2020. I had been called to see her while she was in the hospital due to blockages in her coronary arteries. When I walked into her room, I encountered an older woman with a lot of humor and spirit. She was delighted to learn that I could speak to her in Russian, her native language. Anna had come from Kiev, Ukraine, my birthplace. This, she explained, was where she longed to return to see family. She had the trip scheduled the following month, and would check in with me afterward to plan her heart operation.

But that spring, COVID-19 drastically altered medical practice as I knew it. Elective cases dwindled, and intensive care unit (ICU) beds became scarce. I became more involved in procedures for the very sick, intubated patients. It was then that I encountered Anna again. This time, in the ICU with complications of COVID-19 pneumonia, where she would need an urgent procedure to survive.

Her son had asked me to be honest with him.

“Do everything you can,” he pleaded on the phone with me.

I thought of my own mom at home who was the same age, and shared a similar health profile to Anna. I thought of the distraught man on the other end of the line, frustrated that he could not see his mother, and feeling helpless that he could not fully understand the complexities of her medical condition without a medical background.

I explained that those details weren’t important now. The big picture was she wasn’t going to make it. Everything he had to know essentially came down to a few simple words.

“I don’t think it will help,” I told him. “I don’t think what I have to offer will help your mother.”
There was a silence on the line as I felt the weight of my words sink in. I kept the phone to my ear, although there was nothing left to be said.

“I’m sorry,” I told him finally, and I really meant those words even though they felt empty. I knew they weren’t enough.

I was called to see people who were unstable, had suffered debilitating complications or could not get off the ventilator. Good news was scarce, and there were often tears on the other end of the phone call. The whole experience was made even more impersonal by the necessary visitation restrictions.

Being a surgeon during a pandemic meant adapting my skill set to a different kind of work than what I was used to. Sometimes that work feels futile; sometimes the news is dismal and you enter people’s lives at their most awful and vulnerable. There is no amount of gentle, comforting or honest prose that will bring their loved ones back. But when the body finally gives out — despite all the tubes, lines and monitors — it is all I have left to give.

My daughter turns 2 in March, exactly one year since the beginning of lockdown in San Diego. Since then, COVID-19 has taken the lives of more than 3,000 San Diegans, and millions worldwide. Attached to these lives are the families and friends, and yes, even doctors and other caregivers like myself, forever touched by their loss, grasping for words and memories to fill the empty spaces.

And so, as a community and within our own private lives, we continue to pick up the pieces to make ourselves whole again. As both working surgeons, my husband and I have been vaccinated against COVID-19. Part of the small, but great, steps we take each day to move forward as best we can so that we can raise our daughter in a world where she can see her extended family soon.

*Name changed to protect privacy.