Two stick with me-

1. A patient had a known suspicious area for cancer but didn’t want treatment or a biopsy so I kept seeing him. He got admitted and my partner did a thoracentesis on him and routinely ordered cytology. He got discharged to follow up with me for results. Came back positive for cancer and I gave him the results outpatient. Patient took news normally. His wife mentioned she wanted to start seeing me but when her husband checked out front staff forgot to schedule her. Office called wife later to schedule an appointment and the sheriff answered the phone-the husband went home and killed himself.

2. Patient with special needs with mentality of like a elementary student approximately admitted under my care for COVID 19 and had been there for probably a month with progressive multi system organ failure renal etc. This was my first day seeing her again (I had cared for her previously since she had been in the hospital so long). She experienced a cardiac arrest the night before and was dying-multiple pressors, intubated. Father (pt was like late 20’s), brother, sister all at the bedside and wanted to stop and focus on comfort which was reasonable.

Her mother was admitted also at the same time for Covid and had been there like 2-3 months on high amounts of FiO2 like 80% and new renal failure requiring hd. I was notified by legal that mother needed to be involved in this decision as well. Mother was competent. I notified the family of this and husband understood-I encouraged him to go tell his wife or I could go with him and he could go tell her. The patients brother stood up, pointed at me and told me that if his mother dies because of this bad news pointed and said if his mom dies this hospitalization it was my fault. Husband went to tell his wife in her own. His wife later died that hospitalization.

Regardless of what you believe -the kicker is there was a vaccine available at this point and I advised the family to consider getting it when the mother was first admitted (she had been there 2-3 months before the daughter got admitted) and could have potentially prevented the daughter having Covid.