Make it to the Mat

From the 5/29/2020 newsletter

Make it to the Mat


Katie Recka, MD - Palliative Care Medicine



It was March 31, 2020. I was happily isolated in my VA office, attending a WebEx meeting. My phone vibrated. It was Mom. Probably a misdial. She only calls in emergencies. Couldn’t she just
text?


I was already grabbing my coat and keys before the voicemail was done. Something was wrong. It was Dad. Stomach pain, coded in the emergency room, now in the ICU. Or was it surgery?


That night we huddled together in my childhood home, just two blocks from Bellin Hospital in Green Bay. We were so close to him, but we may as well have all been in Texas for the good it did us. All we could do was stare at the pictures flashing by on the television and wait for the calls. It was Netflix, and the show was an episode of the docuseries, Cheer, and my father was dying.


He’s out of surgery.He’s on three pressors.This doesn’t look good.We have certain visitor exceptions; would one of you like to visit?


All the with the sunny inanity of the television in the background, its face-to- face intensity now archaic. There are no masks in the cheerleader pyramid, no social distancing.


Now I was the one who was spinning and disoriented. My father didn’t have COVID-19, but the presence of the virus in the community would keep all of us out of the hospital, my second home. Now I was (gasp-double flip-will she make it?) a patient’s family member, not a doctor. I wasn’t an insider. I was a helpless daughter, the annoying daughter who kept calling, the daughter born forty years ago in the same building where Dad was intubated, sedated, alone.


We build our own pyramids within our health systems, vibrant and wholesome when they work well, but precarious when they don’t. The days ticked by. At first, Dad was too delirious to use the phone in the ICU, he didn’t remember why he was there, but he was desperate to get out. Then he was in acute care, and he was terrified knowing he might never get back to his family and to his home that were so close, we were almost visible from the window of his room. Finally, he was in sub-acute rehab that we promised would be better but wasn’t. Each step was filled with well-meaning experts who couldn’t accommodate the one thing my father needed, the reassuring voice of a loved one unfiltered by electronics.


We built layers of help. Homecare promised light and fresh air, but with facemasks and eye shields, would we even recognize his home nurse if we saw him in the grocery store? The gear protected everyone from an invisible virus but isolated us. How do you bond with the strangers in your own home when they are faceless?


The whole goal in Cheer is to “make it to the mat.” The athletes practice until they collapse. They run, jump, and flip to the finals despite both physical and spiritual injuries. We watched Dad move painfully from bed to chair. Then he could walk, then take on stairs. A high-five from everyone when he ate at the kitchen table and support when he kept his game face on during the complicated reality of closing the law office he had opened ten years before I was born.


I can and will slip back into my comfortable role, but what do I do now as an insider? The provider with a new normal? We keep going until we get it right.


Our well-trodden path to the conference room is now the well-worn keyboard on our computer. It’s WebEx, Zoom, Skype, FaceTime, Facebook, Instagram, text, and phone. We attack this new normal like athletes do. We need to do it again, and do it again, and do it again so that constantly making connections becomes our normal. We nail that mental backflip until we believe that sheltering apart is sheltering together. If we don’t believe that masks and eye shields and gloves facilitate contact instead of separate, what patient is going to believe us when we look through a layer of scratched Lexan and say things we don’t believe ourselves?


Keep going. Do it again. Make it to the finals. Somewhere, there is another father coding and another family out there spinning and disoriented. We need to be there to catch them. We need to stick this landing hard and leave it all on the mat.



Katherine A. Recka, MD is an Assistant Professor of Medicine in the Division of Hematology and Oncology - Medicine at MCW. Her practice focuses on Palliative Care.