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  • Richard Cree

Hope

Bank Holiday Monday 25th May 2020

Figures for 24rd May

UK COVID Deaths 116 / Total 36,793

James Cook Hospital – Total COVID deaths – 223

All COVID cases within South Tees Hospitals Trust – 41

James Cook Critical Care COVID cases – 7 / 6 ventilated

James Cook Critical Care non-COVID cases – 32 / 10 ventilated

I’m back working on the sole remaining COVID ICU today and I am happy to report that every patient is showing some signs of improvement. This has rarely been the case over the past two months and is most welcome.

For some of the patients the improvement is not surprising. There are always some patients that once you manage to halt the progression of their illness, they will start to get better and will continue to do so. These are often our younger patients without existing medical problems. COVID-19 has turned this expectation on its head. It has proven to be a very unpredictable disease and at times, it seems that all bets are off.

It makes discussions with the patients’ families quite difficult. There is a tendency for the average ICU Consultant to come across as somewhat pessimistic when discussing patients progress with their families.

This is not without good reason. Our patients are so much sicker than the patients on the ward that it makes it difficult to try and predict what might happen within the next few hours, let alone the next day or so. Sometimes we think we are helping families be realistic by remaining suitably vague and non-committal when asked about what we think might happen in the near future.

We live in fear of giving what we might call ‘false hope’ to relatives. We are also fearful of being ‘wrong’. We worry that not being able to accurately predict what might happen may make us look incompetent and undermine any confidence that the family may have in us.

I have come to learn the hard way that this is not the case. I am more honest nowadays about the things that I don’t know. If I do make a prediction I am not afraid to add that it may be completely wrong. I will recognise my own hope that things will improve despite evidence to the contrary and I will not be afraid to acknowledge that a patient has improved for fear that the improvement will not be sustained.

Today was a day that I practised what I have just preached. One of our patients is quite elderly and has been extremely unwell for a number of weeks. Today he is better and I take the opportunity to make sure I tell his family this. It is of course, too early to tell whether this improvement will continue. There is only a small chance that he will ultimately survive but it is vital for the family to realise that this chance exists. They need to understand that we will continue to do our best for their loved one even when we know the odds are against us.

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