Comment: What happens when ‘the curve’ can’t be flattened

A cancer patient had his treatment interrupted and was sent home to make room for a covid patient.

By Dimitrius Maritsas / Special To The Washington Post

Going into my second round of inpatient chemotherapy for Stage 2 Burkitt’s lymphoma, I thought I knew what to expect.

The intravenous infusions would be draining. I’d feel so tired — like I’d aged decades in just a few hours — that I’d wonder if my 21-year-old body was just giving up. The cancer center staff would find me a bed so I could rest while they monitored me. Once the drugs had run their course and my body had stabilized, I could go home.

But then the United States plunged into yet another, bigger surge of the pandemic. Utah, where I live, had thousands of new coronavirus cases each day. The hospitals opened overflow intensive care units for covid patients and redirected other patients elsewhere; like to my hospital. So when I went in for treatment at the Huntsman Cancer Institute, I learned what it’s like to need medical care and not get it because the health-care system is at capacity.

I arrived as scheduled on Nov. 19, prepared for a five-day stay. The staff gave me my first of three infusions through an IV drip in an outpatient room. When it finished, they told me to wait while they got my bed ready. Then a nurse came with startling news: I had to go home. A patient had arrived in need of urgent care and would take the last bed. The hospital didn’t have room for me. They’d phone when they could resume my treatment.

My mom and I were in disbelief as we left. We’d heard about elective procedures getting postponed because of the pandemic, but cancer treatment is pretty time-sensitive. We never learned the specifics of the other patient’s situation, but I couldn’t blame anyone for making the call to delay my treatment so they could save someone with a life-or-death emergency: It had to be truly dire to put chemotherapy on hold. I still had two needles coming out of my port, where I was supposed to be supplied with saline to flush out my system. Without it, I spent the rest of the evening chugging as much water as I could handle from a big plastic jug, hoping it was enough. The next week, the cancer center issued a statement warning that the surge of cases could cause “delays in cancer care.” (Contacted by a Washington Post editor, the Huntsman Center said that “any decisions to accommodate these patients have been made only after confirming it would not curtail our ability to meet the needs of our cancer patients.”)

It scared me to think about people in similar predicaments all around the country. More than a third of people in the United States live in places with a critical shortage of intensive care beds. Doctors in rural areas have nowhere they can transfer patients who need specialized treatment. Health officials from New Mexico to Oregon to Idaho to Pennsylvania warn that they’re on the brink of rationing care.

At home, dizzy from the chemo, my thoughts raced. When would I get to go back for treatment? What if, somehow, I got worse while I waited? Having cancer when a deadly virus was spreading unchecked was terrifying enough; but it comforted me to think I was firmly on the road to recovery. Now, I felt like nothing was certain and like I had to adjust my behavior, always keeping the possibility of scarcity in mind. I’d always assumed that I lived in a country with advanced medicine, well-equipped hospitals and plenty of trained personnel. I trusted that I could get the care I needed. It never crossed my mind that in the United States, those resources would just run out.

Late the next day, we got a phone call saying a bed had become available, so I went back. After my infusions, I asked the nurses if I could do anything to speed up my recovery. Drink water, they advised, and move around the room, if you can; that will help the drugs move through your body more quickly. Throughout the night, I drank as much water as I could. Spotting a stationary bike in the corner of my room, I forced myself to use it until I was too tired to sit up.

In the morning, my blood levels were good enough for me to go home, but the staff advised me to stay in the hospital. “You’re going to feel terrible,” they warned me. It was true: I’d never felt worse. But I decided to leave anyway. I felt bad taking up the bed if I didn’t absolutely have to. I kept thinking, What if there’s someone older and sicker than me who really needs it, and they get refused? My symptoms — mouth sores, nausea, constant heartburn — didn’t feel like they strictly required professional nursing. At home, my family brought me water and meds; I self-administered the shots that would help boost my immune system. I wanted to do whatever I could to lessen the load on the hospitals. Now whenever I go in for another round of chemo, I tense up. There’s always a shadow of worry that they won’t have space for me. And once I’ve got the bed, I try to recover quickly, to make room for the next person.

A lot of people my age think: Well, I’m young and in peak health. I’ll be fine if I get the virus. The worst-case scenario is that I go to the hospital for a few days.

The problem, of course, is that they’re putting someone else’s life at risk, either by spreading the disease or by displacing someone in the medical system. That can feel abstract and hypothetical; it can be hard to wrap your mind around the potential ripple effects of your actions. But I’m living at the edge of that ripple. I have experienced how, in a pandemic, everyone’s actions have very real, dire consequences for others.

As told to Washington Post editor Sophia Nguyen. Maritsas is a fourth-year student at the University of Utah, studying computer science with an emphasis on entertainment arts and engineering.

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