COVID Diaries: Reflections of a Hospice Physician

The COVID Diaries feature visual art, including photography, and written testimonials reflecting on life during the COVID-19 pandemic. Submissions from across the NEOMED community are welcome; see the submission guidelines below.

I thought I had death and dying figured out. 30 years as a hospice physician taught me three principles: the dying are our teachers, WE are the medicine, and often times the most important way to deal with suffering is to just sit with it. But as the boxer Mike Tyson famously said “Everyone has a plan until they get punched in the mouth.” COVID-19 was a massive right hook that buckled my knees and rocked my vision of death and dying. For the first time in recent history, our health care system faced a crisis that threatened not only the system itself, but the health and lives of health care workers. Early on, I envisioned this not as a tsunami, but as a massive rogue tidal wave. We were scrambling to understand the nature of this new virus, scrambling to develop treatment protocols, scrambling to save our own lives and the lives of our loved ones. Zoom meetings became lifelines to share new insights, support colleagues, and develop system and infrastructure responses to increasing risk levels of “Armageddon.” Suddenly, for me, hospice care risked losing its identity. COVID-19 was killing people quickly despite appropriate, and often aggressive, medical intervention. Deaths were occurring in numbers and ways that were unfamiliar to the health care providers caring for them. Increasingly more complex layers of PPE were required to prevent our patients from becoming our unwitting assassins. People were dying alone in isolation. Families were saying a final goodbye as their loved ones were wheeled into an ambulance or into an ER from the family car. Too often the final goodbye was via a one-way phone call or video call, or sometimes not at all as the nursing facilities went into rapid and complete lockdown. People were dying with trajectories and in manners that did not allow hospice to become involved. I have always likened hospice teams as the “first responders” of end-of-life care. When others in the health care system were running away from the care of the dying, hospice folks were running toward them. In the midst of that chaos, I worried how hospice could be relevant, remain helpful, negotiate the storm safely, and stay afloat.

-Written by Kevin Dieter M.D. 

Submit your COVID Diaries content to The Pulse at Select the category NEWS & ARTICLES above the search box, which will generate a screen with a green box “SUBMIT NEWS & ARTICLES.” Click the box and fill in the form that appears. You’ll have the option to include a photo. Title your submission COVID Diaries: _____, including a subtitle unique to your submission, for example, COVID Diaries: Baking My Way Through.

Written pieces should be 200-300 words. Submissions of visual art should be accompanied by an explanatory artist’s statement or personal reflection of 200-300 words that contextualizes the significance of the work shared. 

Questions? Contact Rachel Bracken, Ph.D., at

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