Dying in an age of COVID-19 has changed. Before, family and friends could gather around their loved one as they said their goodbyes over days, even weeks. Things are very different today. Now, it might be a stranger who sits at the bedside.
Two front line workers in Arizona talk about what it's like to hold the hand of someone in their final moments — and what we can hopefully learn from this pandemic.
'These People Don't Slip Away Into A Sleep And Die'
Sandy Mazzio is the clinical director of the COVID-19 care unit at HonorHealth Scottsdale Shea Medical Center. She says death is an everyday occurrence.
"That’s very different from what we’re used to," said Mazzio.
And for Mazzio and her staff of roughly 100, watching someone die from COVID-19 is a different experience. And she’s witnessed many deaths over her 30-year nursing career.
"But these people don't slip away into a sleep and die," she said. "They're literally awake, conscious, and it's like their bodies have run a marathon: physically and mentally, for two-weeks, with no rest, day and night."
And they get to a point, she says, where they’re done. They can’t do it anymore.
"And we literally roll in an iPad and have a FaceTime discussion; the family and the patient have a FaceTime discussion," she said. "They say their goodbyes, and when that's done, they can say to you, 'OK, I'm ready.'"
Staff then start what’s called "comfort care."
"[These are] medications to help alleviate the panic and pain and symptoms of dying," said Mazzio.
Sometimes a family member is present; other times it’s Mazzio and another nurse.
"A lot of times, they've been here a long time, so we'll know things about them. We'll play their favorite music. We talk to them, we rub their head, their back, we hold their hand. And we tell them that it's OK to go," said Mazzio.
And when the person is gone, Mazzio’s nurses return to the floor and continue caring for other COVID-19 patients.
It’s not normal. And it takes a toll even on those who are comfortable with death.
'Why Is God Doing This?'
Jeanna Kozak is a chaplain at Mayo Clinic in Phoenix.
"I will be honest with you. We are tired, and we are seeing a lot more death," she said.
In fact, roughly 15,000 Arizonans have died from COVID-19, making it a leading cause of death during the pandemic, according to the Arizona Public Health Association.
But this is what Kozak does. She provides emotional and spiritual support to the dying and their families.
"I will be honest with you. We are tired, and we are seeing a lot more death.'" — Jeanna Kozak, Phoenix Mayo Clinic chaplain
"And I'm getting a lot of, right now, 'Why is God doing this?' 'Why is God allowing this?' 'How could this be happening?' And it's going to take a lot of time."
Time to process. Like, take the daughter Kozak recently comforted.
"And as soon as I walk in the door, the daughter just gives me a great big hug and begins to cry, because she's losing her mother, who she worked very hard to keep alive and take care of as [she] aged."
The saddest part, says Kozak, was when she followed up with the daughter a few weeks later.
"Her father, turns out, was at another hospital admitted with COVID, as well," said Kozak. "So, she was basically going to lose both of her parents within a very short period of time."
Then, there was the family who refused to give up on their loved one.
"Basically, her lungs were just done," said Kozak.
And the family couldn’t accept that a lung transplant was not an option.
"But rationality wasn't going to help them accept her death," said Kozak. "This particular lady was going to die. And, culturally, they were willing to do anything to save her."
Because we don’t want to face death. We want to live forever and we want our loved ones to live forever, too. So we tend to tune out the numbers — the thousands of Americans who are dying every day from COVID-19.
"Because our numbness helps us survive," she said. "It’s normal grief; this country is grieving."
"In certain respects, death is easy because that person is gone. It's the one left behind that suffers." — Jeanna Kozak, Phoenix Mayo Clinic chaplain
And she thinks that as the nation starts to process this collective grief, we’re going to see a spike in mental health issues, like depression and anxiety.
"In certain respects, death is easy because that person is gone," said Kozak. "It's the one left behind that suffers. And so the family that has to deal with the untimely death, the: ‘Why couldn't medicine fix it?’ ‘Why did it have to be this way?’ All those whys will take time and hard work to unravel."
In the meantime, Kozak encourages everyone to try and live in the present moment, to slow down and approach life with some gratitude. Because death will come — one way or another.