Patients And Doctors Rethink Essential Care As Coronavirus Cases Rise
About a week ago, cancer patient Chuck Dipietro had to go to Chicago’s Streeterville neighborhood to see a doctor about what will be his eighth cancer surgery.
He said it wasn’t until then that he realized how serious COVID-19 is here.
“Until you walk into a hospital, you don’t really get it,” Dipietro said in an interview Friday. “There's no chuckling, there's no laughing. Everybody is moving with a sense of purpose.”
During that visit Dipietro learned he wouldn’t be having his surgery next month, as was planned. Instead, he’d be having it three weeks sooner on Tuesday.
That’s because as hospitals have canceled elective surgeries to mitigate low supplies and capacity as coronavirus cases rise, some high-risk cancer patients have been pushed to the front of the line.
“They said ‘Hey you know, things are moving quickly, we’re canceling surgeries left and right, don’t be surprised if you move up. Do I have a commitment?’” Dipietro said, recounting a conversation with his doctor. “It’s like you almost have to shake on it because guess what, if it’s not you, there’s another cancer patient who would love to have your spot. So, I got a golden ticket.”
COVID-19 has forced people like Dipietro and their doctors to make this tough and quick calculation: Which is a greater risk? Putting off treatment and letting the cancer grow? Or going to a hospital, where you could be exposed to the life-threatening virus?
“COVID has just added a whole other dimension to their anxiety,” said Dr. Chris George, an oncologist at Northwestern Medicine and Dipietro’s doctor.
George said so many of his patients will essentially have to risk their health, or even their lives, in order to get lifesaving treatment.
“People who need chemotherapy, that has curative intent, that’s meant to cure them, we really can’t delay or cancel treatment like that without an extremely good reason,” he said. “And maybe COVID will be a good reason to delay that treatment but right now it’s not.”
George is having to make tough decisions about which treatment he should delay and that has not been an easy sell to patients.
“Sometimes it’s not medically wrong to delay treatment, but the patients aren’t used to that mentality,” he said. “They’re used to kind of rolling of their sleeves and getting busy and getting after it and it takes a little bit of conversation to convince them that it’s OK, in our new world now with COVID, that exposure to the virus on a medical campus is a higher risk to them than their cancer.”
This isn’t the case just for cancer patients. People with chronic conditions, such as diabetes, are also having to make tough decisions about whether to take a risk and carry on with treatment.
Some people don’t have the choice at all, as hospitals have been advised to cancel nonessential procedures, even those that might feel very essential to the person who’s sick.
That’s why Dipietro said he considers himself lucky. But, he added, the coronavirus makes this surgery particularly difficult.
“There’s not going to [be] anybody with me in the pre-op, there’s not going to be anybody with me in the recovery area, there’s not going to be anyone waiting for me in the waiting room,” he said. “You know I’ve had seven surgeries and there’s always been someone waiting for me in the waiting room. Not today.”
Dipietro on Friday was thinking about how he's mustering a little extra strength as he considers surgery alone for the first time.
“I think of good times, times with your family and your friends — I’m a Deadhead and I love to play music, and I think, well, this is the toll — this is what you have to pay,” he said. “I’m going to go into the city and I’m going to be wearing a mask, and dousing myself in hand sanitizer and I’m going to get this sh** done, and if this is what I have to pay, then I’ll f***ing pay it.”
Still, the uncertainty and quick-changing nature of COVID can upend plans. On Sunday, Dipietro learned his surgery would be cancelled.
He said he does not know when it will be rescheduled.
“[I have] no clue when I will get in,” he said in a text. “Others [are] worse than me, but still very discouraging.”
Mariah Woelfel is a reporter at WBEZ. You can follow her on Twitter @MariahWoelfel.
This story has been updated Tuesday, March 24, to reflect that Dipietro's surgery was canceled.