Mental health support is crucial for those recovering from ventilator care

To ease the patients out of their induced comas, whether those comas were coronavirus-related or not, there needs to be someone by their side who can guide them and help them through the process.

A patient is comforted by a doctor in hospital.  (photo credit: NATI SHOHAT/FLASH90)
A patient is comforted by a doctor in hospital.
(photo credit: NATI SHOHAT/FLASH90)
By now, it is fairly common knowledge that in March while I was in Miami, I contracted COVID-19. I was put into an induced coma on a ventilator twice, for nearly 30 days. By far the worst part of my experience was the dreams and the emotional and mental reaction I had to the drugs used to induce me into a coma as well as the time I missed.
When I woke up, both times, I was confused. I was heavily dosed with very powerful drugs that often cause horrible dreams. I thought that these dreams were my reality. At one point, I thought I was in Switzerland and everyone around me was dying. Another time I thought I was being chopped up into little pieces. The dreams were absolutely horrific, and throughout it all, I thought I was going to die. I didn’t know it at the time, but I was suffering from something called ICU delirium.
Over the past few years, hospital staff all over the world have been discovering and documenting that patients who are kept in the ICU for long periods of time often suffer from this condition. ICU delirium can cause a patient to have horrifying, violent hallucinations to the point where they feel that they are going crazy. When they talk about it to others, their feelings are often overlooked or ignored, something that can cause them to feel very much alone and depressed.
When I finally woke up the second time, I needed to re-learn how to walk, how to eat and even how to use the bathroom. It was a terrible experience. My body was so weak I couldn’t do anything by myself. What was worse than all of that, is that I kept asking the doctors and nurses when Passover would be as I desperately wanted to be home and spend the holiday with my family. Everyone was afraid to tell me the truth. Passover had already come and gone, and I had missed an entire month of my life. I missed celebrating the holiday with my wife and children. When my wife, Gitty, finally told me, it was a serious blow.
Between the feelings of deep disappointment of having missed spending Passover with my family and having lost a month of my life, plus suffering from ICU delirium, I was in dire need of someone by my side. I needed someone to counsel me, to ground me and to help me recover from the effects of the drugs that were still running through my system and making me doubt everything and everyone around me.
At one point, I even recall telling my friends Mark Gerson, chairman of the board for United Hatzalah, and Dr. Joel Sandberg how the medical staff at the hospital were trying to kill me. The medical staff at the University of Miami Hospital was absolutely terrific. They are some of the best doctors and nurses I have ever met. I cannot praise them enough for the high level of care they provided me. To think they were trying to hurt me was simply absurd and both of my friends knew that. I was hallucinating wildly and I needed help.
At one point, one of the doctors, Dr. Maria Carolina Delgado-Lelievre, noticed my distress and came over to me to help put my mind at ease. She sat with me for an hour and explained everything that had gone on and everything that I was going through. This helped me a lot. But this was not something that was common there or anywhere else.
ICU delirium is sudden and intense confusion that can include hallucinations, delusions, and paranoia. According to a recent study published in the Annals of Intensive Care Medical Journal, “Delirium is extremely common in the intensive care unit, especially among mechanically ventilated patients… and it is frequently undiagnosed unless specific diagnostic instruments are used.”
Tens of thousands of people have been put on ventilators around the globe as a result of the coronavirus. Those who are lucky enough to wake up and recover from the disease often suffer from ICU delirium as I did. However, many times this condition goes undiagnosed, leaving many people with fear and mental trauma following the physical trauma of the disease. This is compounded by a recovery process that is tumultuous and traumatic.
A different report that appeared on the STAT health news site about ICU delirium stated that “Anywhere from a third to more than 80% of ICU patients suffer from delirium during their hospital stay. And one quarter of all ICU patients suffer from post-traumatic stress disorder once they leave, a rate that’s comparable to PTSD diagnoses among combat veterans and rape victims. Patients with ICU delirium are less likely to survive and more likely to suffer long-term cognitive damage if they do.”
To ease the patients out of their induced comas, whether those comas were coronavirus-related or not, there needs to be someone by their side who can guide them and help them through the process. As a patient who went through this, I can attest that this is a vital need for all patients and can greatly ease the suffering of recovering patients.
The emotional distress of waking up after such an experience can be overwhelming and people need help to get through it. I needed help to get through it. Thanks to Dr. Delgado-Lelievre, I got that help. And when the hospital saw what happened, they instituted a new protocol that requires a trained professional to be present with patients after they are woken up from induced comas on ventilators to help them through the process.
I strongly urge all hospital managers and staff to do what the University of Miami Hospital has begun doing – to be aware of the emotional state of your patients who are recovering from this terrible disease and to have someone by them and help them emotionally. Patients need help in overcoming and healing from this.
Please, I implore you to provide that aid and care and have a mental health professional by the side of the person recovering. It is incredibly necessary and often overlooked in many places. It will help speed the recovery process along and make it far less traumatic for the patients.
The writer is a father of five, a social entrepreneur and president and founder of United Hatzalah of Israel, an independent, nonprofit, fully volunteer EMS organization that provides fast and free emergency first response throughout Israel.