Making a critical connection

The doctor was on her mobile phone using a video app to speak to the mother of a patient in the neurological intensive care unit at UCI Medical Center.

Patients in the 12-bed neuro ICU are some of the most critically ill in the hospital, with brain and spine disorders that, after recovery, often require profound adjustments to life-altering conditions: paralysis on one side of the body, for example, or a limited ability to speak.

With the COVID-19 pandemic preventing families from visiting patients in person in all but the most extreme circumstances, such as end-of-life cases, UCI Health doctors have gotten creative about keeping relatives in the loop as much as possible.

Dr. Sahar Osman, who spent four years completing a neurology residency at UCI Medical Center and is currently in the first year of a two-year neurocritical care fellowship training in the neuro ICU, has won praise from colleagues for going the extra mile to put patients and their loved ones in as close contact as possible during the virtual lockdown at the hospital.

Using FaceTime and an app for physicians called Doximity, Osman spends a substantial part of each shift making video calls with families, describing everything the nurses and other members of the medical team have done for patients and showing what progress, if any, they’ve made that day.

Before COVID-19, most people would sit bedside with their often-comatose relatives, stroking their hands or touching their faces as they comforted and encouraged them with messages of love and hope. They could see for themselves the hard work nurses put in and would be kept informed by the healthcare professionals working with patients throughout the day.

Now families depend on doctors such as Osman – and, occasionally, nurses – to connect with them via video calls (compliant with privacy laws).

Recently, when Osman was speaking to the mother, whose teenager daughter had suffered a series of seizures, something amazing happened.

The girl had been in a medically induced coma for more than a month, with no assurance that she would wake up, despite the fact that Osman had ceased the coma-inducing medications. But when the doctor trained her smartphone camera on the teen and asked her to hold up two fingers, she did just that.

She then gave a thumbs-up and mouthed “Mom,” smiling at her mother’s image on the phone.

“It was legitimately one of the most exhilarating moments of my life,” Osman recalls. “I was excited because my patient woke up. And the fact that she did when I was on the phone with her mom was unreal.”

At first, the girl’s mother was in shock. Then she started crying.

“I was crying too,” Osman says. “We never know if a patient like her will wake up or – if she does – have brain damage that will prevent her from communicating.”

“Be strong,” the mother told her daughter. “Come home soon.”

By Mother’s Day, the girl’s condition had improved so much that she could speak to her mother. Several times on a video call that day, she said, “Mom, I love you and miss you.”

A role model

Because attending physicians switch out a lot in the neuro ICU, fellows like Osman become familiar faces to relatives relying on technology for updates on the condition of patients.

Osman’s compassion and communication skills have not gone unnoticed.

“The way she handles families and responds to questions – and how she’s able to put everyone at ease – was admirable even when she was a resident,” says Dr. Leonid Groysman, a specialist in neurocritical care who directs the neuro ICU fellowship program.

“She has always shown a high degree of maturity, and her ability to understand the families – their worries, their mood in the moment – has always been phenomenal.”

Dr. William C. Wilson, chief medical officer at UCI Health, wrote in an email to Osman: “Thank you for your kindness and dedication to patient care. Your efforts at communicating with families, especially during this stressful time, are laudable and much appreciated.”

And Dr. Deena McRae, associate dean of graduate medical education at UCI’s School of Medicine, calls Osman a role model for all healthcare workers.

“Thank you, Sahar, for investing so much of your time and emotional energy into informing and reassuring the families,” McRae wrote in an email to her. “This is absolutely priceless, and they will forever remember your kindness and generosity.”

Osman says she’s just doing her job.

Pressed, she speculates that her empathy may spring from growing up in war-torn Beirut and living in many places around the world. With a father who worked for the United Nations and a mother who worked in the field of human rights, Osman and her older brother, Heiwad, and younger sister, Sarah, frequently shuttled between the Bay Area and the Middle East.

Osman, who went to medical school in Lebanon, became a multilinguist; she speaks English, Arabic, Dari, and some French, Spanish and Vietnamese.

“It’s really important for me to try to talk to my patients in their language as well as I can,” she says. “They really feel like you care. I had one patient who came in, an older lady who had a stroke. She was nauseous and vomiting, and everybody was trying to tell her to do things by using a translator app on their phones, but she would not respond.

“I looked at her and touched her stomach and said ‘Dau bung?’ – which means ‘stomachache’ in Vietnamese. She opened her eyes, turned to me to get a closer look and said ‘Good job!’”

Osman says her FaceTime and Doximity calls are just an extension of this desire to reach people, to create an emotional bond with them.

“The thing I love about medicine is the human connection,” she says. “It’s a privilege to be part of these really big moments in somebody’s family and in somebody’s life – particularly now. With the coronavirus pandemic, everybody’s going through a universal trauma of sorts.

“So with neuro ICU admission being an additional trauma, I believe it’s important to show a little bit more sensitivity, because family members may not be in their normal state of mind. They may have lost their job. And that adds to all the anxiety going on now.

“I feel better when I make other people feel better. I just think that right now people need a little bit of extra TLC.”