Dr. Sahar Osman was on her mobile phone using a video app to speak to the mother of a patient in UCI Medical Center's neurological intensive care unit (ICU).
Patients in the 12-bed neuro ICU are some of the most critically ill in the hospital, many with brain and spine conditions that often require profound adjustments to life-altering conditions: paralysis on one side of the body, for example, or a limited ability to speak.
Because the COVID-19 pandemic has prevented families from visiting patients 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.
Families today must depend on doctors and nurses to help them connect with hospitalized loved ones via video calls.
A voice for patients
Osman — who completed four-year neurology residency at the medical center and is in the first year of a two-year fellowship training program in neurocritical care — has won praise from colleagues for going the extra mile to keep patients and their families in as close contact as possible.
Before measures were taken to prevent the spread of COVID-19 at the hospital, most visitors were able to sit at the bedside of 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 the efforts made by nurses and other healthcare providers to restore the patients' health.
Now Osman spends part of each shift making video calls to families and describing everything the nurses and other members of the medical team have done for their loved ones. Using FaceTime and an app for physicians called Doximity, she explains the progress, if any, they’ve made that day in the neuro ICU.
Only a screen away
In the spring, when Osman was on a call with the mother of a comatose teenager who had suffered a series of seizures, something amazing happened.
The girl had been in a medically induced coma in the neuro ICU for more than a month. There were no assurances that she would wake up, even though doctors had stopped the coma-inducing medications.
Osman trained her smartphone camera on the patient in her bed. She asked the teenager to hold up two fingers. Incredibly, the girl did just that, followed by a thumbs-up gesture. Then she mouthed the word “Mom,” and smiled at her mother’s image on the doctor's 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. “Be strong,” the mother told her daughter. “Come home soon.”
“I was crying too,” Osman says. “We never know if a patient in her situation will wake up or — if she does — will have brain damage that prevents her from communicating.”
By Mother's Day, Osman said the girl’s condition had improved so much that she could actually speak to her mother during a video call. Several times during that call, she said, “Mom, I love you and miss you.
A role model
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 UCI Health neurocritical care specialist Dr. Leonid Groysman, who leads the neuro ICU fellowship program and is assistant director of the UCI Alpha Stem Cell Clinic.
“She has always shown a high degree of maturity. Her ability to understand the families, their worries and their mood in the moment, has always been phenomenal.”
UCI Health Chief Medical Officer Dr. William C. Wilson told Osman in an email: “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.”
Dr. Deena McRae, associate dean of graduate medical education at the UCI 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.”
Empathy learned early
Osman says she’s just doing her job.
Pressed, she says her empathy may spring from growing up in war-torn Beirut, Lebanon, 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 San Francisco Bay Area and the Middle East.
Osman, who went to medical school in Lebanon, became a multilinguist; she speaks English, Arabic, Dari, as well as some French, Spanish and Vietnamese.
“It’s really important for me to try to speak to my patients in their language as well as I can,” she says. “They really feel like you care."
She recalls one patient, and older Vietnamese woman who had had a stroke patient. The woman was nauseated and vomiting.
"Everybody was trying to tell her to do things by using a translator app on their phones, but she would not respond," Osman says. “I looked at her and touched her stomach and said ‘Dau bung?’ — which means ‘stomach ache’ in Vietnamese. She opened her eyes, turned to me to get a closer look and said, ‘Good job!’ ”
Osman says the FaceTime and Doximity calls to family members are an extension of her 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."
Being admitted to the neuro ICU is an additional trauma, she says, adding, 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.”