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Connecting in a time of distancing

Dr. Neil Gokal, Optum Care Nevada

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Neil Gokal is a physician with Optum Care Nevada in Las Vegas. In the following story he relates, in his own words, how connecting with his patients has changed during COVID, and how a simple act of kindness can make all the difference in the world.

Besides being a primary care physician, Dr. Nilesh (Neil) Gokal is the medical director of Clinical Education at Southwest Medical Associates, a part of Optum. 

He is also the site director and associate program director for Valley Health System Family Residency Program and an assistant professor at the Department of Family Medicine at Roseman University and a member of UNLV's adjunct clinical faculty (SOM).

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With COVID-19 forcing routine patient care to be delivered primarily through televisits, I spend most of my time these days on the phone and computer, checking on my patients.

The conversations are less medical than personal, as we connect about how they're faring in the crisis and ways they're coping with the isolation. Although emotionally exhausting, it's been spiritually rewarding in a way I never expected. 

I relish the kindness of patients who express so much gratitude for their clinicians. And I, in turn, am buoyed by the opportunity to get to know my patients more intimately than a brief exam can afford.

Last week, I was on the phone with a patient I'd gotten to know over the years. Previously raucous and ebullient, she struck me as uncharacteristically frail. Her husband had been ill for over a week, she told me. 

Unable to drive, afraid to leave the house, and without family in the area, she was struggling. I asked if she had any food at home. Timidly, she responded that she didn't. I could feel the shame in her voice.

When we hung up, I did something I rarely do; I took a break. At 12:03, I got into my car, and texted my medical assistant. In minutes, she responded with the address of a grocery store near my patient's home.

And so, in the middle of my work day, I went shopping.

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With a cart full of food, I stood briefly in the parking lot and looked at the blue sky. I felt the warm sun on my face. I took a deep breath. And for a passing moment, I almost forgot the turmoil of the world around me.

The drive to her home was unfamiliar. I navigated dilapidated roads lined with litter and debris. A few concrete structures had curtains over doorways and bars over windows. I parked my car beside the fence that surrounded her home. Hearing the car door close, she cautiously emerged from the entrance. 

When she recognized me, her face lit up with that same warm-heartedness I'd grown to enjoy, her strength peeking out from beneath the strain of her situation. As I placed bags of food on the ground beside the gate, she stood beaming with hands together, almost as if in prayer.

Then she started to weep.

I gave her a wave from behind my mask, and then I, too, clasped my gloved hands.

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So much of my role as a health care leader and physician is to support my teams and push clinicians to practice at the top of their license.

My work is also to nurture the kind of compassion, integrity, connection, and empathy that so perfectly aligned on that afternoon — to remind myself and others of the important work we do every day in service of better, healthier lives.

It was my first lunch break in as long as I could remember. I hadn't eaten, but I was filled. I was reminded of just how blessed I am to be able to connect with the people and patients who give life so much meaning. And I was energized to move forward with grateful fortitude.

But first, I needed a new mask.

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This publication is informational and for educational purposes for practitioners only. The views and opinions expressed herein are those of the authors and do not necessarily represent the views of Optum Care. The views and opinions expressed may change without notice. 

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