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For hospice physician, patient care means you 'walk the path with them'

Dr. Joseph Kras and his daughter, Sophie, at their StoryCorps recording in Olivette, Mo.
Dr. Joseph Kras and his daughter, Sophie, at their StoryCorps recording in Olivette, Mo.
The Kras family

The coronavirus pandemic has forced Dr. Joseph Kras, an anesthesiologist training in hospice and palliative care, to face some tough choices.

His 18-year-old daughter, Sophie, has lupus, which makes her high-risk should she contract COVID-19. Kras has to be very careful when he goes home, and he makes sure to keep his distance from his daughter and disinfects common surfaces to keep her safe.

At the beginning of the pandemic, Sophie was upset her dad kept working.

"Whenever you talked about your duty as a physician, my mind would just turn that around as, 'What about your duty as a father? You could save them, but you could end up killing me,'" Sophie tells her dad during a StoryCorps conversation.

For Kras, it's a matter of balance. He says he would of course feel guilty if she got sick, but "if I don't do it, who is going to? Is everybody gonna step back and not do it? Would I want other physicians to turn their back on you if you were sick? Absolutely not."

As a physician treating end-of-life patients, Kras is committed to both being honest with his patients and making clear he is willing to "walk the path with them, whatever that path may be."

He remembers one COVID-19 patient who, as she was deciding to go on a ventilator, was prohibited from seeing her long-term partner because of hospice lockdown rules. In that moment, he was moved by the idea he might be the last person she would ever talk to.

"There was just the sense of aloneness that was over the room," he says. "And me trying to be present — because sometimes that's the most and the least that you can do for your patients. But sometimes, you know, that's not enough."

If you're a good doctor, he tells his daughter, "a lot of your patients take a little chunk out of you every now and then."

Sophie says that she now realizes how tough her dad's job is. "Even though I don't really tell you, I really admire that you go out there and confront these contagious diseases and people who are dying, and people who are angry and sad," she says.

There are things you can't change, and you just do your best, he tells her. "But, I gotta say, one of the things I miss most is giving you a hug," he says. "And when this is all over, it's one of the things I wanna do."

Audio produced for Morning Edition by Camila Kerwin.

StoryCorps is a national nonprofit that gives people the chance to interview friends and loved ones about their lives. These conversations are archived at the American Folklife Center at the Library of Congress, allowing participants to leave a legacy for future generations. Learn more, including how to interview someone in your life, at StoryCorps.org.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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