My name is Lianne Kraemer, today is Monday, March 30th.
On paper you're going to see that I have a diagnosis
of metastatic breast cancer with 12 brain mets.
Off to chemo we go!
If I am hospitalized with COVID symptoms,
and I have a diagnosis of COVID,
I would ask that you would treat me like any other person who is healthy coming in.
When you have cancer, you really never know what the next week may hold.
And so when COVID-19 was added on top of it,
that added an additional weight of fear.
Because it was sorta like, "Well don't worry, it's only gonna impact or be a danger
to those who are immuno-compromised or those who are older."
When I heard those things, it was kind of like, well that's me though.
And that's a lot of people.
Our country is in the midst of a great national trial.
This is truly an unprecedented situation that we're going through.
A lot of people are hearing about rationing decisions.
Doctors have to make difficult choices on which patients to save,
in the event there aren't enough ventilators.
If they went by what the statistics are, I would not be given care.
My oncologist said that I should make a time-stamped video.
She said you know, take a shower, get out of your sweats, put makeup on,
and then just speak to what you would want done should you end up in the ER for COVID.
I'm providing this video for you at the suggestion of my oncologist.
So the point of this video is that you can see that I'm healthy and doing well.
It's so easy when somebody is sick in the hospital
and you read somebody's medical history,
to assume that their baseline function before they got sick is worse than it was.
And it's very I think frightening as a patient
to feel like your life is being distilled into a set of metrics.
In the event of a pandemic, there has to be a shift from focusing on
doing everything for the individual patient in front of them,
to thinking about doing good for communities of patients.
It is an absolutely tragic situation,
and there are only bad options.
And so the goal is to find the option that is essentially the least bad
for how to treat the most people and how to treat people fairly.
The guidance from some states start by simply excluding
large groups of patients from access to ICU care.
Patients who have metastatic cancer, heart failure, severe mental retardation,
severe mental retardation, or if you have advanced dementia.
And I found that to be ethically really problematic
and almost certainly running afoul of US anti-discrimination law.
Triage is based on fairness, it's based on equity.
It's based on things that it should be,
but it's not what we went into medicine for.
It's just very important that we are able to keep our humanity through this.
We developed an approach that starts with the assumption that no one is excluded
and everyone is eligible to be considered for intensive care.
Each patient needs to have an individualized assessment
that really is focused not on what disease they do or don't have,
but looking at the whole picture of the individual patient.
So my nurse was just in, and she got me all hooked up.
What could a patient do in preparation?
They should talk to their family about what would be their goals
in the face of a very severe illness.
I would request that you use ICU care if needed, with ventilator if needed.
Because my survival should not be based on my diagnosis.
Whether it will make a difference, I don't know.
But what I hope is that at least this will advocate for her level of function,
will give some proof in a way that this is a person who has a boyfriend,
who has a wonderful family, who does so much for so many people.
For doctors who would possibly treat me, look at me as an individual.
Because I am more than what is written on the piece of paper.