Many patients, with the support of their loved ones and hospital staff, have been fighting to stay alive, and for many that has meant going into intensive care units to be put on ventilators. It is often a one-way trip. But others who are admitted to hospitals with advanced illness are having conversations with palliative care specialists about not fighting, if they have a relatively low chance of survival, and some are opting to go to hospice units.

Dr. Craig Blinderman is the director of Adult Palliative Care and the Palliative Care Unit at Columbia University Irving Medical Center, and over the course of several recent days he recorded an audio diary for WNYC/Gothamist about what it’s like talking to patients and family members who are trying to decide how hard to fight COVID-19, when their health was already tenuous before the coronavirus struck. His reflections are lightly edited and condensed.

(Musical excerpt courtesy of The Knights and Christina Courtin, from their performance of Paul Simon's "American Tune".)