As I change out of my scrubs in the resident lounge bathroom, I am exhausted and numb. I put on sweatpants and a T-shirt, taking care of folding my scrubs to avoid touching the dirty spots. I wipe my phone and keys with an antibacterial and antiviral hospital wipe, and place them into my bag. I hang my white coat on a wall hook in my workroom, my stethoscope in the pocket. In the opposite pocket of my coat sit two used face masks, and two used N95 masks that I am too afraid to throw away. Another workday comes to an end; every precaution taken in order to keep the stress and the fomites at work and away from home. I am an Internal Medicine resident in Chicago, and this is my life during the global pandemic of COVID-19.
Throughout my residency, I have actively looked for experiences to improve my medical training. I enjoy the complicated consult; I prefer the medically complex admission. I never thought I would be able to add “global pandemic” to my repertoire of skills and experiences, yet here I am, in the midst of COVID-19. Additionally, other disease processes do not stop during a pandemic. Patients still have cancer, bleeds from their gastrointestinal tract, and heart failure exacerbations. Patients still require intensive care unit (ICU) beds for strokes, heart attacks, and car accidents. The demand on our health care system has never been higher in my lifetime. Medical residents have a unique experience during the COVID-19 pandemic. We are in the hospital for the majority of the day, and we staff everything from the general medical floors to the ICU, and even on occasion, the emergency department. We see patients in all conditions. A resident is often the first physician a patient sees when they come to the hospital. As such, we are truly on the front lines.
COVID-19 has helped to reveal the intersections of multiple fields of science, including public health, epidemiology, patient safety, and quality improvement, laboratory medicine, and medical research. It has also shed light on the fact that health does, in fact, underlie all other aspects of human existence. This fact, although seemingly obvious, is not always immediately understood in first-world nations. Most people (including physicians) live their day to day lives taking the health of our communities for granted. However, we have seen weddings being postponed. Graduations and commencement ceremonies are canceled. Dinner out at your favorite neighborhood restaurant is canceled. Your long-awaited trip abroad is canceled. The pandemic has demonstrated that this disease knows no race, ethnicity, or socioeconomic class. When it comes to COVID-19, the world is small, and we are all at risk.
Taking health for granted is also demonstrated in politics. Public health policies are often ignored or put on the back of the docket. The issue is, when public health is working well, you don’t notice public health policies or processes. When there is a lack of public health infrastructure or improperly functioning policy, health systems collapse. As an example, we are experiencing this now with the lack of comprehensive testing infrastructure for COVID-19.
Being a physician during the pandemic also means being connected to new information globally through all avenues. Many medical residents are millennials, meaning we grew up during the social media revolution. Social media has an immense role in popularizing the #stayhome movement. Instagram, Facebook, and TikTok all have their own campaigns to encourage people to stay home and prevent the spread of COVID-19. Health care workers have popularized the “We came to work for you, stay home for us” photo campaign over multiple social media platforms. “Memes,” which were popularized by the millennial generation, are cleverly captioned images or videos that comment on a piece of cultural identity to explain a universal thought or feeling. Using humor, memes have helped people cope with the stress and anxiety of the pandemic. They are created by anyone and disseminated via all platforms of social media. As social media has shown us, there is a human component of the pandemic that is important to appreciate. People from all walks of life have come together to support health care workers and the community. Liquor distilleries are making hand sanitizer, non-medical companies are manufacturing ventilators and masks instead of their own products, shoe companies are giving free shoes to health care professionals, and restaurants are delivering free lunches to health care workers despite their own financial difficulties with furloughed staff and restaurant closures.
I have been lucky enough to have a job that is considered essential during these trying times. I have a steady paycheck, and I have a place of work to present to daily. It is a true gift to have a sense of purpose, and that has been grounding during the chaos and uncertainty in our current state of health care. I have never felt a greater sense of pride in being a physician than I do now. Yes, I am scared for the health and safety of my family and friends. I am also scared for my own health and well-being. I am still afraid of running out of personal protective equipment, scared of being exposed, and anxious that we won’t be able to handle the volume of patients that are headed our way. But, the experience of COVID-19 has reaffirmed the sense of duty I feel to my patients and my community, and this is by far the best lesson I could have been taught in residency.
As a medical resident, I remain hopeful, for the sake of my colleagues, patients, and my own mental health. I have to believe that this is a “war story” I can tell my future residents about when I am an attending physician. My hope for the world moving forward through the pandemic is that we never take for granted the power of community and our ability to come together. I hope we never take for granted our health care system and the importance of public health infrastructure. I hope we collectively have the strength to make it through the crisis. I hope we remember it’s a small world, after all, and we’re better together.
Poornima Oruganti is an internal medicine resident.
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