Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

COVID-19 has us on our knees

Jenna T. Nakagawa, MD, MPH
Conditions
March 21, 2020
393 Shares
Share
Tweet
Share

We are in a bizarre state of limbo within the crisis. We feel hopelessly behind, yet still attempt courageous efforts to be preemptive. My residency program, for example, had a fantasy of identifying which services were essential and which were not, staffing physicians appropriately, and staggering work hours to minimize exposure and allow others to be available for back-up when some inevitably fall victim to either quarantine or the virus itself. Imagine our dismay when we, overnight, lost five residents to quarantine. Imagine how our morale tanked when we realized that all we had were our text messages, that we could not be there in person, could not feasibly “cover” for one another. We suddenly felt we were not teams but individuals, numbers waiting to fall, and we were, more or less, on our own.

Even somewhat isolated, I feel some sort of belonging in the hospital. Here I’ve had the privileges of seeing the best and the worst of humanity, and for that show, COVID-19 has built a particularly large stage. For every physician who is risking his/her life to be on the front line, I’ve heard one say, “I didn’t sign up for this.” Resentments escalate quickly as we blame our departments for not providing enough protection, others blaming the government for a lack of guidance, and us all judging each other for how we’ve chosen to respond, or not respond. Those who are choosing to distance themselves are shamed for being selfish, and those who are working overtime are shamed for being “martyrs.”

Complicating our response, the responsibility over life, and the potential for risking our own have triggered memories of losing patients in the past. There is nothing more painful than knowing a patient’s poor prognosis, and being able to offer nothing. We’ve been taught to internalize this guilt, however, because we can’t afford to be lost to failure. So we learn how to deliver bad news like letters we didn’t write, and wash our hands frequently. And when a crisis like this occurs, we don’t respond like heroes. We respond like veterans from a war that their country didn’t realize they had fought. The crisis feels like a nightmare, with all the feelings of failure and inadequacy that we were told to keep to ourselves.

Our spirits and bodies are deteriorating. My close friend in family medicine told me she hasn’t slept in two days. My other friend, who is an infectious disease fellow, said she’s never felt more burnt out. I haven’t in slept more than three-hour increments for the past week. I go to the grocery store worried I might be carrying the virus and exposing innocent people, and leave after buying groceries I don’t have time to cook.

And yet.

There is this glimmer of humanity among those mourning the loss of control. The agony of defeat is but a reflection of how much determination remains within us. After waves of person after person who could not look me in the eyes, I’m humbled by the ones who did. The Medicine Senior who listened to me and did what he could. The ICU resident who looked up from her hands, chapped and chemical-burned from repeated hand sanitizing, and apologized for not being able to help me find a bed for my patient. All their beds are full. I tell her it’s not her fault. And then we wished each other luck, because we know we both need it.

I think of Antoine de Saint-Exupery’s words that were equal parts somber, and revering: “Perfection is achieved, not when there is nothing more to add, but when there is nothing left to take away.”

I think about how, in these vulnerable times, we are stripped of our resources, our science, and our egos, and left only, perhaps, with our purpose. The thing that keeps us waking up from our short naps, the thing that makes us show up to work, the thing that gives us something to protect, something to fight for, something to win. Perhaps it is that thing which will help us realize we were never selfish, or martyrs, or alone. We were just human.

It’s 2 a.m., and I’m sitting across from my patient. She used to be a nurse. Well-groomed, both she and her space are tidy. She shuffles carefully around her bed in a hospital gown and slippers from home. She’s been diagnosed with recurrent cervical cancer, and just yesterday made the decision to not receive chemotherapy. Despite spiking high fevers, she is cheerful when I see her. She’s regained her appetite. “Salt,” she proclaims, “is the answer.”

She slaps her own veins and, as I try to place an IV, makes me feel better about myself. “You’re not going to try. You’re just going to do it.” And as we approach an hour of attempts, of failures, and finally, a couple victories; as we both sit in silence watching her blood drip slowly, at a rate insufficient to call promising, into a blood culture vial; she lets out a sigh of relief. “Well, it’s been a journey.”

And isn’t it just beginning.

Jenna T. Nakagawa is a resident physician who blogs at her self-titled site, Jenna T. Nakagawa, and can be reached on Twitter @JTNakagawa.

Image credit: Shutterstock.com

Prev

Use COVID-19 as a catalyst to banish burnout

March 21, 2020 Kevin 2
…
Next

Is centralized quarantine in our near future?

March 21, 2020 Kevin 2
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
Use COVID-19 as a catalyst to banish burnout
Next Post >
Is centralized quarantine in our near future?

More by Jenna T. Nakagawa, MD, MPH

  • Outrage at how the health care system “cares” for women

    Jenna T. Nakagawa, MD, MPH
  • Doctors don’t have the luxury of grief

    Jenna T. Nakagawa, MD, MPH
  • Please call me doctor: In defense of feminist medicine

    Jenna T. Nakagawa, MD, MPH

Related Posts

  • How to get patients vaccinated against COVID-19 [PODCAST]

    The Podcast by KevinMD
  • COVID-19 divides and conquers

    Michele Luckenbaugh
  • State sanctioned executions in the age of COVID-19

    Kasey Johnson, DO
  • A patient’s COVID-19 reflections

    Michele Luckenbaugh
  • Starting medical school in the midst of COVID-19

    Horacio Romero Castillo
  • COVID-19 shows why we need health insurance

    Jingyi Liu, MD

More in Conditions

  • U.S. maternal mortality crisis: a deep dive

    Alan Lindemann, MD
  • Contemporary weight loss: Unveiling the quest for elusive elixir

    Osmund Agbo, MD
  • Why patients write: stress relief, self-care, and sharing experiences

    R. Lynn Barnett
  • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

    Angel Garcia Otano, MD
  • Family support is pivotal in the treatment of schizophrenia

    Frank Chen, MD
  • Exploring disfigurement and self-worth

    Kathleen Watt
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Motorcycle helmet laws: Balancing freedom and financial impact

      Stephen Cohn, MD | Conditions
    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • How compassionate leadership saved this physician [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • Lively communication in the service industry

      Deepak Gupta, MD | Physician
    • Contemporary weight loss: Unveiling the quest for elusive elixir

      Osmund Agbo, MD | Conditions
    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Avoiding Male Doctors Is Not Discrimination. It May Be Risk Aversion.
  • What Is the 'Carrot Tan' Trending on Social Media? A Dermatologist Weighs In
  • Did Gabapentin Improve Post-COVID Olfaction?
  • Fentanyl Death Trends; Food Additives and Heart Disease
  • What If the Doctor Is Out?

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Motorcycle helmet laws: Balancing freedom and financial impact

      Stephen Cohn, MD | Conditions
    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • How compassionate leadership saved this physician [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • U.S. maternal mortality crisis: a deep dive

      Alan Lindemann, MD | Conditions
    • Lively communication in the service industry

      Deepak Gupta, MD | Physician
    • Contemporary weight loss: Unveiling the quest for elusive elixir

      Osmund Agbo, MD | Conditions
    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...