I had spent the morning in the operating room, holding open the mouth of a young man while the resident physician attempted to stabilize the fractures in his jaw bone and lace wires between his upper and lower gums, much the way one would thread a shoelace between the sides of a sneaker. Peering into the patient’s mouth, I couldn’t help but wonder if he could be an asymptomatic carrier of the novel coronavirus, a virus that had invaded some of our lungs and many of our minds over the last few weeks. Conversation between nurses, doctors, and surgical technicians circled around Costco’s inventory, ammunition sales, and the suggestion from one attending physician to layer two surgical masks, one on top of the other. For a profession grounded in being “evidence-based,” I was struck by the degree of opinions circulating on the best way to survive the emerging pandemic. The young man’s surgery finished uneventfully, but instead of inquiring about the next procedure on the schedule as I usually would have done, I was jarred by a sense of uncertainty and decided to head home. I arrived to find the announcement from our medical school’s administration that we would be suspended from clinical rotations for the foreseeable future due to risks related to coronavirus.
I felt immediate relief from the news that I could limit my exposure to the virus and minimize the risk of spreading it to vulnerable patients by staying at home. I worried about patients: I had one man with kidney cancer on multiple chemotherapeutic drugs, and as a young and healthy person, I could unknowingly introduce a shred of virus into his hospital room that his immune system might not be able to resist. As a medical student, I contributed to patient care by taking in-depth histories and writing notes for the medical team, but I was secondary when it came to the medical decision-making that kept patients alive. While in the preceding months of third year I had yearned to have more responsibility for patient care, now I felt relieved that I didn’t have to choose between caring for patients and the welfare of myself or my family. It was the first time since entering medical school that I felt grateful that I did not yet have a medical license.
But I wonder how it will feel, as will be the case in a little over a year, when I have no choice but to stay in the hospital and continue working. I do not expect that upon graduating from medical school, I will also graduate from feelings of fear, uncertainty, or resistance to sacrificing my personal life for my work. In many ways, I will be forced to face it even more directly. As of now, I cannot know how it feels to care for patients sick from COVID-19, but I am certain that if I were standing where my mentors are now, shrouded in protective gear, I would feel conflicted over my duty to patients versus my commitment to my family and my own wellbeing.
Since transitioning to studying surgery while “sheltering in place” at home, I’ve seen daily portrayals in the media of doctors as heroes. And they are. Not only are they hardworking and committed, but they are putting that energy into service. I’ve been humbled to read accounts of physicians living separately from their families so they can continue to work while keeping their partners and children from becoming infected. But beneath my admiration is self-doubt, because no matter how hard I dig, I have no desire to be the kind of “hero” that gives up the safety and wellbeing of my family and myself. Can I belong to this profession, serve, and care for my patients, without having to give up everything else? We are, without a doubt, living in a time in which expectations placed on doctors are heightened, and one could argue that the sacrifices required now do not apply to medical practice in normal times. But I believe that the current pandemic highlights a long-held burden, self-imposed on physicians, and emphasized in the public eye; that they perform their role selflessly without acknowledgment of their individual needs or emotions.
Although reports from physicians are abundant in the COVID-era media, I have encountered few physician role-models who have expressed authentic fear or anger at the prospect of sacrificing the welfare of themselves or their families to an overburdened and under-resourced health system. Perhaps this is not the time or place for those kinds of stories. But as a third-year medical student, I welcome unfiltered narratives from physicians on what it feels like to be working and living today. Not just from a perspective of hero, which I cannot relate to, but from the perspective of a conflicted, complex human being. In the long run, I am confident that the more authentic we can be with one another and ourselves, the better we can serve patients from a place of genuine understanding. The women and men caring for patients in our hospitals today are heroic not because they don’t feel anger at the dearth of protective equipment, or fear at the thought they might become sick themselves, but because they continue to show up to care for patients despite these conflicts.
Simone Phillips is a medical student.
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