We treat self-sacrifice as a currency in medicine

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The world of COVID-19 has two poles: the frontline workers bravely putting themselves at risk for the greater good, exiled to tents in their backyards to protect their families – and the rest of humanity, asked to do its part by staying home.

As a medical student, I have felt somewhat untethered – aligned in training and identity with the former, but relegated to the latter out of necessity. I have felt shame that I am not one of the people putting my life on the line to combat this pandemic. This feeling has caused me to reflect on what gives us value as physicians and health care providers, and the more I have thought about it, the more I have come to the sad realization that we treat self-sacrifice as a currency in medicine. This is not a new phenomenon, but one that has reared its head in my thoughts recently.

At the beginning of the third year, you receive the following advice no less than ten times: Be the first one to get there in the morning, and the last one to leave. Early in training, medicine becomes a performance, one where the prize is awarded to the one who may lose the most. Want to be the best surgeon? Never say no to a case that rolls in at 7 p.m., even if you don’t see your kid for the 4th time this week. What about intern of the year? Tell your friends with pride that you stayed at the hospital until 10 p.m. every night, finishing charting while your spouse ate yet another dinner alone.

Fitting with the times, this past week, our class had a “Wellness in the time of COVID-19” interactive Zoom meeting. It did not take long for a common theme of emotions to emerge. “I feel guilty for taking a break for the first time in forever.” “I feel guilty for not helping.” “I felt so bad for not being on the front lines that I over-committed to remote efforts and just want the emails to stop.” We are so used to being put on a sacrificial pedestal – our non-medical friends and family know we work the hardest, give up the most in service of our patients – that not having this pedestal anymore, we are set adrift.

But in this time of uncertainty, with no grade to grasp for, no honors to aspire to, we mobilized, perhaps for the first time, for the right reasons. My classmates and I started a virtual scribe program, aimed at alleviating the burden of writing discharge summaries from busy attending physicians on the frontlines. We stood outside to collect PPE. We contributed to literature reviews to help answer key clinical questions in real-time. And we stopped apologizing for using this time to sit in the sunshine, to hug our children, to pet our dogs, to watch bad TV, to try out new recipes.

There is no word other than “heroic” to describe the efforts currently being undertaken by physicians on the frontlines of this pandemic, but I fear that this language only does us a disservice. It normalizes the fact that our “heroes” use homemade masks for weeks on end and lose their lives for it. That they give up happiness to strive for excellence. In the time of COVID-19, and in the future, physicians can be heroic, and they can be flawed, and they can be afraid – for above all, they are humans.

Dasha Klebaner is a medical student.

Image credit: Shutterstock.com

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