Confessions in the time of COVID-19

Anguish festers, not having being caring doing enough
Not enough to salve the suffering,
Like a medic behind the front lines,
Arbitrary lines, enemy lines too –
Synesthete to unseen struggles,
Bearing witness to uncertainty. Loss.
Sheltered and “safe,” guilt echoes with every knock.
Overwhelmed, retreating,
But oh please, not too far.
Beyond walls, masks, lines,
There is sacred work to do.

I wrote this 55-word story in solidarity with my medical students and colleagues I had invited to share their lived experiences during COVID-19 on our Stories in Medicine blog.  I wrote out of a need to “unmask” the guilt and angst of some of my colleagues and myself who, though practicing physicians, do not find ourselves directly on the front lines during these tumultuous times. Rather, we are dismayed to alternate between waves of anguish and guilt.  Anguish for the suffering of our brothers and sisters in places like New York and New Orleans.  Guilt, for not being shoulder to shoulder on the front lines.  Guilt, because we are able to do things to take care of ourselves and our families in ways others are not.  Our hearts break for our colleagues and families, their patients, and the families of their patients. We can only try to imagine a small portion of what they have gone through and will go through in the aftermath.

At the time of writing this article, my home state of Arizona has not reached the levels of morbidity and mortality of other states, but we have not been unaffected. We have had enough deaths to find the need to comfort one another after the loss of loved ones and family members or friends. As a medical educator, I have said good-bye and wished students well who have graduated early in order to be part of fighting the pandemic.  I’m a medical educator and a physician, but I’m also a daughter – a daughter who fears for her mother’s safety during each shift she works as a nurse, some 1,800 miles away. My mom has had several health scares in the past. (My mind is pulled back to the time I received a call from the ED just before she was prepped for the cath lab, which she left with two stents implanted.)  In those times, I’ve been able to catch the next plane and be by her side. If anything should happen now … I don’t allow myself to think too far ahead these days.

Instead, I work to stay in the present.  These days I take heart from the overwhelming responsiveness and acts of caring of those around me. I’m beyond inspired by the armies of medical students who have mobilized immeasurable contributions in these bleak days.  They’ve been pulled from clinical rotations to reduce exposures to and from patients. They don’t know when they can go back. Yet they persevere onward, with new innovations on a weekly and sometimes daily basis.  Their work has resulted in airplane deliveries of test kits, PPE, food and supplies to the Navajo Nation, contributions as editors of a new Literature Surveillance Team on the latest on COVID-19, sewing masks for hospital teams and putting together care kits for patients experiencing homelesness, and so many more countless acts of compassion, altruism and love.

For any of us who are not directly on the front lines, there is something more we can do—something meaningful and needed that will make a positive difference for the future.  We can reach out and provide guidance and support for our health profession students. We can empower them to do what they started their training to do – helping others.  We must remember that they, too, will be health care leaders when future pandemics strike.  While uncertainty seems omnipresent in these times, some things are certain. What our students are learning by doing now will have a resounding impact on what comes next.

Jennifer R. Hartmark-Hill is a family physician. 

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