“You have shown our nation and our world what it means to care for and sacrifice for others, to truly serve. You remind us that in moments of crisis, we have a choice. We can retreat to our corners and fend for ourselves. Or, with hands outstretched and hearts wide open, we can reach out and lift each other up.” – Vivek Murthy and Alice Chen here in this open letter to physicians during the COVID-19 epidemic.
In the past 3 weeks, there have been so many times that I have been moved to write, and yet, I have thought it a luxury that time could not afford. I thought that I would be taking myself away from the anxious, scared and ill patients, from my papers languishing from years ago and from yesterday, from my family who are ALL HOME and the cleaning and caretaking for which I am usually so fortunate to be able to employ help. I thought it would take away from me checking on my family, my parents who I have banished away from our home, my cousins, my friends both doctors and not.
Today, however, we had an exercise during our faculty meeting which changed things. In recognition of the immense emotional toll, the constant and searing burden of anxiety and worry for ourselves and our families, and for the long road anticipated ahead, my colleague led us in a beautiful exercise. He told a story of gratitude, and then invited us to announce what act of self-care we can do to lighten our anxiety and be kinder to ourselves.
Immediately, I realized that, for me, writing is not an opportunity cost, but rather an act of self-care. Given this, I committed to writing three times a week again, to maintain my sanity, reflect in a safe space, and be able to give those thoughts a home so that I may move on to the other necessary things of this day.
I have felt the emotions brimming for the last three weeks, since U.S. projections became dire, since our clinics were reorganized, since daily COVID-19 updates and tweets became the stuff of intense anticipation and baited breath. The two weeks since I saw my first patient in our respiratory screening clinic, arriving to a new clinical site on a Saturday morning with my precious N95 in its crinkly paper bag, changing into blue, hospital-issued scrubs for the first time in nearly a decade. The one week since virtual precepting became routine. Every tweet I read, of medical students gathering PPE to support the front lines, of neighbors checking on one another, of governors rising to the occasion and giving credit to all essential workers has made me more proud of the place I live and my part in this response.
The global pandemic from SARS-CoV-2 is unprecedented in my lifetime, yes, and this time is something that I will never forget. It is, however, the strength and generosity of our physician, provider and hospital-worker response that has made a deep impact on me more than anything else.
Before this pandemic, the sacred altruism and limitless well of goodness expected by our profession were visibly stretching, cracking and altogether breaking, especially in primary care. Burnout was taking root in our ambulatory and hospital-based activities, and thoughts of careers beyond medicine, where self-worth was clearer and making a difference was possible. Every day, we care for patients in ways that cannot be monitored for compensation, we are frustrated by our inability to fully address social determinants of health, we are moved by the incremental and monumental changes that we help people to make.
In the midst of this pandemic, the one thing that has positively changed is the adaptability and receptivity of traditionally staid institutions to rise to the challenge and the demands of those on the front lines. Converting from 10% to 50% telemedicine visits within one week. Focusing on possible disparities early and pushing forward the agenda to highlight LEP and disabled patient care in the interim solutions, recalibrating research time to focus on the pandemic and hospitals and researchers joining forces to hit this thing from every angle.
And the selflessness, commitment, focus, brilliance and steadiness of my colleagues in facing this pandemic is clear and true.
There is a lot that is still scary. Lack of PPE, the impending surge, the inability to normalize life for our families, the anxiety of every patient interaction. The strong fabric of colleagues and friends meeting this foe together, however, is a singularly positive light through the intense haze of prediction and quarantine. That, and, hopefully, a new generation of general internists, ID docs and public health workers with a united goal of worldwide health, safety and humanism.
Life and Sundry Adventures 