When do you leap into the unknown and venture into the uncomfortable? Is it after methodical deliberation or is it much more abrupt, emboldened by a critical decision? Perhaps it is a deep drive within you, one that propels you forward in a way in which you cannot look back.
Recent events have highlighted a systemic problem within our world, our country, our state, and our community. People of color fight an uphill battle in every facet of life, at every socioeconomic level. The COVID-19 pandemic is no exception — as we all know by now, patients from lower socioeconomic backgrounds are disproportionately afflicted. But the spotlight has refocused on a chronic pandemic: systemic racism.
The pandemic points to an important lesson: a rejection of traditional leadership structures, at least those that feed into a profit-based medical system, may be necessary in order to create a different world. The union provides such a framework, vesting power in a collective of voices. But in order to succeed at the level of a union, physicians need to let their voices join that collective — they cannot expect a delegate or representative alone to do the entire job, just as we might expect a program director to guide us in the right direction.
I learned to trust my own discomfort as an indicator of the toxic power dynamics that breed abuse for both patients and health workers. I became even more attuned to the pitfalls of professionalism because of my membership in Put People First! PA (PPF-PA), a human rights organization made up of working-class people building power to win universal health care.
The nurses noticed the behavior first — how he answered for her, his arms on her shoulders, and, on the day of discharge, his refusal to leave her room to retrieve her medications. The labor & delivery floor was already in full swing when her nurse came over.
In the first two months of 2020, I watched with alarm as a cordon sanitaire descended on Wuhan. I lived there as an anthropologist completing my research on Chinese medicine in 2017. Friends from Wuhan — most of them doctors — were suddenly describing scenes out of a dystopian nightmare.
Has social distancing paradoxically made us closer? Can disease be tragically beautiful? I pondered these questions as I reminisced over the past few weeks working on one of the medicine floors in my hospital, grappling with these thoughts almost every moment as I have witnessed the world respond to the COVID-19 pandemic.
It is difficult to put into words the level of frustration and despair that I have felt over the last few days watching the schizophrenic national response to this COVID-19 crisis and its detrimental effects on the work conditions of my colleagues. As an internal medicine physician working in Utah, it feels like it is the calm before the storm as emergency room and urgent care volumes are down as people try to socially distance to correct the spread of this virus. Other areas of the country are not so lucky.
As I check in on my patients each morning, I wonder if some will unexpectedly decompensate and die over the coming weeks. I think about myself and my co-residents who are in the hospital all day swabbing patients for COVID-19 without adequate personal protective equipment. Many of my co-residents are on home isolation as a result of this exposure, waiting for their test results and praying that our government will step up and fund more mask production, or civilians will return the N95s they’ve hoarded, or the set of a TV medical drama will donate their props to us.
Earlier last week, one patient had been referred in from their family physician, and the onsite senior resident, Adam, had been the doctor to assess them. Symptoms were vague — generally unwell, off food, bit of a cough, possible headache. Viral swabs were taken, because pretty much anyone that had lately walked through the hospital door with even a suspicion of sepsis now had samples sent off.
As an internal medicine resident working at Mount Sinai Hospital in Manhattan, COVID-19 has taken over our workroom conversations as the number of new cases enters exponential growth. As an anthropologist who lived in Wuhan for a year and has regularly kept in touch with physicians there since the city was placed under lockdown on January 23, 2020, COVID-19 has proved to be an unprecedented crisis.
In America today, history is repeating itself with ardent voices calling for division between “aliens” and “nationals,” instilling an “us” versus “them” mentality. What is happening under our watch is eerily reminiscent of the internment camps of World War II and the separation of individuals based on ethnicity that we have seen throughout history. We have created a climate of widespread fear, detaining immigrants and asylum seekers in abhorrent conditions, without a basic standard of care, and separating parents from children.