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.
In medical school, I was taught to sit at eye level when speaking to patients, ask how they would prefer to be addressed, and ask open-ended questions to allow them to express themselves. I learned to interject with “That must be really difficult for you,” or “I can only imagine how that makes you feel,” as a way to show empathy and foster better connection with patients.
I was appointed to do the morning shift in the COVID ward of our respected hospital. The unit is a negative pressure area and, to us doctors, it is comforting as we embark on the Icarus flight.
I’m a soon-to-graduate allergy and immunology fellow and the circumstances surrounding the COVID-19 pandemic have catapulted every single physician into uncharted, and sometimes strange circumstances.
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.
Softly and subtly, the rustling of the leaves quickens and a cool breeze sweeps across the town. A child rocks gently on a swing and a father stands in the bazaar bartering for the best value for vegetables for dinner. His wife is hospitalized with hemorrhagic dengue; shivering with fevers that rise and fall as do her blood counts.
Residency is a challenging time plagued by long hours, overwhelming clinical service loads, escalating documentation requirements, and inadequate resources for support. A recently published study in the New England Journal of Medicine illustrates how mistreatment in the training environment takes an additional toll on medical trainees.