I’m bombarded with emails of rapidly changing policies to prevent infections and identify COVID-19 patients (in the course of writing this, I’ve already received three more emails), I’m having a hard time finding masks because the nurses are hoarding them in some corner or taking them home, I feel regret for previously telling friends when they asked me that the coronavirus outbreak is likely not to cause this much death, I cringe when I’m pulled to work in the emergency department as the admitting officer on duty, and I must say that I am supremely tired of watching the news. I’m a second-year internal medicine resident at a small community hospital, but near a busy metropolitan area. The rapidly spreading virus has caused me to question the preparedness and soundness of our medical system. My resident WhatsApp group, which for the past several months before the COVID crisis was only filled with memes about constipation, fecal disimpaction, and our least favorite nurses, has now accrued more serious messages per minute than ever before. I’ve lost the COVID count, the number of cases we know about so far. There are pregnant residents, moms, dads, those in close proximity of elderly family members, and those who are already quarantined. Panic is rampant, and I find myself concluding every night by perusing long internet posts of people begging for surgical masks. I finish my shift and stumble into the shower after hopping to the bathroom, haphazardly removing my scrubs in the process, so as to avoid any contact between anything I’m wearing and my surroundings – hoping that public policy and infection control guidelines will soon have more precision than my poorly coordinated, pitiful attempt at sterility. “Let’s see what the networks show tomorrow,” I think to myself, visualizing pathogens washing off my skin, dying, as the hot water runs down my back. As a resident, I’m younger, sometimes much younger than other physicians in the hospital I work at, and I wouldn’t want to expose older physicians when I could be of some help. It’s a time of great uncertainty, and I’ve read every godforsaken article that I could get my hands on. Yet I still don’t feel prepared, and no one around me, not even the most experienced well-read physician knows how to approach this crisis. It’s a highly dynamic, rapidly changing situation, and there are still no “right” answers. Despite the understandable panic and the obvious anxiety we face as young doctors, this is a time that will rarely come in our careers. And whether or not we are interested in disaster preparedness or emergency medicine, we can use this as an opportunity to alter the face of healthcare in this nation. Many of us went into medicine fantasizing about a time when our skill and knowledge would come to such use in a dramatic and unpredictable way. Yes, we may love the daily management of chronic disease or the acute management of well-known diseases, but very rarely do we get the chance to be on the front lines of a war, a war against a highly contagious, poorly researched virus. We were not around when HIV was so poorly understood, and new breakthroughs were being found, we weren’t practicing when oral rehydration therapy began to be widely used to prevent childhood mortality, and we weren’t involved when smallpox was declared eradicated in 1980. These milestones were before our time, and we enjoy hearing about them from our older colleagues and mentors. When they tell us stories of the “old days,” the “crazy” days, when there were no work-hour rules, when they treated interesting cases, we can’t help but crave having stories of our own to tell future generations of young physicians. We want others to know that we’ve had our time around the block, that we helped eradicate coronavirus, that this isn’t our first rodeo, so to speak. Yes, we are scared, deathly scared, but we have a surge of adrenaline, an inalienable faith in the power of our craft, in the soundness of scientific discovery, and in our ability to learn every day so we can apply this knowledge to future patients. This pandemic is a balance of risk, unpredictability, humanism, and challenge so rarely seen and so profoundly seductive to us as new, eager clinicians that our deepest fears of contracting the virus are dwarfed by our even greater ambition, our grit, and our focus. How we respond to this outbreak, how we save lives, and how we tell our stories could very well later be the stuff of tales of heroism, of us being able to say, “Back when I was a resident, we had to walk uphill both ways,” and of a shared passion. We have come out of the doldrums, my friends, and the only way through this is together. Harsh V. Bhavsar is an internal medicine resident. Source
