I’m Sorry: A Letter From A Pathology Resident On The Frontlines

I hope that this letter finds you (and myself) alive and well after all this COVID-19 craziness ends. I never really got the chance to explain everything when I was taking care of you. It wasn’t your fault you ended up at the hospital when you did, and you deserved so much better.

First of all, I was a pathology resident. A redeployed pathology resident. Actually, redeployed isn’t the right word because I never really took care of patients to begin with. You see, my specialty involved performing diagnostic tests, which was not a very valuable skillset to have as your primary doctor. Don’t get me wrong, I was a doctor, and what I normally did was valuable. However, when my hospital asked me to take care of patients because of a physician shortage from COVID-19, I had no idea what to do. In fact, that last time I had seen a patient in a setting like yours was over two years ago when I was a medical student. When I saw you, I honestly didn’t really remember how to do a physical exam or write a clinical note. I had only a vague idea of what most of your medications even did.

I hadn’t studied or even thought about many aspects of what I learned in medical school since starting residency. I didn’t think I would need to. I had to focus my studies on my specialty to prepare for my board examinations and for what I thought I was going to be doing for the rest of my life. Actually, even that’s partly a lie. I had very little downtime to study due to a busy clinical schedule. Any “free” time I had, I used to try to make a little extra money to support my wife and baby. I didn’t make enough to pay all our bills despite trying to live frugally. Daycare was too expensive in this part of the country for my wife to work. The hospital wouldn’t let me engage in a money-making educational venture taking pathology pictures of our specimens because, despite being HIPAA-compliant, it “didn’t directly benefit the hospital.” So I spent what little time I had doing odds and ends to survive.

That reminds me that I should apologize for any negativity I may have exhibited. It was hard for me to feel that my hospital had my best interest in mind at any point, let alone when they asked me to lay everything on the line and take care of COVID-19 patients. I know people say that doctors should be willing to sacrifice everything for their patients, but when my hospital asked me to give them my all, I wasn’t sure they were coming from the right place.

I’m sorry I looked scared. I was scared. Not for me. For my wife and daughter. If it were just me, I’d be more than happy to join the frontline, but being part human, I would have rather kept my family safe than be directly involved with patients. When this all started, I thought I would be doing what pathologists do: triaging tests, answering clinician’s questions, overseeing quality assurance, etc. I was more than willing to do all that and more. My program didn’t warn me this might happen when I joined. However, if I had known what was going to be required, I may have never gone to medical school. I know that’s not very doctor-like, but it is very human.

You might be wondering if there were any other options. I don’t know. Was using pathology residents a good idea? Probably not. Were there better ideas? I can’t say. I wish you had been luckier and gotten a radiology resident. At least they do an intern year.

Please don’t think that I didn’t want to take the best care of you I could. Nobody asked for this to happen, least of all you. I just hope it was all enough, that it was all worth it. We all did what we had to do, or at least what we were asked to do. I did what society asked. I owed them a great debt, after all. Over $300,000 worth.

The author is an anonymous physician.

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