On Monday morning, a medical assistant finds me with a nasal swab in hand. I scribble my signature and temperature on the form he hands me. “Ready, Maria?” he asks, and then laughs when I groan in response. I tilt my head, close my eyes and wait for the worst part to be over. After 15 minutes of waiting in the student workroom, he tells me I am COVID-19 negative and set for the week.
Part of my third-year internal medicine clerkship in March of 2021 involves engaging in rounds at nursing facilities, each with individualized COVID-19 protocols. While some require a simple screening, a few facilities require documentation of a negative test every week. This means that in addition to daily temperature and symptom screening, I get tested for COVID-19 each week.
On this particular day, I first see Evelyn* in the memory care unit. The 97-year-old woman, who the nurse called “pleasantly confused,” does not understand why I am wearing PPE, nor is she aware that we are in a pandemic. She is wearing a sweater in my favorite shade of purple and has a well-loved stuffed dog on her lap. She motions for me to come closer and whispers in my ear that one of the nurses is grumpy. “You know, the mean one,” she says as she raises her eyebrows. I laugh because I have no idea what to do with this information. She laughs too and squeezes my gloved hand. My attending places my other hand on her chest, and I feel vibrations. “Is this a palpable thrill?” I ask, surprised. It is the first one I have ever felt.
As I rip off my yellow gown and take off my gloves after finishing up with Evelyn, I hear, “Excuse me, are you all coming to see me today?” Michelle’s room is right across from Evelyn’s and she is waiting by her door in an ancient wheelchair. I take in her perfectly coiffed hair and her surgical mask slipping down her nose. She is not on my attending’s list, but I gown up and spend time with her anyway. I ask if everything is okay and she shrugs in response. Visitors are restricted, so I am mindful that she has not had anyone visit in weeks. Her sad, hazel eyes make me want to give her a hug, but I do not think I am allowed. I rub her back with my gloved hands instead. I smile at her but wonder if she can tell because of the N95 that I am wearing. She asks me if I am religious, and I hesitantly say yes, unsure about where this conversation is going. “Can you pray for me?” she asks. I lightly squeeze her bony shoulder and promise her that I will. As I get up to leave, I ask her to pray for me too.
At a quarter to five, I step out of the building and take off my N95 and face shield, relieved to not have to wear them until tomorrow. I approach my car and see my reflection on the window. My face is oily and I trace the lines on my face with my fingers — a physical reminder of pandemic life.
I come home drained. My throat hurts from screaming through my mask the whole day. I change out of my work clothes while I microwave my pasta and crawl into bed with my dinner. I balance the bowl on my lap and open my laptop. I attempt some practice questions, but my brain is on strike. I get four out of 10 questions correct on a section. I close my laptop, frustrated. I promise myself to wake up at 5 a.m. to give myself extra time to study tomorrow morning. I respond to texts, starting some with, “Sorry for the late response.” A friend calls soon after I reply to her text and we chat for a bit. She asks me about my day. I bite my lip and give a vague response — not sure how much I want to share.
I remind myself that it was a good day — so why does my heart feel so heavy?
The weight of the suffering I witness each day stays with me. I try not to let my heavy and bruised heart overwhelm me and wonder how my peers do this. Do their hearts look like mine? I do not share how I feel with the residents and attendings I work with, not wanting my feelings to be invalidated or to be told to “toughen up.” I am self-conscious about my sensitivity, no matter how many times I remind myself that it is one of my strengths. My non-medical-school friends ask me what it’s like, and I censor my stories. “Some days are challenging,” I say and then promptly change the subject to something lighthearted. I am relieved that we are not FaceTiming because tears build up behind my eyes.
As a future psychiatrist, I am concerned about the lasting emotional and psychological impacts of the pandemic. I worry about young children being boarded up in emergency rooms for weeks due to the lack of psychiatric beds, pregnant mothers battling severe cases of COVID and my peers being pulled out of their rotation sites due to breakthrough infections. I witness the impact of social isolation and depriving older adults of visits from family and friends. My heart aches when I think about my parents and grandmother on the other side of the world. As I continue to care for my patients, I hope my parents and grandmother in Japan receive the compassionate care that I strive to provide for my patients.
As a medical student, I try to alleviate physical and emotional suffering and build rapport and connection while trying to learn as much as possible. I set limits on how many articles I read about COVID-19, but I give in and read as many as I can while I lay in bed. Despite the suffering around me, I try to learn and hope my best efforts are enough to be a good medical student, friend and daughter.
*All names have been changed.