The first thing I notice are his boots. He’s still in his street clothes, having just been admitted. He looks thin, emaciated — his clothes hang off him, shirt collar drooping down from his neck like peeling paint. His boots, however, seem to fit him properly. They look warm, well-worn but sturdy, like they have weathered a hundred bitter winters and could withstand a hundred more. For some reason, this comforts me.
In this episode we interview Dr. Tait Shanafelt. Dr. Shanafelt is a Jeanie and Stewart Ritchie Professor of Medicine, Chief Wellness Officer, and associate dean at Stanford University School of Medicine.
For better or worse, I have always partaken in escapism in one form or another. “Escapism,” defined as the practice of avoiding a difficult reality by immersing oneself in distraction or entertainment, is a concept that rose in popularity in the 1930s as a natural reaction to the Great Depression of the previous decade. Although I did not know it at the time, I have been practicing escapism since 2000 BC (before COVID). As the eldest daughter of immigrants who were new to the continent and busy building a life from scratch, I would get lost in stories from a very young age. I had little in the way of friends and even less of an interest in being popular, so naturally I was drawn to books to fill that emotional void; novels were the way to my heart — fantasy and fiction, oh my!
For many of the elderly and their families, the COVID-19 pandemic has been a scary and trying time. A major concern has been the physical health and safety of this vulnerable population. In addition to community infection control measures like social distancing and avoidance of public gatherings to slow the initial spread of the outbreak, public health officials have also endeavored to protect high-risk populations by recommending electronic visits with loved ones, whether they are at private homes, nursing homes, or in the hospital.
The pressure and anxiety surrounding Step 1 is one of the main reasons cited by the USMLE to justify its adoption of a pass-fail grading system. However, many medical students are met with more trepidation about their future as this major anticipated change in Step 1 takes effect.
I hope my classmates, communities, and I all dance far more often with health than sickness. I pray that soon the last hospital bed holds the last patient with COVID. I hope justice and truth prevail. I hope we hold onto what we carry: the love of friends and family, a resilience tried and true, bravery unbridled and faith that we will persevere among the challenges life affords. I hope that after long days of caring for others, we care for ourselves and call a friend, a loved one, a therapist — and remember how far we’ve come. We have been patients, and we will be patients, even as we care for patients.
Presenteeism does not simply exist for seasoned providers; it seeps down the medical training pipeline and perhaps poses the greatest threat to trainees at the start of their careers. The fear of missing out as the “beginner on the team” can be paralyzing when there is so much important knowledge beyond us. Such pressure persists longitudinally, too, as trainees at every level fear that taking time off will appear as a lack of dedication to clinical education or will result in lower performance evaluations.
Upon arriving at the room, we learn that the nurse continued trying to speak to this patient in English despite the patient’s evident inability to speak the language. Following her half-hearted attempt at “patient education,” she proceeded to lift the patient’s gown and attempts to strap on the monitors. As a result, the woman is frightened by her nurse because she is unaware of what this foreign nurse is doing to her and her unborn child. One week out from detention. She is scared. Imagine.
Our illness narrative, the COVID narrative, is about so much more than regaining health (though I acknowledge that for those afflicted by the disease, overcoming the debilitating circumstances may be more than can even be hoped for). Returning to Frank’s ideas, our narrative is about rediscovering the voice that was stolen by forces beyond our control.
In this episode, Peter and I put together the culmination of our first season of podcasting. We took lessons from leaders in medicine, business and the military to bring you five rules for leadership.
This feeling of loss and subsequent reflection revealed to me something fundamental about how I experience time in my own life. As I depart the anatomy lab, I stand on the shores of time’s river and gaze into the clear water’s surface. In it, I see a reflection of growth and of internal transformation — a reflection not of who I was but of who I have become. I emerge not only learned in anatomy but also with insight into the impact that individuals can have on one another.
On the first day of anatomy, we were reminded that this course was a once-in-a-lifetime experience and that we were privileged to be experiencing it. For those of us first-year medical students who might not pursue surgery nor experience physically interacting with and entering the human body again outside of surgical clerkships, the professors said this would be an intense time. We would peer into the spaces and structures that — on some level — make up every human being.