With the development and distribution of the COVID-19 vaccine and the arrival of the summer season, people are feeling happier and beginning to come out of their homes. It’s clear that there is a growing sense of hope that the pandemic may be approaching its conclusion. However, standing in the way of our pursuit of normalcy is the refusal among some to partake in the vaccine, despite its proven efficacy and safety by experts.
The Match process is an emotional roller coaster ride that feels like it lasts forever but also flies by. Being on the other side and looking back, I wanted to do my part and share my thoughts about how to stay grounded and sane during this time.
A 5-year-old African American boy presents to the emergency department with left leg pain. His leg is exquisitely tender to palpation…. If I read this vignette in the first year of medical school, I would have navigated to the multiple-choice answers to select anything related to sickle cell disease. The question writers are stating that the patient is Black, young and has a painful limb — this is not a difficult diagnosis. Rather than envisioning …
I was raised by two physicians who did not “differentiate” until well into their rotational year, and they did, as their generation tends to say, “just fine.” But the reality is that what was “just fine” for physicians-in-training even one generation ago is no longer as feasible.
I often joke about how worthless my art history studies were, but I never mean it. The truth is that my training in the humanities, while being unconventional for medicine, has prepared me to be a better physician and clinician.
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!
I took a quick trip to Target a month ago and browsed for new jeans. I approached the clothing section and was suddenly struck by the overwhelming challenge I had undertaken. From rack to rack, I had to choose from a multitude of different brands (Levis, Wrangler, True Religion and more), different styles (skinny, bootcut, tapered and more) and different colors (blue, black, tan and more). I had to figure out my current exact size and, even then, there are many different ways to size jeans (small-medium-large, waist-by-length and others).
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.
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.
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.
“We are taking him to rehab,” she said. I could hear a faint sigh of relief and happiness permeating her voice, which had been distinctly absent for the last few months. I could also hear wind whooshing in the background and a distant trail of her voice, which meant they were already on the road.
As physicians, we must work to lift patients up when they are struggling, rather than shaming them into well-being. As Dr. Donald Berwick once noted, it is not always patients’ diagnoses, but their helplessness that kills them. Indeed, the helplessness we instill through our focus on individualism and molecular pathology in the clinical setting will ensure that this epidemic kills millions prematurely and costs billions of dollars. If obesity is a disease caused by society — its inequities, trauma, and expectations — then the solution for obesity should address more than just the patient sitting in front of us.