As I write this, more than 100,000 people have died in the United States from COVID-19 — more than any other country in the world. The world has lost 358,000 souls. It seems both like yesterday and the distant past that I was last a learner in the hospital. Time now has a sense of meaninglessness that makes its passage difficult to mark, as days blend into weeks, weeks into months and so on.
COVID-19 was first confirmed in the United States on January 20, but didn’t become a weather-like topic of daily conversation until early March. I was in the middle of a surgical intensive care unit rotation where I was busy falling in love with critical care. It was only slated to be a two-week elective, and that first week of 12-hour days was equal parts exhausting and exciting. I remember working with one physician on the Monday of my second week who repeatedly mentioned how amazed she was that I was still allowed to be in the hospital every time I asked a question or presented a patient. She even “offered” to send me home early that morning, but I declined, asserting that the school had yet to make any announcements. The email barring all students from clinical services came out that afternoon, and all medical students were sent home en masse.
The days that followed were filled with anxiety and sadness. How could they think that benching all of us was a good idea? I deep-cleaned the kitchen and living room. Don’t we occasionally provide some value to patient care? I went for a run. Hasn’t our training prepared us to be even a little useful? I started preparing for residency applications. What if we just worked with non-COVID-19 patients, so we didn’t use up personal protective equipment? I reorganized my books. Isn’t there anything useful we could do? I drank a lot of wine.
The truth is that I wasn’t anxious about any of that. I was anxious because I was used to moving at such a fast pace that slamming on the breaks gave me whiplash. I was desperate for things to do because I had forgotten how to slow down and relax — how to just be. Slowly, I began to see the opportunity that quarantine had presented me with. We have all had to stop our lives but, having now had some time to think about the state of us, what parts of those lives do we want to take back up again once allowed to do so? What parts of our lives are better left in quarantine? And what really matters to us as members of society?
Quarantine was difficult at first because it challenged my identity. Who am I if I can’t do the thing I’ve devoted myself to doing? Thinking back to medical school applications, I remember pouring my heart out onto the page and submitting who I was for judgment to the admissions gods who would decide whether or not I was worthy of entering the profession. I was judged to be adequate and was grateful to be given a white coat. And yet, medical school itself has been a rather disease-like state. It has grown to take up space that didn’t belong to it, metastasizing into every corner of who I think I am, eating away at self-esteem, relationships, and at some points, even my actual body. But my relationship with medicine is complex; it has also afforded me the enormous privilege of deeply connecting with patients at times of tremendous vulnerability and suffering as well as joy. Medicine has taken me to both the depths of my despair and to the heights of my humanity. Being abruptly ripped away from such experiences in the hospital was painful at first, but having had a bit more time now to reflect, I can see that it was also healthy. This time in isolation has reminded me not only that I am more than a medical student, it has reminded me that my value as a person is inherent and not something I have to earn.
Slowing down has allowed me to see that I use productivity to try to convince myself of my own worth. On the days I’ve been “unproductive,” I see myself as a disappointment, and yet on days that I accomplish a lot, I still don’t feel good. Productivity feels like a baseline requirement. Where did this hungry ghost come from? The drive to be productive has convinced me that all time in which I am not producing something is somehow wasted and that the only way to feel better about who I am is to do more.
Unfortunately, I am not the only one who suffers from this disease. COVID-19 has exposed this at a national level too. In what other country do we see citizens protesting for their ‘right’ to produce and consume instead of their right to access health care so they can live? COVID-19 has done a lot to expose a core American value: that productivity equals worth and that our value to society is commensurate with our ability to consume. I would argue that many of the deaths we’ve experienced in the United States have been caused by the deadly combination of both the virus and our consumerism. The “invisible scourge” isn’t COVID-19, it’s the way we dehumanize each other by valuing what we produce more than we value each other.
Perhaps the most important lesson I’ve learned in quarantine is just how valuable human connections really are. Truthfully, I think it is a deep instinctual knowledge of this fact that brought me to and keeps me in medicine. When I think back to the most meaningful experiences I’ve had in the hospital I don’t think of the days I was most productive and got the most tasks checked off my to-do list; rather, I think of the day I snuck off to my patient’s room to celebrate her 88th birthday with a slice of carrot cake (her favorite) when her family couldn’t visit. I think also of the day that I had the honor and privilege of holding my 55-year-old patient’s hand as he passed away peacefully from a tragic accident. The days I find most meaningful in the hospital are the days when, despite all else, the human connection between two people is most palpable — the days we are able to be entirely present with each other and experience joy or relief together. And I equally cherish those days when we face sadness and grief without turning away, even — and especially — when it is difficult. Despite the ways in which medical training has been trying, I fall in love with it more and more each day.
As my time to return to the hospital approaches, I begin to worry that I’ll lose the diagnostic clarity with which quarantine has allowed me to see myself and the ‘diseases’ that ail me. I wonder if I’ll get lost again in the haze of productive busyness, losing the perspective I’ve gained in this time. But then I remember that each interaction I have with a patient or a colleague is an opportunity for connection, a shortcut back to this perspective that quarantine has given me. It’s is an opportunity to make meaning together and remind each other of our inherent worth, and no amount of busyness can get in the way of that.
Image credit: Slow (CC BY-NC 2.0) by Ian Britton
Contributing Writer
Geisel School of Medicine at Dartmouth
Sylvia Guerra is a fourth-year medical student at the Geisel School of Medicine at Dartmouth in Hanover, NH. Prior to beginning her career in medicine, she completed her undergraduate degree in religion at the University of Rochester and her Master of Theological Studies at the Harvard Divinity School. She is interested in pursuing a career in general surgery. She is also interested in the intersection of medical education and health equity and hopes to make this a central part of her surgical career. She lives in White River Junction, Vermont with her partner, their two cats, and eight chickens.