Much ink has been spilled in analysis and speculation about the manner in which the COVID pandemic has changed our culture and our health care system. These are important questions, but perhaps the most essential question for future physicians is how living and training during the pandemic years has altered us intimately, even spiritually.
For current third-year students across the country, the pandemic hit at a notably unstable moment in our lives. Mere months after many of us began medical school in new localities amongst new communities, all was suddenly fragmented. We were scattered across the country, back into childhood bedrooms and hometowns (if we were lucky), and confined to migraine-inducing digital squares.
Despair came in silent surges and remissions as the fabric of our society frayed. Everything buzzed with data. We watched lives tick on internet dashboards like the stock exchange. We spoke of “public health” — murmuring, watching, waiting like the Israelites, unsure if redemption had come. Waiting. So much waiting. We took Step 1.
Then, all at once, we found ourselves thrust into wards and clinics. Like countless cohorts before us, we struggled to adjust to every new rotation, and like them, we grounded ourselves in the people beside us. Fate placed these strangers — persons whom we had previously met in passing while milling outside of lecture halls – with us in the trenches. They, our fellow wayfarers in the wilderness, became our closest friends.
But as the bell tolled, newly-formed bonds abruptly diverged at the end of each rotation. Promises of happy hours and text messages fizzled. Residents spun around us like a roulette wheel each day — the overwhelmed, the budding master clinician, the career climber, the arduously demanding, the beloved good shepherd.
Patients met us on uneven ground. Some peppered us like birdshot; most we fumbled through; a few dropped anchors into our souls. We tried to make sense of it all and reclaim our fragmenting personhood with both hands on the rutter. In this chaos, we were forced to adapt, and eventually learned acceptance or some other slipshod way to survive.
But something was unique about our experience, something that past cohorts did not experience — the shock. In the preceding year, characterized by shutdowns and distancing, we had adapted to an environment which hardly resembled the reality of clinical practice. In a year of isolation, we learned to survive with the social support of fewer friends and family than ever before.
Health care, to us, had been framed as a kind of public enterprise, one practiced on abstract populations instead of complicated individuals. Now at the bedside, we travel beside ailing humanity, leaning on our fellow pilgrims along the way. The wards, while often unsettling, offer us a glimpse of the beauty that can be found in a healing communion amidst the brokenness.
The woes of our lives and our profession are real and many. They have been laid bare by the pandemic years’ tumult. Now, the essential question for our field of medicine in this era of agony and uncertainty is this — can we begin again?
As this year ends and we find ourselves in another holiday season, a time when even our own calloused facades soften, this question feels especially dire. We have ached for relief amidst the desperation that we have so often felt these past months. A broken system in a broken nation in a broken world weighs heavily on our backs in these moments of despair, and each time it gets harder to find the way out.
How are we to care for patients when they won’t even care for themselves? Can we be true healers when health care systems are seemingly designed to obstruct us? How much of ourselves are we willing to sacrifice for the job, for our patients? By now, we all feel more than a little weary.
As bleary-eyed Jimmy Stewart pleads at the end of his classic Christmas film, we want desperately to live again after months of just surviving. In our struggles to endure, we have often neglected what makes us human: passions outside of medicine, relationships with family and friends, our places in our communities, spiritual needs and even basic bodily health. Like him, we too will find the renewal of our lives in the antidote of despair — hope.
Hope, often misconstrued as a sort of Hallmark platitude, here means the desire for and expectation of what is good. This is where I take my solace: in the million seemingly minor ways in which you and I have connected with each other and our patients over these past months. Despite the cynicism and vanity that our job can breed, I have learned to hope in your goodness again.
Image credit: new snow melting (CC BY-NC 2.0) by withrow