Our Stories in Time of COVID-19
From the Stories In Medicine Editorial Team:
During this unprecedented time of the COVID-19 global health crisis, each one of us has been uniquely impacted in so many aspects of our lives. In this time of uncertainty, fear, lack of medical resources, and social-distancing, we want to provide a supportive community for everyone. The Stories In Medicine Blog was originally created for medical professionals, students, faculty and the general community to have a shared virtual space to provide unique perspectives and insight. In this time, we need the support of the community more than ever. We are all going through this together, yet the impact is unique and personal. This is a monumental moment and will be undoubtedly written in the history books. In the future, we will reflect, process the aftermath, and heal. Yet in this present time, it is so important to give ourselves the space to process in real-time so that we can be there for our family, friends, and patients. If we can listen and understand one another, we can better understand ourselves and the events taking place. Your voice is in your story and we'd love to hear what you have to say. Please read below from your amazing colleagues and community, and we encourage you to share your story in whatever capacity you feel is right for you. The more people we have writing in, the stronger our network!
1.) Flying Across the COVID19 Pandemic
By Julie Tran
MS2, University of Arizona College of Medicine-Phoenix
Flying 2,271 miles across the pandemic
From Arizona to Maryland
A partially-crowded and noisy flight
My purpose?
Visiting my father for the very last time
Who now lays still and pleasantly serene
15 scattered passengers on the flight back home
A quiet plane for nostalgic memories
I will always miss and love you, Dad.
Always.
On March 16, 2020, my father passed away in Maryland while I was across the country, in the middle of my Transitions block at UACOM-P. Whether it was from COVID19 or not, I am uncertain. However, during my flight both to and from Maryland, I had time to reflect on the situation. I remember being stunned by the sudden rush of emotions from both this pandemic and my father’s death. This is further amplified by my experience of seeing the stark difference in the partially-filled flight on the way to Maryland and the practically-empty flight one week later on the way back to Arizona. Given the current events, I feel fortunate to have seen him for the last time before his cremation. In the same vein, I am thankful for this reflective opportunity to share my feelings during this disheartening time.
2.) The Fear
By Dr. Robin McFarlane
PGY-2 Neurology Resident, Banner University Medical Center-Phoenix
He comes in with a cough of a few days, fever, diarrhea, vomiting and signs of pneumonia on CXR:
Has he had Covid exposure? No.
Has he had any travel into Covid cities? No.
Does he have Covid? Did I touch him?
Did he cough on me?
Get him tested and get him home.
Go home.
Get out of the ED.
Stop infecting other people.
We've taken the swab and gotten the test. Go home and we'll call you with the results.
Three days later he's back. The Covid results were negative.
He's worse.
How is he worse?
He doesn't have Covid!
Maybe we should re-test him?
In the midst of the fear, the streptococcus pneumonia that had seeded in his blood stream and in his brain was missed. He was septic. He has meningitis. He has ventriculitis. He has endocarditis. He has a left ventricular thrombus. He’s likely going to die. Much like "ACS rule out," "covid rule out" should not be an appropriate thought process. It's not enough to rule out a single entity. Find out why your patient is sick.
Look at the patient. Treat the patient.
Do not let The Fear cloud your decision making process.
3.) 55-Word Story
By Kaylee de Tranaltes
MS4, University of Arizona College of Medicine-Phoenix
I saw your photo today, your PPE.
Your goggles are fogging, your mask is not an N95, but it’s all you have.
I wonder if you get sick whether they will let me see you in the hospital or if I will have to sneak in with my badge.
I’ll stay home for you, mom.
4.) Pandemic
By Julia Ghering
MS3, University of Arizona College of Medicine-Phoenix
My chest burns.
I don’t know why.
It’s not a fever.
Not a cough. Not dyspnea.
But I am afraid. I’ve been afraid for so long.
Since the practice test in May last year.
And every day since. Things were supposed to get better after STEP.
Why did things get so much worse?
5.) One Day in March
By Jennifer Priest Mitchell
Faculty Coordinator
University of Arizona College of Medicine-Phoenix
Morning.
Powerful rain.
Lunchtime.
Coats still damp under surprising sunshine.
Coordinators often ate together, walked, laugh.
Outside, we joyfully spoke of families, careers, weather.
Sprinkles fell, wind stirred.
We threw away one another's napkins, no cares.
Returned to office.
"Work remotely due to COVID-19 concerns."
Bundled up folders, laptops, all we needed.
For one week.
6.) Ubering in COVID-19 Pandemic
By Diep Nguyen
MS1, University of Arizona College of Medicine-Phoenix
My girlfriend and I had just gotten off a plane of thirteen other passengers to an almost empty Phoenix airport. Like everyone else, we both wore masks as we headed outside. We decided to Uber as usual. *Ring ring* The Uber driver called: “Hello…can you please cancel the ride?” We were baffled since he did not give a reason for the cancellation request. My girlfriend refused to cancel since there was a cancellation fee that would be afflicted on us if we cancel before 10 minutes of the Uber app matching. I felt uneasy as we waited for the 10 minutes before we could cancel to avoid the fee. To our surprise, he ended up showing up in a red sports car around the 8-minute mark.
The passenger window went slowly down, revealing a stern, scowling face and a “Are you Diep?” as he opened his trunk. After confirming our identities, I dropped all of our luggage in the back trunk and got ready to enter the vehicle. The door was locked. I looked inside to ask him to open the door and was met with a scrutinizing, serious face. The driver sighed, stroked his brow and exited the car:
Driver: “Where are you from? New York City?”
Me: “No… Maryland.” I just remembered the news earlier that broadcasted about how NYC was being hit hard by COVID-19.
Driver: *Sigh* He nodded slowly, shaking his head as if he could not believe that he was going to drive two people from the airport in the midst of this pandemic. He marched to the front of his car and came out with a bottle of hand sanitizer and a Lysol spray. Without words being exchanged, my girlfriend and I held our hands out, understanding that he would not let us in his car without being sterilized first.
As we got into the car finally, he opened all the windows in his vehicle, including his sunroof. He looks back and says, “this is to protect us you know, keep us safe.” He glared at us occasionally throughout the ride as the cold freeway winds blew through my right eardrum. He drove the whole way with his left elbow crease covering his mouth and nose like a N95 mask. I felt both bad for him, since I could tell that he was just scared of the COVID-19 like the rest of us, and irritated by the uncomfortable ride home. It’s hard to describe; the look he gave us did not feel good. I wanted to reassure him that I was not infected or contagious, but the atmosphere in the car was so tense. I was afraid of making him panic since he was so on edge.
We eventually made it to our home. As we prepared to get out the car, the driver’s facial expression softened for the first time. His stern voice became more apologetic and he apologized for the way he handled the situation. I do not remember what he said was the reason he treated us harshly, but I do remember that he did not mention COVID-19. But my girlfriend and I definitely understood his treatment of us was the result of COVID-19 fear. As we walked towards our apartment door, we looked back and saw our Uber driver frantically wiping his back seats and trunk with alcohol wipes.
7.) Waiting
By Briana Corkill
Medical students are watching as our mentors and leaders fight on the front lines of a war we’re too young to join.
What can we contribute from the safety of our homes?
We will continue our education, working towards a future where,
next time,
we will be standing next to you, and no longer behind
8.) Three 55-Word Stories
By Ann Staudinger Knoll
Part One: It's Ok to Mourn
It’s ok to mourn
missed vacations,
cancelled weddings,
lost opportunities
I was going to shadow in the OR,
work on research,
hopefully publish,
Chip away at the crushing weight of residency applications
how can I be enough?
But here I am at home
doing yoga
learning how to breathe deeply
and rest in the discomfort
Part Two: Helplessness
There is a helplessness in being a medical student
Far enough along to be useful in basic tasks,
but not far enough along to be wanted.
Trapped behind computer screens
watching the world crumble.
The medical students have to keep themselves safe
a doctor says
To replace all the doctors that die:
A heartbreaking destiny
Part Three: The Calm Before the Storm
I watched many sunsets in NYC
through windows of the subway or on my fire escape.
A beautiful settling after a long day.
Now I watch the sunsets in Arizona
and try to imagine the panicked flurry of NYC hospitals
How can it be so still here?
The calm before the storm
My heart breaks
9.) Yes or no?
By David Beyda, M.D.
Yes. No. Okay yes. Not so fast. No. There are criteria that I have to follow. He’s 65 years old, struggling to breath, eyes begging for help. He doesn’t “qualify” for ventilator support. Everyone is looking at me. His wife is looking at me. He’s looking at me. I don’t know how to do this. I can’t do this. Not again. Too many faces. Five since this morning. No. No. No. No. No. Call for an ethics consult? That’s a fool’s errand. COVID-19. The devil’s in the details. Criteria trumps virtue. I turn and see another face. Yes. No.
(This is what physicians are experiencing at the bedside.
As part of a state and national pandemic ethics oversight committee, I struggle with giving solace to the physicians who have to make the hard decisions at the bedside.
Ethics, the virtue of caring, is buried under the overwhelming lack of resources.
Hence, the scenario. Real is what real is.)
10.) Enough
Melanie Schroeder
The internal struggle of being enough:
Two years of medical school but what can I contribute?
I’m told to stay at home but is staying home enough?
I’m told to keep connected but is looking after myself and my loved ones enough?
I’m told to stay informed but is doing my research enough?
I’m told to lead but is educating others enough?
I’m told to remain optimistic but is staying positive enough?
In times like these, it will have to be.
I am enough.
11.) IT’S OKAY
by Mohammad Khan
(Originally published by "The Differential" at: http://www.thedifferentialdx.com/its-okay/)
It began with whispers and mumblings. “What do you think of this new disease in Wuhan?” “Will it come here?” At the beginning of the year, the effects that the COVID-19 Coronavirus outbreak would have on medical school education were inconceivable. It started with the LPC final dinner being canceled; our opportunity to say thank you to our mentors who showed us the ways in which disease affects the patient. I went in for EPIC training the following Monday and had a brief orientation to my Internal Medicine training site. We spoke, got the contact information for our team, and bade each other well for the day of work tomorrow. That evening we received an email telling us our in-person rotations would be canceled for at least the next two weeks. The decision arrived late in the night, but it would not be until the morning when we would realize the true ramifications of this decision.
After tumultuous sleep, the next morning came upon us with apprehension and dread. We were to be quarantined at home until further notice. We just stayed at home. Our education would progress through online learning modules designed to simulate the patient experience. It was a strange affair. From our first online conversation with our online course director, Dr. Younger, it was clear that this was uncharted territory for all of us. Perhaps that is the thing that made it bearable. Although the way ahead is murky, we all need to remember we are in this together. Yet, as the days pass by, without the flow of working at the hospital, they begin to blend. How effective can online medicine be for education? One day into another of waking up, reviewing, and having more time on our hands. Even with diligent study, there is still extra time in the day to be quiet and to reflect.
The dichotomy between slow days and the rapid pace at which agencies are trying to adapt to the outbreak has created friction. Many students are planning to take their Step 2 Clinical Knowledge certification exams, and yet last week half of all MD/DO students were randomly told that their examination dates were to be canceled and that rescheduling would be necessary. It becomes a harrowing experience when the forces that help certify us begin to buckle, and we students are left to hurry and wait on morsels of updates. The reality of canceled test dates, travel plans that require reorganization, and the looming specter of interview season all weigh down on us.
So the question is, how do you, the reader, feel? I am tired and feeling lost. There is a rhythm to medical school, and that rhythm provided stability. Now that life is in discord, it wears on the soul. How do we maintain our drive? There are days where I can focus and study as I should be, and there are others where I just stare at pages and retain nothing. The most that gets accomplished is some catching up on shows and art projects. Yet, the spirit of medicine is to help when you can. While the responsible thing as students is to remain at home to preserve the PPE supplies, it is juxtaposed with a desire to work and help in the hospital. Even though we are doing our best at home, there is still a feeling of guilt that afflicts us. When days drift into nights, and nights become days of anxiety, it behooves us to rely on the greatest strength of medicine, that being our unity. No matter how bad things may get, the heart of medicine is that the physician is the one who will listen. So for all those who are struggling in medicine, and those who are also feeling lost, all I can say is that this sucks. These answers are not easy, and it would be facetious to claim otherwise; yet what I can do is say, you are not alone.
12.) Confessions in the Time of COVID-19
by Jen Hartmark-Hill
Full Essay Published by KevinMD.com
13.) Curing the Quarantine Blues
by Alyson Tukan
Here, I reflect on my favorite quarantine activity – running. The fresh air and exercise of running kept me sane, healthy, and in good spirits throughout the difficulties of the pandemic.
Feet pounding. Music pulsing. Muscles burning.
My body moves in perfect synchrony
I take a deep breath and fill my clear lungs with air
The rhythm of the road erases the monotony of the indoors
The warmth of the sun melts my worries
Breathe in. Breath out.
I celebrate the blessing of my health
Author Biosketches:
1. Julie Tran is a student at The University of Arizona College of Medicine-Phoenix, Class of 2022. She graduated from Franklin & Marshall College in 2017 with a bachelor’s degree in molecular biology and a minor in philosophy. Her interests include spending time with her boyfriend, cooking, traveling, and cosplaying for different conventions (i.e., ComicCon, Anime Con, etc.).
2. Dr. Robin McFarlane is a PGY-2 Neurology Resident at Banner University Medical Center-Phoenix, Class of 2022. She completed medical school at the University of Washington School of Medicine.
3. Kaylee de Tranaltes is an MS4, Class of 2020, at the University of Arizona College of Medicine-Phoenix. She wrote the submitted 55-Word story as a journal entry after reflecting on a photo of her mother at work on her COVID floor that week.
4. Julia Ghering is an MS3 at the University of Arizona College of Medicine in Phoenix, pursuing a certificate of distinction in health humanities.
5. Jennifer Priest Mitchell is a Faculty Coordinator at the University of Arizona College of Medicine-Phoenix. She enjoys writing, baking, hiking, and spending time with her favorite inspirations.
6. Diep Nguyen is an MS1 at the University of Arizona College of Medicine-Phoenix
7. Briana Corkill is a first-year medical student at UACOM-P and is most interested in emergency medicine. She is active in community health initiative programs and is the CHIP leader for Wildcat Night at Verde Park and Night at the Children's Museum. She is also a proud dog mom to five dogs (and one hamster). When she isn't studying, she can be found rock climbing, either at her local gym or local outdoor crag.
8. Ann is an MS1 who moved from NYC to Phoenix to enjoy the sunshine and cacti while attending medical school. She enjoys running, learning how to keep her plants alive, and snuggling with her cats while watching TV. She is interested in pediatric neurosurgery, and she eventually hopes to practice back home in NYC. These stories were inspired by the wide range of feelings and processing through these feelings during the initial weeks of the COVID-19 pandemic. I grieve for so many things -- the loss of a normal day, the loss of the traditional medical education and experiences, the devastating loss of life. Once I started writing, there were so many stories I wanted to tell. These stories are meant to share small moments of personal grieving during these illusory times in the hopes that someone else might see their grieving mirrored and feel less alone.
9. Dr. David Beyda is the Chair of the Department of Bioethics & Medical Humanism at the University of Arizona College of Medicine-Phoenix
10. Melanie Schroeder is an MS3 at the University of Arizona College of Medicine – Phoenix. Her short story depicts the insecurities of physician training that many do feel with the high expectations. This sentiment has only been amplified by COVID-19. Her piece is a reminder of taking the time to remind ourselves that we are doing our best and that is enough.
11. Mohammad Khan is a fourth-year medical student in The University of Arizona College of Medicine – Phoenix, Class of 2021. He graduated from Arizona State University in 2014 with two bachelor's degrees in biochemistry and biology. He then worked as a teacher and completed a Master's in biomedical diagnostics in 2017. For fun, Mohammad (who also goes by Mokha) likes to practice at the archery range, work on calligraphy, game, and fountain pen writing, and read science fiction novels. He is interested in medicine with a focus on educating patients.
12. Dr. Jen Hartmark-Hill is a Mayo Clinic trained Family Medicine Physician. She works at the University of Arizona College of Medicine-Phoenix as full-time faculty and directs the Program for Narrative Medicine & Health Humanities. www.narrativemedphx.com She cares for patients experiencing homelessness with Street Medicine Phoenix. www.streetmedicinephoenix.com
13. Alyson Tukan is student in the Class of 2022 at the University of Arizona College of Medicine – Phoenix. She completed her undergraduate education at Trinity University in San Antonio, Texas with a double major in Neuroscience and Spanish. At UA COM-P, Alyson serves as the Medical Student Government secretary and is a member of the Student Ambassadors and the Certificate of Distinction in Service and Community Health. She is passionate about volunteering, martial arts, yoga, running, hiking, and knitting.