Just a tuesday

In medical school we were taught hope. We were taught the infinite ways we could help a patient. We learned hundreds of medications, participated in surgeries, learned modalities, and were educated on counseling and rehabilitation. A notable piece missing from this education was how frequently medicine is a helpless pursuit and even more importantly, how sometimes it has no role.

The COVID-19 pandemic has taken the fast track of this learning to a new level. As a new resident, I am learning the futility of caring for patients with covid. We’ve all experienced the counseling of a helpless physician in the past when we presented with a cold. “It is just a viral illness and will resolve with time.” That helplessness was frustrating for us and infuriating for patients. They wanted antibiotics, a nasal spray, a referral. They’re desperate; they wanted something, despite the risk of harm.

During covid, we have learned this futility to the extreme. Patients are often grasping at any possible therapy to treat this disease-rheumatic agents and anti-parasitics not exempt. Despite this, a large portion of the population declines the overwhelmingly best strategy against covid: vaccination. Treating gravely ill patients with covid, knowing that despite your best efforts, your academic curiosity, your years of training, the staff’s endless proning and cleaning, trach care, donning and doffing, is excruciating. Initially I was broken by this. I would ask myself what I missed; what did I do wrong. Should I have asked nephrology for their input sooner? Should I have put him on an insulin drip sooner? Did I miss a festering superimposed bacterial pneumonia or a pulmonary embolism? I eventually accepted it wasn’t me and accepted the futility.

In the meantime I would cycle back to clinic in the afternoons after transitioning patients to comfort care, calling their families with depressing updates, watching their kidneys fail, their oxygen requirements increase. I would go to clinic and then battle patients on the vaccination. I would tell them the stories. I would tell them I have seen too much death too early in my career. I would tell them I lose sleep knowing they are not vaccinated. Reassure them the only reason I bring it up is because I care and I am scared for them. Largely they ignored me.

I am tired of this. My empathy is strained but nowhere near gone. I feel callouses forming, humor filling the place of grief. I find frustration where there once was inspiration, cynicism where there once was hope. I still grieve, I still lose sleep, I still care deeply. I love this job more than I ever thought I would but it weighs on me more than I ever thought it would.

5 thoughts on “Just a tuesday”

  1. Grayson, there were over 200 UVA employees working in the medical field who quit there jobs over the vaccination mandate. As a community health nurse working with seniors, I’m happy to tell you that most of the individuals whom I serve have done their part in every way possible to live through these terrible time. They have gotten vaccinated and boosted, they have distanced and masked and been responsible for their healthcare throughout the past two years. They are still here to tell about it, but many of their unvaccinated family members are not. I’m wondering if I may share your message on my Facebook wall? Many would appreciate what you have said. Thanks for sharing this and being there during these unbelievably difficult times.

  2. You’re doing great work. You’re trying to connect with people who have been brainwashed by charlatans, and that’s a really tough battle to win.

    It’s OK if you don’t have an endless well of empathy and compassion. Most of us don’t.

    Hang in there man. Keep doing your best. I’m sure you’re making a huge difference to many people even if you can’t help everyone to see the light. Thank you. Thank you. Thank you.

  3. Try and remember that you are doing your best – and far more than most. Then, think about your next trip into the mountains and/or one the many trips you’ve already done that give you joy.

    Think of it as a form of mental correction by focusing your mind on the beauty in this world.

    Just a thought.

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