Saira Elizabeth Alex
Houston, Texas, United States
|The Isle of the Dead. Max Klinger after Arnold Böcklin. 1890. The Art Institute of Chicago.|
As medical students, we eagerly await the start of clinical rotations since the first day of school; we anticipate building memorable connections with our colleagues and patients. This is an account of my days as a medical student, three months into clinical rotations, during the COVID-19 pandemic. I write to narrate the beginning—to remember how the public health crisis came to reconstruct my daily life in March of 2020.
March 3, 2020
I started my infectious disease elective a few days ago, on hindsight—a rather timely rotation. The attending, a respected man with an immense love of teaching, turns to us with a tired look in his eyes, which I initially attribute to a busy hospital service. “Sorry I’m late for rounds. We’ve been meeting extensively to finalize policies for when COVID reaches our hospitals.” We nod. I think we all have an inkling that today would mark the first of many long days.
During the morning report meeting, my attending faces the large room in his white coat and addresses the unspoken fear and uncertainty tucked away in our minds. “Since I’ve started seeing potential COVID patients, my wife has asked about my safety. I share this tender moment because I want you to know that the anxiety in our community is real and valid—I’ve experienced it in my own family. I urge you to reach out to your own.” He stifles his exhaustion with a brief yawn and a smile: his heroism is showcased even in small matters.
I admire the leadership of our attending who is front-line in these historic times. He speaks eloquently about the emotional tax that this pandemic demands of us. I have been playing out permutations of scenarios in my head about how this pandemic could devastate us, each sequence more daunting than the last; and so, I find respite in his words.
Later in that busy afternoon, my attending pauses while shuffling papers: “I wonder how deeply this is affecting medical student education. I am truly sorry.” I stare momentarily. The truth is that I have still been living out my childhood dream of becoming a doctor. I am caring for patients with a lot of classic textbook cases, plenty of diseases I had hoped to encounter when I took my pre-clinical courses, and a lot of “Wow! It’s amazing you’ve already seen this case—it was a while before I got to see one of those!”
“Should medical students be attending these meetings in the future?” a physician remarked after the case-based lectures, now carefully tailored to accommodate a group of no more than twenty-five people. The divisiveness of the role of medical students in a clinical setting became starkly apparent, and I stood right in the middle—a new medical trainee eager to serve, but unequipped with enough training to anticipate the consequences. Given the growing PPE shortage, concerns about patient safety, and my inability to make independent medical decisions, a part of me understands why the medical student role might be labeled as “non-essential.” But given that medicine has consumed my being, I struggle to understand how that kind of dedication could come from someone who is “non-essential.” This conflict between passion, reason, and resources remains unsettled this evening. I stand awaiting the wisdom of those before me.
I shout into the air of our small team room, “Sorry everyone, but I have to run for class! See y’all tomorrow!” I wish I had chosen the words of my goodbyes more wisely. Later, we receive news that the teaching hospitals are closing their doors immediately to medical students, given the potential risk we pose for patient safety. Over the next few days, we learn that our clinical responsibilities will be suspended for months. Even before receiving my white coat, I had visions of how I wanted and expected to experience my medical school curriculum. This was an unwelcome reminder of the fragility of human designs.
With my routines interrupted and social distancing prioritized, I find myself lost within the small perimeter of my studio apartment. My anxiety is at its peak. My mother, a nurse, is working in a ward with a patient under investigation for COVID. The angst lingers all hours of the day: will she get sick? How will we survive if she does get sick? Should I apologize again for the fight we had last week? Do I say any goodbyes?
The country is now in a state of emergency. Social media buzzes with news of healthcare workers dying or writing their wills, physicians demanding PPE, video clips of inspiring physicians speaking on cable news channels about pressing matters, and colorful graphs that I stop interpreting after a while. The angst lingers.
March 27-April 3, 2020
Case counts are climbing rapidly across the country, and there is terrifying news of devastation all over the world. The medical student body has banded together to serve in non-clinical and public health roles. Under the guidance of our deans and mentors, we have transformed our seemingly helpless position into an empowering movement. Ordinary people around me are doing extraordinary things from the sidelines.
My story rests here, for now. It is a privilege to be useful in a time of crisis, to be someone who can help the community. March was a long month and seemed to have no end in sight; but like everything, it too has ended. I hope better for April, but I know that the worst is perhaps yet to come. These are uncertain times, and I pray for the safety of all those who are serving the community in these challenging moments.
SAIRA ELIZABETH ALEX is a third-year M.D./M.P.H. student at Baylor College of Medicine and UTHealth School of Public Health. In 2018, she graduated from The University of Texas at Dallas where she studied Neuroscience and Literature. Her career focus is on exploring the intersection of public health, medicine, and storytelling.