By John C. Messinger
On March 17, 2020, in the first days of the COVID-19 pandemic in the United States, the Association of American Medical Colleges (AAMC) released a statement strongly urging medical schools to pause all clinical rotations and patient-facing activities.
While there was a clear necessity to limit student participation as a means of reserving PPE and creating a safe environment for patients and health care providers, restricting medical students from clinical settings has drastically changed their education.
As a first-year medical student removed from training at the time of this announcement, my greatest fear has been that these changes will alter my approach to care for patients.
After being sent home to take the remainder of my classes from the bedroom of my parents’ home, I realized how detached this content learning was from the humanistic aspects of medicine. Through online courses, my professors were able to effectively deliver material related to human physiology and the pathology of disease, but patient interactions were removed from my daily learning.
As I watched the mounting death toll during COVID-19, it became clear to me that I will often to fail to physically heal the individuals that I encounter. Whether due to a lack of knowledge on how to treat a certain condition, a disease that unequivocally overwhelms even our most potent therapies, or socioeconomic factors that hinder our patients’ ability to access care, healthcare practitioners sometimes are left with few options but to acknowledge and honor the lives and experiences of our patients.
As providers, recognizing the vivid lives of each of these individuals can be emotionally challenging, but it is essential to appreciate the significance of each life and to provide humanity and solace in their most vulnerable moments. However, such gestures have been hampered under the conditions of the pandemic.
These conditions have limited providers in time and in number during interactions with patients, preventing them from learning much about the individuals they care for beyond what is recorded in a chart. Family members have been barred from healthcare settings, hampering their ability to give texture to the lives of patients or to participate in their loved one’s care. Surgical masks, face shields, gowns, and gloves obscure human expression and touch that are instrumental in communicating empathy between patients and caregivers. While many health professionals lament these changes and long for a return to the days before COVID-19, others are being indoctrinated into medicine only having known this way of providing care.
The first patient I cared for upon returning to the hospital for my internal medicine rotation was a young veteran, in his 40s, who was hospitalized for acute hepatitis. As the patient’s condition stabilized, I called his mother with updates and to ask if there was something she would like me to tell her son. She told me to tell him that she loved him and was rooting for him and that his dog Ruthie, a black spotted pit bull mix, was missing him. Before I could deliver this message, I was told that my patient had contracted COVID-19 while in the hospital and would be transferred off of our service to a medical team that cared for COVID-19 positive patients. He passed away just a few weeks later. I still think about this patient and how I was unable to deliver him the love sent by his family, a human connection that would have been more therapeutic than any of the failed treatments he was given.
Having lost the opportunity to experience the gravity of such moments, I worry that my classmates and I will not see or come to appreciate the need for humanism in medicine. I dread that I will not understand the power of a loved one’s presence in a hospital room. I am concerned that my hesitancy to remove my gloves and touch my patient’s hand will limit my ability to connect with them as humans and not just vessels of disease. As the medical system recovers from the extreme burdens of the COVID-19 pandemic, we must acknowledge how the current context has impacted the education of the next generation of medical providers. We must work to elevate the importance of humanism in medicine. In times such as these, when all of our efforts fail to combat illness, human connection has more value than any medicine we are able to provide. Acknowledging the value of this is instrumental in the development of healthcare professionals.
John C. Messinger is an MD candidate at Harvard Medical School.
This post is part of our digital symposium, In Their Own Words: COVID-19 and the Future of the Health Care Workforce.