A Heavy Heart ”in-Training, the peer-reviewed online publication for medical students
Monday morning, a medical assistant finds me with a nasal swab in her hand. I scribble my signature and my temperature on the form he hands me. “Ready, Maria? He asks, then laughs when I moan in response. I tilt my head, close my eyes, and wait until the worst is over. After 15 minutes of waiting in the student workroom, he tells me that I am COVID-19 negative and that I am ready for the week.
Part of my third year internal medicine internship in March 2021 involves participating in rounds to nursing facilities, each with individualized COVID-19 protocols. While some require simple testing, a few facilities require documentation of a negative test every week. This means that in addition to the daily temperature and symptom screening, I am tested for COVID-19 every week.
That day I saw Evelyn * for the first time in the memory care unit. The 97-year-old woman, whom the nurse called “pleasantly confused”, doesn’t understand why I’m wearing PPE, nor is she aware that we are in a pandemic. She is wearing a sweater in my favorite shade of purple and has a beloved plush dog in her lap. She waves me over and whispers in my ear that one of the nurses is in a bad mood. “You know, the bad one,” she said, raising her eyebrows. I laugh because I don’t know what to do with this information. She laughs too and squeezes my gloved hand. My assistant places my other hand on her chest and I feel vibrations. “Is that a palpable thrill?” I ask, surprised. This is the first I have ever felt.
As I rip off my yellow dress and take off my gloves after I’m done with Evelyn, I hear, “Excuse me, are you all coming to see me today?” Michelle’s bedroom is directly across from Evelyn’s and she is waiting by her door in an antique wheelchair. I look at her perfectly groomed hair and her surgical mask sliding down her nose. She’s not on my attendee list, but I dress and hang out with her anyway. I ask if everything is alright and she shrugs in response. Visitors are limited so I’m aware she hasn’t had anyone in weeks. His sad hazel eyes make me want to give him a hug, but I don’t think I’m allowed. I rub her back with my gloved hands instead. I smile at her but wonder if she can tell because of the N95 I’m wearing. She asks me if I am religious, and I answer yes hesitantly, not knowing where this conversation is going. “Can you pray for me? ” she asks. I squeeze his bony shoulder lightly and promise him I will. As I get up to leave, I ask him to pray for me too.
At a quarter to five, I exit the building and remove my N95 and face shield, relieved that I don’t have to wear them until tomorrow. I approach my car and see my reflection on the window. My face is fat and I trace the lines on my face with my fingers – a physical reminder of pandemic life.
I go home emptied. I have a sore throat from screaming through my mask all day. I take off my work clothes as I microwave my pasta and slip into bed with my dinner. I swing the bowl over my lap and open my laptop. I try a few practical questions, but my brain is on strike. I get four out of 10 correct questions on one section. I close my laptop, frustrated. I promise to get up at 5 a.m. to give myself more time to study tomorrow morning. I reply to text messages, starting with “Sorry for the late reply”. A friend calls me shortly after I answer her text and we chat for a bit. She asks me about my day. I bite my lip and give a vague answer – I don’t know how much I want to share.
I remember it was a good day – so why is my heart so heavy?
The weight of the suffering I witness every day stays with me. I try not to get overwhelmed by my heavy and bruised heart and wonder how my peers are doing this. Do their hearts look like mine? I don’t share how I feel with the residents and assistants I work with, not wanting my feelings to be crippled or told to ‘toughen up’. I am aware of my sensitivity no matter how many times I remind myself that it is one of my strengths. My non-doctor friends ask me what it is and I censor my stories. “Some days are tough,” I say, then quickly change the subject to something light. I am relieved that we are not FaceTiming as the tears accumulate behind my eyes.
As a future psychiatrist, I am concerned about the lasting emotional and psychological impacts of the pandemic. I worry about young children are on board in the emergency room for weeks due to the lack of psychiatric beds, pregnant mothers with severe cases of COVID and my peers removed from their rotation sites due to breakthrough infections. I witness the impact of social isolation and of depriving the elderly of visits from family and friends. My heart sinks when I think of my parents and my grandmother halfway around the world. As I continue to care for my patients, I hope my parents and grandmother in Japan will receive the compassionate care that I strive to provide to my patients.
As a medical student, I try to alleviate physical and emotional suffering and build relationships and bonds while trying to learn as much as possible. I limit the number of articles I read about COVID-19, but I give in and read as much as I can while I stay in bed. Despite the suffering around me, I try to learn and hope that my best efforts will be enough to be a good medical student, friend and daughter.
* All names have been changed.