Searching for Human Connectedness During COVID-19
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Section of Hospital Medicine, Division of General Internal Medicine, Weill Cornell Medicine New York, NY, USA; 2Center for Global Health, Weill Cornell Medicine New York, NY, USA.
The COVID-19 pandemic has fundamentally transformed doctor-patient communication, stripping away moments of connection that define the humanism of medicine. The barrier of isolation has impacted patients and patient care, and has also affected the experience of the physician. Though in-person connection is impossible to replicate digitally, technology has restored some sense of togetherness. J Gen Intern Med DOI: 10.1007/s11606-020-06082-9 © Society of General Internal Medicine 2020
am in my eighth week of COVID care as an internal I medicine physician in New York City. Despite being surrounded by patients and my colleagues, the days have become oddly lonely and disorienting as I prep to see my next patient. I follow my drill: don scrubs, a tight-fitting N95 mask, and plastic goggles. I then slide into my second protective layer—a large yellow paper gown, pale blue hairnet, latex gloves, and an awkward plastic face shield. I am now ready to enter my patient’s room and introduce myself. He is 47 years old, a beloved father, and breathing too fast. I can barely see through the two layers of foggy plastic over my eyes, but even then, I can see he is scared. My week-old mask is grimy and smells. I am hot and light-headed wrapped up like this. Senses blunted by all the PPE, my mind wanders. I feel acutely alone, disconnected, in my thoughts and body, in almost a futuristic sense. Maybe this is what it is like for astronauts floating around in their moon suits when in space, trying to move forward. I introduce myself by literally yelling “hello” through the layers of protection so that my new patient can hear me over the humming of oxygen tubes and cardiac monitors. “I’m Dr. McNairy and I’m going to be your doctor today. You can call me Molly.” Sometimes they nod, sometimes they cannot hear me above the din and I scream louder through my suffocating layers. I laugh at myself. It feels absurd to be screaming introductions but the patient cannot tell through the layers of Received May 10, 2020 Accepted July 27, 2020
plastic. The physical exam is remarkably brief and centers on checking the monitors for the most important prognostic data for COVID-19—the heart rate, respiratory rate, and oxygen level. I’m supposed to stand six feet away while talking to the patient but it is hard not to resume old habits. I put a gloved hand on his shoulder, but the PPE seems to silence the reassurance I’m trying to express. I hurriedly inform him that he has tested positive, and while neither of us are surprised, it comes with a wave of fear and worry for us both. Will he get sicker? What is his prognosis? Will he survive intubation? And if he does survive, will it be with a breathing tube in his neck and what will he think of his new life? Before COVID-19, we would typically round as a team. I would often sit on the patient’s bed, with students and residents
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