“To help people.” This short phrase has been used for generations, in a variety of forms, to respond to inquiries about what motivates students to enter the field of medicine. The cohort of medical students who matriculated in 2020 likely responded no differently. However, seeing doctors—whose positions we were prepared to endure years of grueling education to assume—suffer at the hands of an ever-changing disease that has dominated conversations and transformed billions of lives suddenly made those words feel small.
Processing the tragic loss of hundreds of thousands of American lives was not an extracurricular activity I thought my first semester of medical school would include. Recognizing classmates solely by the upper half of their faces, weighing viral exposure risk in decisions to participate in needful clinical opportunities, and knowing professors only by voiceovers on PowerPoint slides are all phenomena that none of us were prepared for.
As I reflect on what inspired me to enter this field, I am reminded of a project I conducted as a fifth-grader. While living in Accra, Ghana, and learning about pediatric hospital care, I went on a site visit to conduct an interview. I clearly remember stopping short as I walked into the ward, shocked by the sheer number of bodies in the area. The initial wave of shock passed and was replaced by a child-like curiosity. Children of all shapes and sizes gathered around their parents—so many in need of services available in very limited supply. Seeing their suffering birthed an unquestionable motivation for change.
From that moment on, I felt a deep and growing passion for medicine, a passion that went largely unchallenged until the fall of 2020, when I walked into the strangest and most difficult semester of education I have ever received. Entering the hallowed halls of medicine during a time indelibly stamped by the impact of COVID-19—a pandemic unrivaled in our lifetimes—is a phenomenon I believe many will work to study, process, and characterize over the coming years. I hope my few observations can serve as a starting point, a catalyst for further conversation, and an opportunity for us to mourn what we have lost but also begin to uncover what this very same loss may offer us.
In the midst of this pandemic, we have lost certainty. We have lost the ability to predict. The knowledge of when we will see loved ones. The joys of in-person connection and communal learning. On a personal level, COVID-19’s unsolicited additions to my education have even chipped at my resolve to be a doctor at all. In the face of preexisting trepidation at the novelty of medical work and the mountainous amount of knowledge to be gained, this new baseline of unknowing has been all the more unsettling.
What we have lost is clearly great. However, we’ve only begun to scratch the surface of what we have gained. When the ability to learn with others is challenged, we find ourselves with a deeper appreciation for the value of collaboration in classroom and research environments. When there is a limitation in our ability to reach the communities we are committed to serving, we see greater evidence of the power of advocacy, which can in turn fuel us for the arduous work that is medical training. When our desires to provide answers and a cure are limited, we rediscover the healing that is offered by being present and the deep dignity restored by an attentive ear.
I have a strong proclivity to experience the emotions of others. And as such, I have experienced great despair in the face of the pain and difficulty this pandemic has brought. When I have taken breaks from hours of reviewing microbiology slides, only to see the number of my fellow Americans dying at the hands of this horrendous disease plotted on charts with dizzying slopes, I have lost the ability to rest. During one study break, I decided to take a walk in the brisk cold of November, hoping the physical exercise would give my brain the reprieve it needed to learn more bacterial pathologies. As I walked, I found myself sensing moisture on my cheeks and having to clutch my center in order to hold myself up, weighed down by grief for the more than 3,000 American families who had again lost loved ones on that day alone. This sensation was both similar to and vastly different from what I had experienced so many years ago in Accra. The sheer acuity of the pain was something I could not draw parallel to. This experience of pain is also something I have gained.
We tend to avoid pain as a survival mechanism. It makes sense. Evolutionarily speaking, it could seem maladaptive to lean into discomfort and grief. However, this leaning is precisely the opportunity our class has been presented with that distinguishes us from many of our more advanced colleagues. What we have gained this year is a divinely unique opportunity to grapple with global pain, suffering, fear, and despair, the same things that have motivated remarkable innovation, bravery, and care in ages past. Medicine is not just an opportunity to help people. It is an opportunity to help the most desperate. To write new questions and fight for answers daily. To stare hopelessness and blank pages in the face and conjure up the determination to work for new and improved methods, treatments, and possibilities anyway.
So, how do we continue to learn in the face of the great uncertainty that we face daily? We hold on to what is true, what is honorable, what is pure, lovely, commendable, excellent, and praise-worthy. We set our minds and hopes on these things as we step over the hurdle of despair and into the potential for motivated action. We ask for help. We embrace our humanity, which confers limits on our understanding and ability, and then, with a better knowledge of self, we move forward. We seek inspiration from the journeys of those who have succeeded before us. We remember that medical advancement is often, if not always, catalyzed by great need. The etiologies and sequelae of diseases that we now understand have come from a desperation and perseverance motivated by the intense grief and pain of members of our society, grief that we are now, as a world, a little bit more familiar with.
My hope is that the new normal of medicine will be invariably influenced by this truth. That, in order to be successful clinicians and global citizens, we must feel pain, we must see suffering to commit wholeheartedly to the work of healing. Perhaps the legacy of this horrific pandemic could be that pain and grief do not in themselves have to be ends. Instead, when boldly approached and walked through, pain has the potential to be a powerful conduit for the amelioration of community ills, and for positive social change. Perhaps we can also now fully acknowledge that courageously walking through difficulty is undeniably done better with others, united together in understanding.
Let us now embrace the immense privilege we have to learn medicine, however unique the circumstances of this time are. Let us learn to heal, empowered by a resilient hope that allows us to intimately engage with this time of uncertainty and pain. May the global tragedy that has been such an unprecedented addition to our medical curriculum also be a source of great wisdom, inspiration, and strength for the field of medicine and the world as a whole. May COVID-19 help us, “to help people.”
Agnes Ezekwesili is an MS1 at the Perelman School of Medicine.
Image by Tracy Du, an MS1 at the Perelman School of Medicine.
