I had been dreading this moment for weeks. Yet, when the email confirming my redeployment to internal medicine finally arrived, I initially felt a sense of relief. At least my immediate future was no longer uncertain.
Soon though, panic set in. As a third-year resident in radiation oncology in New York City, it had been nearly 2 years since I had worked on an inpatient medicine floor. Now, however, in response to the city’s devastating COVID-19 outbreak, I was being asked to help my colleagues at the frontlines manage a devastating public health emergency. While I was happy to try, I did not feel ready for such an abrupt and radical shift in my job responsibilities.
As I began preparing for my new reality, my doubts multiplied. Would I have time to relearn how to operate an unfamiliar electronic medical record in the midst of a crisis? What would I do in the case of a medical emergency? Would I be of assistance to my internal medicine colleagues, or a burden?
I arrived early for my first night shift as a walking paradox—a medical version of Schrödinger’s cat. I was simultaneously a radiation oncologist and an internist, a specialist and a generalist, a resident and an intern. The duality of my occupational existence only amplified my unease. As sign-out neared, I braced myself for the imminent arrival of a seemingly insurmountable set of fresh challenges.
To my great surprise, however, they never came. While the shift was undoubtedly busy, and the learning curve steep, the night proved manageable. Not only was I able to relearn some of the particularities of the electronic medical record and refamiliarize myself with the operations of an inpatient hospital floor, but I was also able to tend to all of my patients’ needs. I made it through the night.
How did it happen? My colleagues, many of whom (but not all) had also been redeployed to fight COVID-19, proved crucial. They volunteered their time and knowledge to show me how to place orders, write notes, and properly don personal protective equipment. They helped clarify hospital procedures. And, most importantly, they provided support when I needed it most. Now over a week into my reassignment, I can definitively say that they have eased my transition to internal medicine. I am immensely grateful for each and every one of them.
American medicine has always been riven by internal rivalries. Unfortunately, they have not always been constructive. Unfair stereotypes of various medical specialties circulate widely in medical schools and hospitals. In an era in which the pressures of being a physician have never been greater, their collective effect is ultimately corrosive. The result is a culture that does not always prioritize kindness in interactions between health care providers.
This has thankfully not been my experience during my reassignment, and as more of us are redeployed to fight the virus in the coming weeks, I hope we can permanently upend this status quo. In the near term, we must continue to assist one another during this trying time. No one should feel unsupported. In the longer term, we must use this time to recognize that the work our colleagues do on a day-to-day basis is both essential and worthy of respect. The upshot, with luck, will be a medical culture more grounded in respect and understanding.
The COVID-19 outbreak will prove to be a seminal moment in the development of an entire generation of physicians-in-training. I hope that the bonds we form at the frontlines prove to be permanent.