It was 1984, and I was rotating through the Pediatric ICU (PICU) as a sub-intern during my fourth year of medical school.
Her name was Aisha, my first PICU patient, a two-year-old with a presumed diagnosis of a new mysterious disease that was only seen in IV drug users and gay men – AIDS.
Aisha was the first child in our hospital who had acquired the infection through maternal-child transmission. Every day, I gowned, gloved, goggled, masked and went into her glass-enclosed isolation room to perform all the procedures she needed. Aisha’s nurse was the only other person allowed in the room routinely.
Over the next two weeks, I got to know Aisha’s family well, a family living in relative poverty in rural Virginia. I did my best to explain her condition to them as we all watched her health gradually decline. Finally, we could do no more, and she succumbed to pneumonia.
After the code was called, I slipped out of the PICU and into the hospital chapel where I cried for an hour, wondering how this could happen to an innocent child, how I could have prevented it, how I could still be a pediatrician and watch children die.
No one was there for me at that time: no chaplain to process the grief; no attending to console me; no resident support group to surround me in love. I just gathered myself up and returned to work in the PICU. Everything back to normal.
As physicians, we are constantly asked to stay detached and put “patients first.” We are all experts in repressing our feelings, putting our heads (and hearts) down, and getting to work. But too often this just leads to resentment and burnout.
During the peak of the COVID-19 pandemic, all of us in the medical profession were being called to double down with a warrior mentality. We were asked to do whatever was needed, prepared and equipped or not, with protocols changing daily. All the while, worrying about exposing family and friends to this virus. Now, we are suffering from the emotional fallout of that experience.
Physicians were already suffering from burnout at alarming rates before COVID-19 hit. Our call to action and self-sacrifice can only make the situation worse UNLESS we all contribute to a culture of compassion for ourselves and each other. Here are some small concrete suggestions for how we can do this. Try one or two each day.