The time for courage
Emily E. Volk, MD
February 2022—We pathologists tend to share traits common among physicians: We are often type A overachievers, driven by perfectionism, our own unrealistic expectations, and a deep fear of failure. Normally, these characteristics help us to achieve our goals, in life and in caring for patients.
But these are not normal times. In the COVID-19 pandemic, it is almost impossible to feel like we’re doing a good job. Like so many of you, I am working significantly longer hours than usual. At the end of each day I am often left with a sense of despondency that there’s not enough time to get everything done, or to do it all as well as I would like.
To get through this crisis, we have to let go of our perfectionism and embrace doing what we can. We need to accept that if we’re doing what we can, it’s enough. Even if our individual efforts seem inadequate in dealing with this pandemic nightmare, the collective effort is adequate.
Each day in my hospital I feel like I’m taking a bath in COVID-19. But I go home, rest up, and do it again the next day. I imagine that most of you share that experience, so here’s what I would ask you to remember: There is bravery in that. There is courage in going back to work, day after day. We need to recognize that and honor it in each other and in ourselves.
Dr. Volk
For me, the ideas of medicine and courage—in acknowledging the fear and doing the thing anyway—have always been closely tied. I was so certain about my career in health care that I enrolled in a six-year combined bachelor’s and medical program at the University of Missouri in Kansas City. My earliest clinical experience began when I was just 20. The program recognized the challenges of starting so young, and partnered junior students with more senior students. I am still in touch with my senior partner, a woman named Dana Thompson, MD, who is now a pediatric ENT at Northwestern.
In Dana I saw the model of a bold and fearless young woman. She was the first person to volunteer herself for tests nobody else wanted to do. At the height of the AIDS epidemic in our inner-city hospital, she was first in line to examine patients with end-stage HIV—and I was right there with her. She taught me that opportunities were often in the gaps that other people didn’t want to fill, and that every opportunity allowed us to improve our ability as physicians.
She also emphasized for me that being there for the difficult things, whether it was in the room for the autopsy of our patient or doing the physical exam for someone other physicians would have preferred to avoid, gave us the chance to dig deep and see the humanity in all of our patients, regardless of their conditions or their willingness to help themselves.
Her lessons have served me well in medicine, but perhaps never more so than right now. There is so much fear about when and how this pandemic is going to end, among health care teams and the patients we treat. We pathologists are anxious every day about how we will make it through in the face of crippling supply chain and staffing shortages. We deal with our personal frustration about caring for patients who won’t get vaccinated, and about having to deal with the emotions of deaths that feel unnecessary. We routinely confront misplaced anger from people who have made testing a scapegoat of the pandemic, when we all know it is impossible to test our way out of this crisis.
But even in the worst health care situation most of us have ever experienced, we can dig deep to see the humanity in each other and in people with whom we don’t agree. The humanity behind every test tube and biopsy. The humanity of the cranky surgeon and the exhausted emergency medicine doctor we count as colleagues. We can find the courage to keep showing up.
In this time of crisis, we physicians have a blessing that many people do not: the gift of purpose. We know how much our work matters, and we know what we need to do every day. We know that we are needed. It is a comfort that can carry us through hard times. In our darkest pandemic days, we must hold on to that purpose and recognize it for the blessing it is.
Dr. Volk welcomes communication from CAP members. Write to her at president@cap.org.