School of Medicine
This essay is part of our series, Flattened By the Curve, which features the voices of doctors, nurses, healthcare workers, and others on the front lines against COVID-19. For information on how to submit, click here.
I’ve often joked that the theme song of medical school should be the line from “Colors of the Wind” where Pocahontas sings, “How can there be so much that you don’t know?”
As a third-year medical student — the most junior member of any medical team — I am used to saying “I don’t know.”
I’ve struggled to find a way to be useful during this pandemic. As much as I want to support my hospital on the wards, there’s so much that I don’t know.
I don’t know how to manage ventilator settings.
I don’t know how to navigate COVID protocols.
I don’t know how to tell a patient they are dying.
But I can offer this, the most important lesson I learned this year, to frontline workers and others struggling with uncertainty:
It’s perfectly okay to say “I don’t know.”
Saying “I don’t know” on the wards is not an admission of failure or an indictment of one’s intelligence — though it often feels that way. It’s an acknowledgment that there’s a gap in one’s knowledge, with an implicit promise that this gap will be actively filled, through study or experience. It’s less “I don’t know” and more “I don’t know yet.”
My classmates and I will be applying to our respective specialties this fall. Every week, our administration hosts a virtual town hall, creating a space for 150 anxious medical students to ask questions about how COVID-19 might disrupt this application process. Often, the answer we get is a more diplomatic version of “We don’t know yet.”
As frustrating as this is to hear, I can imagine how much more it frustrates our faculty and staff to say; as experts in their fields, they are used to having the answers. Their job is to answer questions: from patients, from families, from students. They are far more removed from not knowing than I am.
Will testing centers remain open so we can take board exams on time?
How do we make decisions on where to spend at least three years of training if all interviews are virtual?
How do we interact with patients in a post-COVID world?
We don’t know yet.
And that’s okay. These gaps will be actively filled. Through study, through experience.
On our exams, we are given clinical vignettes: A certain person of a certain age comes in with a certain set of symptoms. On our exams, we are supposed to pick up on subtle clues — a recent cold, an abnormal lab value — and use our knowledge to put these symptoms together to uncover a diagnosis. It’s a lot like putting a puzzle together.
On our exams.
Life right now is a different type of puzzle: we’re left with a pile of jumbled, disjointed pieces. How do we start putting this puzzle together when we don’t have the box to tell us what it’ll look like?
How can there be so much that we don’t know?
For now, we have to be okay with “We don’t know yet.”
John Carlo Pasco is a third-year medical student at Boston University School of Medicine with interests in pediatrics, narrative medicine, and advocacy. He wishes he could help more.