Columbia University Irving Medical Center
New York, NY
This 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 spent my last week of internship in bed. After a year of acclimating to the wards, transitioning to a new electronic health record, confronting the sea-change of COVID-19, and joining in protest with the Black Lives Matter movement, suddenly I found myself hobbling with a cane to use the bathroom, unable to exercise my writing hand, my body cocooned in a dense fog of pain.
A couple of months earlier, with the New York City subway system effectively blacklisted for risk of SARS-CoV-2 transmission, I had opted to take the scenic route to work: one of my co-residents is a seasoned cyclist with ample advice to spare, and once he had answered all my consult questions, I was eager to introduce this ritual to my workdays. I visited my local bicycle shop and by the end of the week I had a bike, lock, lights, and helmet in tow.
I felt like I had discovered flight. Every morning at 5 am, I spun out to see rosy-fingered dawn coalescing into day along the Hudson River. I was miraculously alone as the bright city just began its stir. The birdsong and greenery in Riverside Park reminded me of long-lost college mornings in Vermont. At the end of a six-mile stretch, there is a blind corner leading to a steep hill that connects the bike path to the road, and I always dreaded and looked forward to the capstone challenge of that incline. But in turning the corner that day, I collided head-on with a motorized scooter, was propelled over my handlebars, and landed on my helmeted head.
So I was told. I have no recollection of that morning. My first memory is waking up in a gown and C-collar in the Harlem Hospital Emergency Room, my residency program director’s voice sounding through the speaker of my shattered cell phone, and a searing, incandescent pain.
“Where does it hurt?” I was asked. I pointed to different body parts, and spot X-rays were ordered, but the truth is that it hurt everywhere. I tried to find the words, but the agony was all-encompassing. I felt it to my core, my mind in pieces as well. “No general theory about pain,” wrote Alphonse Daudet in In the Land of Pain, a 19th-century chronicle of his torturous experience with tertiary syphilis. “Each patient discovers his own, and the nature of pain varies, like a singer’s voice, according to the acoustics of the hall.”
The acoustics shifted when one of my co-interns appeared at my bedside. Though he had just finished a 24-hour shift in our hospital, he still exuded a vitality that I could not muster but nevertheless gave me courage. I was no longer alone. He remained by my side, holding my hand, until my cousin arrived, who tagged in and took me home so that I wouldn’t have to be admitted to the hospital for further monitoring. Since we both kept very busy — I’m an intern, she’s an attending physician — my cousin’s presence had always been a background comfort, but when the time called, she heeded it without reservation.
Post-concussion syndrome can manifest with psychological symptoms, and it was helpful to have that frame of reference, to normalize the darkness that in the subsequent hours and days would enmesh me. “You could have died,” I was told, and at some points, when the pain was overwhelming, I wished I had. Yet almost every time my mind drifted towards the gallows, in would come a text message, a phone call, a visitor, a delivery. I had long considered myself to be fiercely independent, and until disaster struck, I had not fully appreciated the village that encircled me, providing coverage like a mantle over my head.
I claim no knowledge of the inner workings of the residency admissions process, nor how that process will shift with the rollout of virtual interviews, but in my week of dedicated rest, I was able to reflect on the virtues of a program that values and cultivates family. The concept of family-centered rounds has long been touted in pediatrics as instrumental to the care that we provide to our patients, but I see now that those family-centered principles can form the very scaffolding and culture of a program, and every relationship, every overture, every message of solidarity brought me new insights into how to build an institutional home that nurtures, protects, and allows me space to grow. In perpetual awe, my mother recounted that when she called my program director in the aftermath of the accident, he said it without hesitation: “We are her family.”
Yet my intern year also made me keenly aware that not everyone has that bedrock of support. I saw patients face illness and suffering alone, others stymied by conflict and the censure of their families. My pain is temporary. My lockdown is temporary. But for others, such circumstances are not moments of pause so much as lifelong burdens to bear, and I must hold fast to the importance of making space, checking in, and listening, even if and when I cannot understand. I can still change the acoustics of the hall. And though I know I will always have blind spots when it comes to caring for others, I hope at least that this one has been filled — and, like riding a bicycle, that I never forget it.