New England Journal of Medicine
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.
A stranger lay motionless on the ground. Moments earlier, he had tripped and fallen while running. I was the only witness; the street was deserted. I was unsure of what to do next. Breaching his 6-feet bubble to check on him was fraught with risks after COVID-19 had laid siege on society. As a doctor, I had never questioned this instinct but this time I hesitated: should I go and help?
For a doctor, this shouldn’t be a complicated question. A few months ago, I was on a date shopping for Christmas presents. The mall’s echoey atrium amplified the hordes of people inside. Everything clamored for our attention: look-at-me window displays, listen-to-me song remixes, and smell-me aromas. As we navigated through this chaos, one thing caught my eye: someone was lying on the ground.
I walked over for a closer look. A woman squatted beside this person. She looked concerned. She wore a backpack and from her wrist dangled a freshly unfolded department store bag. Someone in uniform stood nonchalantly a few feet away holding a walkie-talkie. “What’s happened here?” I asked as I squatted beside her.
“I found her like this. She’s probably overdosed but she’s still breathing. An ambulance has been called. I think she needs Narcan.” I was struck by the directness of her structured response. I introduced myself as a doctor; she was a pediatric cardiac nurse. While waiting for support, we took turns to check our new patient. Someone’s finger was always on a pulse. She monitored the patient’s breathing; I monitored the patient’s consciousness level. I used the flashlight of my phone to check her tiny pupils. I asked the person in uniform if there was an automated external defibrillator nearby. Resuscitation algorithms flashed through my mind. My hands twitched with the muscle memory of how to interlock them for chest compressions. A few minutes later, an ambulance crew arrived. Narcan given, patient conscious, job done.
“I have never seen someone like that before,” said my shell-shocked date as we walked out of the mall. Although I was used to this reaction from patients’ relatives and friends, I rarely experienced it from people I personally know. My clichéd life as a doctor meant most of my friends were also doctors, and our herd immunity protected us from the distressing nature of acute illness. I felt guilty for bringing her, a nutrition and wellness consultant, into the world I know, where sickness was the rule and wellness was the exception. “I’m sorry you had to see that. I can’t help it – it’s a natural instinct to stay and try to help.”
I didn’t do much for my patient beyond being there for her, acting as a safety net and a reassuring presence. But during the pandemic, my presence was far from reassuring for the stranger who had tripped and fell. Coronavirus had coated everything with a layer of risk. Physical closeness, which I relied on for diagnosing and comforting my patients, was viewed with suspicion. It induced anxiety instead of relief. As I looked at the stranger lying several feet away on the street, I was acutely aware of the harm I could inflict just by breathing in his vicinity. I was also conscious of exposing my own vulnerability. COVID-19 has warped society’s altruistic instincts; instead of doing something, the best way to help was to do nothing.
I wanted to rush over and check on this stranger, but instead I ruminated on a thought: “What value did I add to this stranger’s health beyond being a potential source of infection?” Nevertheless, I walked towards him. “Hey! Are you ok?” I called out. There was no answer. Muffled by my mask and dampened by distance, I wasn’t sure if he had heard my voice. I broke the bubble and walked up to him. “Do you need some help?” This time he looked up: “No I’m good, but thanks.” He got up, dusted himself down, checked his hands and knees for cuts, and gingerly continued on his morning run. I caught his glance. His eyes were filled with gratitude.
Although COVID-19 is constantly renewing our social contract with everyone, some rules are still the same. People always appreciate a helping hand, and we should trust our instinct to extend it, from whatever the distance.
Ken Wu is an editorial fellow at the New England Journal of Medicine in Boston and a paediatrician training in London in the United Kingdom. He loves to write and can be found struggling over spelling and grammar differences across the pond. He also frequently sits at his piano daydreaming about being a concert pianist.