Grief, Chaos, and COVID: How Medical Trainees Can Cope

Jillian Horton, MD, FRCPC

Disclosures

April 18, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

During my third year of residency, a peer whispered to me that something strange was happening in the ICU: A patient was in isolation, with only staff allowed in. That patient had had contact with one of the index cases of severe acute respiratory syndrome (SARS) in Canada. A few days later, our lives changed.

Rotations were altered. My friends and I were often stuck in intermittent self-isolations, checking our temperatures every few hours. Life as we knew it ground to a halt. It was a long time before things got back to normal.

That experience shaped our healthcare community and changed all of us. In Toronto, SARS disproportionately affected healthcare providers. For most of us, this was our first concrete exposure to the reality that our career exposes us to the threat of death. Staff physicians at one of our teaching hospitals became seriously ill. I was indescribably angry at system failures that contributed to their risk. Three healthcare workers died during that outbreak. I grieved for them and their families and worried obsessively about my own safety.

No handbook can help navigate a crisis that disrupts education and leads to the critical illness of our teachers, friends, and peers. However, my experience as a medical trainee during SARS has taught me some important lessons about navigating grief and loss—lessons I want to share with you for the weeks and months ahead, as we confront the ongoing COVID-19 pandemic together.

The Medical Community Is Your Community —Lean Into It

We all know that imposter syndrome among trainees rattles confidence. Early in a medical career, it can also affect the sense that we "belong" as part of the healthcare community. Depending on where you are in your training, you might feel as though you haven't logged enough years to claim this professional group, this medical "family," as your own.

As of right now, you are one of us.

I used to frame that feeling for students in more familiar language: "When do you go from being a tourist to a local?" The answer has nothing to do with how you feel. You become a local when the locals see you as one of them. Please know that as of right now, you are one of us.

You may wonder if you have a "right" to grieve for the doctors, nurses, and other healthcare providers who are dying in this terrible crisis. You do. You see yourself in them, and rightly so. If you are questioning your right to grieve for them because you have not "earned" it, trust that your conflict is entirely normal. But make no mistake, this is your community.

The actions being taken by so many learners across the country—students providing childcare, fighting to secure personal protective equipment (PPE), serving however they can—are all ways to show solidarity with your community. Every job, every effort, matters right now, and it is all in support of one thing, which is our mission.

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