Placing one pebble on another

I finished a few evening shifts in the hospital (I asked for more, but we'll see what I get assigned). I felt very lucky that they went all right. The roughest edges of the COVID-19 pandemic are felt in the emergency room, the intensive care units. There the doctors and nurses, the techs and janitors and sitters and nursing assistants, are accompanied by death and near-death. The typical hospital ward, on other hand, is usually (now as in non-COVID-19 times) marked by large stretches of rhythmic tedium punctuated by frantic activity.

The “bio” wards (as the containment units for COVID-19 patients are called) do have a different feel, a churchlike hush, a procession of hooded figures, anterooms to don protective equipment and chambers to doff them. But even there, it was such a comfort for me to participate in the ordinary rituals of seeing patients in the hospital: low-wattage pleasantries and jokes exchanged with people at the nurses' station; rumors of snacks; gossip about which hospital executive did what to whom and why.

Yes, there is death all around these days. There is the woman almost ready for discharge, whose husband is dying in another hospital's ICU. [Identifying details changed.] There are the dashboards with the latest COVID-19 statistics, which I and other doctors check obsessively to no great benefit. There is the vast gulf between models and statistics, on the one hand, and lived experience, on the other. R-naught (R₀)is simulated. Fear is palpable.

To be an embodied human being and to fill a role (a small role, piling pebble on pebble as Newton had it), was a true joy. Working in health care can be joyful. That it's scary and dangerous for so many right now is a product of the disease, but also born of our rapacious institution.

Wearing the face shield felt like bearing a priestly breastplate. As insufficient as I am, I felt like a healer when I leaned close to a man who was hoarse from the breathing tube that was removed from his throat just yesterday. “Thank you so much doctor,” he rasped. “It was nice to meet you.”

It was nice to meet him, too. And I squeezed his hand just because I could.

Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews. He is also a poet, journalist and translator in Yiddish and English. This post originally appeared at his blog.