To the Editor: As a pediatrics resident, I am comfortable treating infants in respiratory distress. As a psychiatry resident, I am comfortable treating acutely psychotic adults. Treating adults in heart failure, however, is quite far outside of my comfort zone. Yet this is what I found myself doing during our hospital’s surge, when increasing numbers of COVID-19 patients were admitted and additional internal medicine residents were needed to staff the intensive care units. Medicine is filled with hierarchy, divisiveness, and assumptions among and about physicians of different levels of training and physicians of different specialties. Through my time as a resident, I have experienced my fair share of condescension from consultants, disagreements with nurses, and harsh critiques from attendings. Before my COVID-19 “deployment,” I prepared myself to return to these seemingly unavoidable consequences of being an “intern.” However, my week as an intern was filled with words and gestures of encouragement and support, prompting me to wonder why we health care workers have tolerated our malignant system for so long. Despite my lack of knowledge about heart failure treatment, our team still functioned as a cohesive unit. We acknowledged that each of us held different levels of training and skill sets, which fostered open communication. During rounds, we were able to view the same patient through multiple lenses, leading to more well-rounded discussion than I have experienced in other settings. Even though we had fewer formal teaching opportunities, we were able to learn from each other’s practical knowledge and skills, and these lessons will stick with me much longer than many of the morning reports I have attended. We capitalized on each individual’s strengths, which proved extremely valuable for patient care during this unprecedented time. I expected frustration from the staff, given their years of experience, as they fielded my numerous questions; however, they greeted me with overwhelming kindness. I found myself with a renewed sense of gratitude for all of the hospital employees working alongside me, each with their own set of wisdom and clinical skills. We all felt the anxiety of being exposed to the virus, the discomfort of wearing an N95 mask, and the fatigue of working long hours. The shared trauma we were experiencing was the common thread motivating us not to wear each other down, as has happened all too often in the past, but to lift each other up. Isn’t this the way health care should be? Acknowledgments: The author would like to thank Erin Baroni, MD, supportive leader of the team described in this letter.
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