Racing through the Hurricane

If medical school is the classroom portion of a driver education course, residency is the practical portion. As a graduating medical student, I have learned the textbook rules of the road, but now I am preparing to start residency, where I will learn how to actually drive a car. It may be nerve-wracking and inefficient at first, but I will improve with time and gradually gain more independence. 

At least that is what is supposed to happen. Beginning residency amid the COVID-19 pandemic feels like being given the keys to a race car in the middle of a hurricane. Everything is faster, more dangerous and more stressful than I anticipated, and it feels as if the textbook rules only loosely apply. But, regardless of the state of the pandemic and of my own anxiety, I will enter a new hospital on Wednesday, July 1st as a physician. My job description will include many roles that I prepared for during medical school: caregiver, teacher, researcher, advocate, and team leader.

However, with the onset of the COVID-19 pandemic has come additional expectations of all physicians: spokesperson and journalist. Physicians have become integral to the public’s understanding of this crisis by collecting, disseminating, and explaining the news in both public and private forms. In doing so, they have been thrust into the spotlight to an unprecedented extent (when was the last time every American knew the name of the director of the National Institute of Allergy and Infectious Disease?). 

As a young physician, I find this role to be interesting and, in many ways, intimidating. While communication skills are emphasized in medical school, they are focused on interactions with one patient rather than mass communication. This leads me to wonder: am I prepared for this responsibility? Certainly, the spotlight on me and my resident colleagues in no way compares to national leaders such as Dr. Fauci, but it is still present, and we must consider how to approach it.

 In a media landscape filled with accusations of “fake news” and conspiracy theories, physicians are often looked to as a source of accurate and trustworthy information. Unfortunately, not all fulfilled this responsibility. For example, physicians from California actively promoted misleading statistics in a YouTube video that downplayed the severity of the epidemic. While their YouTube video was eventually removed, a Facebook post highlighting their deceptive findings has been shared more than four-thousand times (left). As CMU journalism professor Dr. Ed Simpson notes, it can be difficult to spot false news when it comes from seemingly authoritative sources. This sends a powerful message to young physicians, such as myself. Simply by putting “Dr.” in front of our names, our words carry more weight than they did just a day earlier when we were only students. 

But for most physicians, the spotlight is smaller, with the audience being family, friends, and social media followers. In Emily St. John Mandel’s Station Eleven, a novel about a pandemic and the world it leaves behind, a doctor calls the protagonist to offer a dire warning of the disease and encourage him to flee. He paints a grim picture: “A hundred and sixty [patients] in the past three hours. Fifteen of them have died. The ER’s full of new cases.”  This kind of warning, issued in private to a friend, does not occur only in fiction. Locally, a physician was found to have exaggerated the severity of the pandemic in a personal communication. To be clear, there is no evidence to suggest that this exaggeration was malicious. However, this underscores the importance of being accurate, as you never know how long your conversations will stay private.

It is important to note that these examples of poor communication on the part of physicians are far from the norm. Many have publicly expressed concern about the consequences of misinformation, including that promoted by physicians themselves. COVID-19 has affected nearly every aspect of my graduation from medical school, but as I pick up the keys to start driving for the first time, I also recognize that this pandemic has given me the opportunity to learn an important lesson: my words as physician, regardless of my level of experience and intended audience, can have significant consequences.