This perspective is brought to you by Steve M. Selbst, MD. Steve is the APA Immediate Past President (2019-2020).
April 28, 2020
I was feeling sorry for myself in the midst of a terrible pandemic. I worried about my family. Doesn’t everyone? I have not seen my 102- year old father in 6 weeks; the nursing home does not allow visitors. I am only able to see my 6-month old grandson from a distance of 6 feet. I am dying to pick him up and snuggle with him for a few minutes… hours, days. All social events have been abandoned. The Phillies have yet to throw a pitch! And after 40 years as an emergency physician, I have not worked a shift since mid- March. Because I am a “high-risk, senior citizen”, I have been taken off the front lines. I am very grateful for this extremely kind gesture and my wife is so relieved. Nonetheless, I am suffering some guilt, almost like ‘survivor guilt’. My younger colleagues are working for me and putting themselves at risk. They have families too. Fortunately, the ED is quiet and I do not believe others have had to work additional shifts because of me. Most importantly, none of my colleagues have tested positive.
One only needs to watch the news for 5 minutes to get a reality check. Emergency Departments across the country are overwhelmed, thousands have died, millions are out of work, long food lines are prevalent, tremendous suffering abounds. Just seeing the New York City healthcare workers in such pain is enough to jolt anyone back to their senses. I have a job, my health, unbelievable colleagues, and a chance to spend more time with my wife than ever before. Hardly any reason to complain.
Time to rechannel my energy. Fortunately, my administrative role as Pediatric Residency Program Director, and GME Director has kept me busy and given me purpose. As you all know, medical education has changed dramatically in just a few weeks. The students are gone, inpatient census is way down, and the outpatient clinics are temporarily closed. We have rearranged our staffing completely to have a resident team that can fill in whenever needed. We have all tried desperately to continue to give our trainees a meaningful experience. Like most, we have ramped up our virtual conferences, assigned podcasts and journal articles to bring us together electronically 3 times a day. It is no substitute for patient care. It is not even close to the educational experience we promised at Orientation. Despite it all, the residents are incredibly optimistic and their positive attitude is inspiring. They have certainly learned about crisis management and disaster planning!
Resident stress and morale is the biggest challenge. While the hospital is ‘quiet’, the stress level is off the charts. We have had only a few COVID positive patients. But every patient (and every parent) is a potential carrier. Maintaining close connections with the residents and fellows is imperative. We have our spring ‘feedback sessions’ (electronically, of course) with each resident, which give us a chance to gauge their anxiety. We text them all weekly. Our amazing Chief Residents are also in frequent communication with the group. We bemoan the cancellation of our treasured end-of- year parties that make residency fun. Even Resident Graduation is threatened. We may have to celebrate graduation in our cars, on the hospital parking lot. It will be memorable for sure. At least we will all be together- sort of.
Of course, we were deeply saddened when the PAS meeting was cancelled. This was a tremendous loss. Our APA members and trainees lost the golden opportunity to present their creative work. And all of us missed a cherished occasion to connect and network with each other. Furthermore, the APA suffered a significant financial shortfall. Hopefully, this will not have long- term consequences for our programs. I worry that hospital budgets will be greatly impacted by this pandemic and physician travel, and even research endeavors, may be in jeopardy for the near future. This could endanger PAS 2021.
Before we get too depressed, let us again put everything into perspective. The things that used to be so important to us are now further down the list. The world will never be the same, but the APA remains strong. Eventually (hopefully soon) we will be back to our full strength. I am confident that our scholars programs will continue to produce superb researchers and leaders. Our research networks will again flourish and bring valuable evidence to light. Our APA Communities will continue to share ideas and innovations. There will be other scientific meetings for all of us to enjoy and display our work. APA members will continue to mentor their colleagues, to nurture their trainees. I look forward to a bright future. I especially look forward to seeing you again– hopefully, without the masks.
Steven M. Selbst, MD