By Michael Bertenthal
As a kid, I was a devoted soccer goalkeeper. I lived for the opportunity to step in front of an oncoming shot to protect the net. I loved the action of diving to make a save, getting my knees skinned and uniform muddied, and occasionally colliding with oncoming players.
When I entered high school, I encountered players senior to me who had the skill or physical stature that I had not developed, and I was asked to be the team’s backup. I made a mental list of my roles on the team. I told myself that if I practiced hard, I was not only preparing myself to enter a game when my number would be called but that I was also pushing my teammates to improve in their roles. I was even voted a team captain because of my encouragement to others and served as something of a player-coach role through my guidance from the sidelines.
As a fourth year medical student set to graduate in May, living through the era of COVID-19 has me again considering some of these roles.
I pursued a career in medicine for some of the same qualities that attracted me to goalkeeping. I enjoy working on a team and doing whatever I can to protect—patients from disease. I don’t mind putting in the hard work, to get dirty in the pursuit of a cause greater than myself—helping people, my patients, in some of their most difficult hours. Like goalkeeping, it is sometimes necessary to put one’s self in harm’s way to do this.
As COVID-19 has developed into a pandemic, we medical students have been left in its wake. Throughout medical school, we have learned to walk an unusual line between student and doctor. This crisis has now bolded that line. As universities across the country sent their students home, we too have been told to stay home.
There are many reasons for this. Our roles as student doctors require supervision, which is difficult in these hectic times. Our very presence in clinical settings utilizes precious masks, gowns, and gloves. Beyond that, what unique responsibilities and liabilities do universities face to protect their students from harm, and how is that distinct from that of paid employees, such as residents?
Setting aside the idea that students miss out on observing and partaking in clinical activities during this historic moment, the fact remains that fourth year students are merely weeks away from being considered competent to care for patients as house staff. What practical sense, then, does such an artificial line between student and doctor now make?
For this reason, political leaders across the country are calling on medical personnel who are currently outside of the workforce to begin seeing patients. Medical schools in some of the hardest hit areas have obliged by expediting graduation and licensure requirements to call fourth year students, suddenly, new residents.
For the rest of us, we wait. It’s now again useful for me to consider my goalkeeping days as I sit here on the sidelines of the health care system. As students in an uncertain time and in an ill-defined role, we can build our knowledge of the pathophysiology and epidemiology of SARS-CoV-2. This will make us better equipped to treat patients when our “numbers” are called. Students have even carved out opportunities to assist clinically, if remotely. We can serve in other vital roles in the community: in food provision, child care, and housing services. These are familiar protector skills that many of us have mastered over the years. We can be captains of encouragement by supporting our loved ones emotionally, and we can also support them medically by providing guidance on best practices. We too can step back and focus on aspects of ourselves that, upon reflection, need tending. We can practice much needed self-care prior to the next onslaught of training ensues.
Invariably, sitting on the sidelines is an uncomfortable and disappointing position. May it help cultivate a fire that will burn inside of us to do our best for our patients when we return to action. May it help us consider what is the best version of ourselves that we can contribute—now and in the future.
Michael Bertenthal is a 4th year medical student at Loyola University Chicago Stritch School of Medicine. He recently matched at the University of Chicago in pediatrics, where he is excited to continue to serve in Chicago’s communities by contributing to health and wellness opportunities for children and families.