September 2021 WATERtalk with Emma Goldberg

Notes from WATERtalks: Feminist Conversations in Religion Series

“Life on the Line: Young Doctors Come of Age in a Pandemic”

with Emma Goldberg

Wednesday, September 15, 2021

Audio recording available here; Video recording available here 

Mary E. Hunt, introduction

Good afternoon. I am Mary Hunt, co-director of the Women’s Alliance for Theology, Ethics, and Ritual. I am in the WATER Office in Silver Spring, MD with our other co-director, Diann Neu, our lead Volunteer, Joe Scinto, and our new staff colleague Liza Johnson of the Lutheran Volunteer Corps.

Like all of WATER’s efforts, this WATERtalk is not simply an academic seminar. It is a way to learn in order to bring what we learn to the creation of a more just and equitable world. Never has this been so acute a global need as during a global pandemic which is why when Sharon Groves of Auburn Seminary recommended her, I jumped at the chance.

WATER has been located in Silver Spring, Maryland since 1983, but we know there is a rich history of this place from long before we were here. With a commitment to working for justice, we make this land acknowledgement:

We acknowledge that we are all on indigenous land. Silver Spring, Maryland, where WATER works is located, is on the traditional and contemporary land of the Piscataway and Nacotchtank (sometimes known as Anacostan) peoples, the original stewards of this territory. We are committed to making clear the names of these lands and the community members from these nations who reside alongside us. We acknowledge the trauma that is deeply embedded in the foundation of this country. We recognize the deep historical, spiritual, and personal trauma that has impacted indigenous communities, communities of color, as well as immigrants and other peoples. We affirm the right of all people to bring their whole selves and their stories into this space. We confirm our intention to promote healing, respect, and love for all people and our commitment to caring for creation.

We are not acquainted personally but I hope you feel at home in this circle, Emma.

Emma Goldberg is a reporter at the New York Times, writing for sections such as Health and Science, Styles, Gender, National, and Culture, among others. Her cover stories have featured campus techlash, surgeon moms, young women running for office, and low-income medical students. Since the start of the coronavirus outbreak, she has turned her focus to the lives of students, physicians, and nurses battling the pandemic. She is the winner of the Newswomen’s Club of New York Best New Journalist Award and the Sidney Hillman Foundation’s Sidney Award. Emma received her BA at Yale and MPhil at Cambridge University.

A few weeks ago, I was channel surfing and came upon Emma talking about this book on C-Span. It was fascinating as I am sure you will discover this afternoon.

I think this is one of the early volumes in what I predict will come to be known as Pandemic Literature. Emma asks: “What did the doctors who graduated medical school early at the heights of the first Covid-19 wave in New York City learn about themselves and their profession?” I would add, what can we learn about ourselves through them?

 

Welcome Emma and thank you for joining us.

 

Emma Goldberg’s Notes from WATERtalk:

• Figuring out what to write as a journalist and reporter locked down in the house- sense of paralysis
  • How to put a spotlight on covid frontline workers?

• Decided to highlight six recently graduated medical students
  • Important distinction: many med students in 2020 were given the option to graduate early and begin work (before their residency) in hospitals immediately- some seeing covid patients within days of finishing their studies
    • “Last year of medical school is supposed to be easy.”
  • Mid-to-late 20s is a period of wrestling with identity
    • Didn’t feel like doctors yet, but were no longer students
    • For example: one subject’s first signature as a doctor was on a covid patient’s death certificate

• What does courage look like?
  • Not always fearlessness- often a compartmentalization of fear/anxiety along with a strong commitment to the work
  • Finding resiliency and a source of identity
  • Sometimes training alone cannot prepare one for the task
  • Doctors needed to understand why they chose the profession
    • Many younger doctors now are saying they have chosen the profession because of the need to infuse more warmth and relationship into the field of medicine
    • Justice-based: diversifying the medical field

• Work looked different to the new doctors than what was taught in med school
  • Masks required the use of body language which diminished identity on both ends
  • Less time at bedside, with families not present
    • Couldn’t get to know the patients contextually
    • Despite this, doctors were often the only support system for patient
    • Increased need for emotional bonding and heightened reliance between patient and doctor– emotionally challenging
  • Losing patients much more rapidly

 

• “They had been taught how to save lives, but at the moment, sometimes all they could bring was their humanity.”

 

• Why these doctors?
  • They represented a new face of medicine
    • Currently <6% of doctors are Hispanic; <5% African American
    • Show the changes in medical climate
  • Some doctors felt personally responsible to become doctors
    • For example: queer doctors in response to the HIV/AIDS epidemic
    • Serve underrepresented groups- all the more important in a pandemic which disproportionately impacts certain minority groups
    • Concordance: when the racial/economic/cultural identity of doctors and patients match up, there are better health outcomes (Oakland Men’s Health Disparity study)

 

• Read excerpt: pp. 120-123.

 

Q and A

1. How did you manage to maintain your own stability during the researching and writing of the book?

Emma: I was invigorated by the people and the city [New York City]; their joy and humanity.

For example: clapping at 7:00 pm from balconies created feedback loops of support

A focus on artwork, music, and books outside of the current moment also helped to keep me grounded

 

       2. In reflection of my own role as a chaplain, I wondered where I “fit in” with no physical interaction, and found that my role was to support the staff who actually went into the covid units.

Emma: Not everyone thought of chaplains as frontline workers, but they were/are such a critical part of the hospital ecosystem. Many doctors I talked to described ‘crisis of faith’ moments and sought the guidance of chaplains. Medical interpreters are also seriously overlooked!

 

       3. Did you get any sense if the doctors had training in navigating interactions with patients of different religious backgrounds?

Emma: Religious training didn’t come up in conversation, though for some doctors religious decisions were more apparent.

 One example: one doctor of Orthodox Jewish faith deciding whether or not to work on Shabbat– she discussed with her father the implications, and he counseled that the Jewish injunction of Pikuach nefesh (that the preservation of life overrides virtually any other religious law) allowed her to continue her work when she otherwise would not.

Another example: The same doctor described her aversion to the idea of a “foul shot God”– a God who is only called upon as a last-ditch effort, such as to save someone from covid who is intubated and highly unlikely to survive.

 

       4. Did those who had relevant specialization do better? Any recent reflections if their experiences working in covid units informed their decisions to specialize in their area/question their decision to become doctors?

Emma: What is good about medical school is that it begins with a broad training and then specializes. So at the point where these doctors were graduating, they had yet to do their residencies in their specializations. Many doctors had not been trained– and were not on the track of– internal medicine. But because everyone was figuring out covid, even doctors who were very experienced, the newer doctors were learning right alongside them.  In terms of clinical preparation, it was so new that specialization didn’t take much precedence. That being said, not all were emotionally prepared in the same way.

For example: one woman had specifically chosen pediatrics because working with older patients reminded her of her grandma, but found herself caring for dying elderly covid patients. She probably had a much tougher time than others who had not deliberately decided to avoid a certain age group.

When the doctors had finished their time and moved on to their specialized internships, many actually noted that they were treated with more respect and felt better prepared because of the work they had done after graduating early. None expressed that it had made them question their career choice.

5. Is there any new language emerging during the pandemic to help describe all that is happening?

Emma: The “battlefield” language is shifting and no longer ringing true. There have actually been studies suggesting that phrases like “fighting the battle” are toxic for cancer patients– if they die, have they then failed? The same applies in covid units. It harms morale.

For example: Some graduating doctors were termed the Covid “Coalition Forces” or “Covid Army” or likewise, which directly contradicts with the rule of “first, do no harm.”

 

WATER thanks Emma Goldberg for her wonderful book and for her generosity in sharing it with us.