By Laura Porterfield, Clinical Assistant Professor, Interim Vice Chair of Clinical Affairs, UTMB, Department of Family Medicine
Before entering, I put on my armor: surgical cap, KN95 mask covered by a secondary surgical mask, face shield, gown, and gloves. Donned in protective gear, I’m barely recognizable even to colleagues who know me well.
Grabbing a clean stethoscope, I stride to the examining room, where I pause to read the patient’s name before entering. In the room, the patient sits more than six feet from my computer station, and like me, all but her eyes are hidden behind a mask she wears to protect others from the virus she may carry.
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After reviewing her symptoms and medical history, I document her exposures and risk factors, examine her, and determine she is safe to go home. Before ending the visit, I run through the usual educational spiel: test turn-around time, our rate of false-negatives, self-quarantining, and what to do if she ends up testing positive. When I bring up the CDC’s recommendations on returning to work, she interrupts me.
“I lost my job a couple weeks ago because of this whole COVID thing.” With a forced laugh, she adds, “So at least I don’t need to worry about getting a return to work letter.”
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Glancing at her chart, I notice a stark “None” next to “Insurance Coverage.”
I then look back at her face, meet her eyes, and notice something I had previously failed to see. There is fear in her eyes. It dawns on me that she’s scared about more than whether she has COVID, or if she’ll expose her elderly mother and asthmatic son to the virus. Her fear runs much deeper. How will she feed her family? Will they be evicted when she can’t pay rent? And how will she afford her diabetes medications now that she has no insurance?
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“This has been really hard,” I say, holding her gaze.
“Yes,” she breathes. “It has.”
Since March, I’ve worked at a COVID assessment clinic: testing patients for the virus, determining whether they’re safe to go home, and providing education. Every patient that walks through the doors is there because of COVID. That’s our focus: COVID, COVID, and more COVID.
At times, the monotony of the task can lull me into viewing patients as mere virus victims and vectors of spread. It can become difficult to remain mindful of my patients’ humanity, to remember that they are real people, complete with fears and struggles, resilience, and strengths.
But another factor has made it even easier to slip into this mindset. Masks. Don’t get me wrong: masking is one of the most important measures we can take to reduce the spread of COVID. They are a crucial part of the public health response to COVID. And for healthcare workers, masks are all the more essential in ensuring that we keep our patients safe while we care for them. As a colleague who loves Star Wars recently quipped, healthcare workers have become like the Mandalorian: we are inseparable from our masks; never removing them in the presence of others. This is the way.
Though masks are a key part of protecting ourselves and others from the virus, they also conceal the smiles, frowns, and other expressions that keep us in tune with our patients. Masks make it harder for us to remember that the person behind it is more than just another positive result on our county’s daily caseload report. Before the pandemic hit, medicine was already beset by the temptation to treat diseases or body parts instead of the whole person. Now it’s become even harder to resist this temptation.
But resist, we must. Until times change, we must embrace masks. Yet we cannot allow our masks to prevent us from seeing the whole human being in front of us. Whether in a COVID clinic, primary care office, or hospital room, our patients are more than just contributors to the latest COVID statistics. They are human beings who trust us with their health, and in so doing, entrust us with their hopes and dreams for the future.
So, before you end your next patient interaction, look beyond their mask, into their eyes, and behold their humanity. For as Cicero once wrote, “The face is a picture of the mind. But the eyes are its interpreter.”