Behind the Mask – The (Socially) Distant Acute Care Surgeon

Social distancing has now become the norm across the land. This is a necessary effort to prevent the spread of the coronavirus and its potentially deadly consequences. The ‘COVID lockdown’ as I call it in my casual conversations has had a ripple effect across many lives and industries beyond the patients and families and day-to-day work of the US healthcare-industrial complex.

In these days of COVID, the new normal for me is covering myself for all encounters. Asymptomatic infection is high. In any given day, I will see multiple new patients in short order and even with the highest level of hygiene, I might be the greatest risk to a patient for whom a trip to the hospital is unavoidable. I do not shake hands. I do not begin with a warm smile to ease the anxiety. I do not hand out my card with a reassurance that my partners and I are available 24/7 – just call.

I am a surgeon. I am no stranger to donning a mask for sterility in the OR or for bedside ICU procedures. I am no stranger to donning a mask to protect a vulnerable cancer patient who nevertheless needs me to examine their abdomen. And when my hands will be touching a body part during an exam, I am no stranger to donning gloves.

My hands and cuticles are raw year round because they are no strangers to repeated contact with 70% alcohol-containing solutions.

I still perform the exam. I still explain the diagnosis and my rationale for the treatment options in a level of detail that would make residents roll their eyes (if they were still allowed to see patients by my side). But I don’t ask for permission to sit at the foot of the bed while I do so. I don’t gently lay a hand on a covered knee while having a very difficult conversation.

Often, family members will ask if it’s okay to hug me at the end of an encounter (even if the outcome was their loved one’s death). Currently, patients are not allowed visitors outside of very rare exceptions. There is no hugging in COVID lockdown.

Sometimes, I cry with my patients who never expected to need a surgeon until the day they met me. Tears are a body fluid. There is no crying in COVID lockdown.

But my patients are so very alone right now. Whatever they are stricken with – and luckily for me and for them so far it hasn’t been COVID-19 – these are dark and scary times in their lives and they are all alone. Completely, totally alone. And I can do nothing to ease that loneliness behind my mask.

The warmth and non-medical touch during these encounters matters as much as detailed explanations but I am trapped behind my mask, unable to be the kind of surgeon that I truly am on the inside. I feel inadequate even though my clinical acumen and technical skills are unchanged by the COVID lockdown.

I am compliant with the need to be distant and sterile during these encounters because it is how it must be. However, the heartbreak of every encounter is real for me and my patients. Some will survive; some will not. Will they or their families be grateful for the surgeon behind the mask who played a role in some way?

Who am I to say. 

4 thoughts on “Behind the Mask – The (Socially) Distant Acute Care Surgeon

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