How We Trudge On

I had a lot to celebrate in the first month of 2021—making it through a strange semester of medical school, turning another year older, getting my two-dose series of the COVID-19 vaccine, and learning how to administer the shot so I could aid in the inoculation efforts. But so far in the new year, there were causes for celebration as well as moments of pause. Although we celebrated the new year weeks ago, several dire challenges from 2020 remain. The news cycle is dominated by COVID-19, reporting more deaths and more hospitalizations every day in neatly placed in graphs and tables. As vaccines make it into arms, scientists warn of even more transmissible viral variants that have not yet reached our shores. It is abundantly clear—another deadly wave is coming.

As we look towards an uncertain future, it seems like a Herculean task to keep up as our healthcare infrastructure teeters on the verge of collapse. Healthcare workers are stretched thin caring for ever-increasing caseloads. Many have taken to social media to describe the utter exhaustion of the COVID wards and implore the public to take this threat seriously. I often wonder how they find the strength and resilience to endure and even thrive in such an environment. I often wonder about the forces that drive us to bounce back in the face of great loss, the forces that empower us to trudge on through hard times.

As I reflect on the powerful forces that empower us to endure, I remember my first patient in the student-run clinic, a forty-something year old man I’ll call Herbert. Herbert was a regular at the clinic, seeking our care ever since he had a stroke that impacted the left side of his body.

Before I opened the door to meet Herbert for the first time, I had to pinch myself. This was not Zoom. In the typical “learn by doing” manner, I was to perform the entire history and physical on a real person for the first time, rather than mime the motions over a Zoom call. The MS3 who would accompany me during the visit reassured me that he would step in if I didn’t know what to do. I entered, exchanged a few pleasant greetings, and sat down at the leather swivel chair next to the exam table. I was immediately put at ease by Herbert’s baritone chuckle, the kind that you would hear from an old friend you ran into at the supermarket. I asked him about the stroke and about his left arm, which clung to his body as if held there by an imaginary sling.

Herbert explained that he had the stroke in his mid-thirties. His injury prevented him from doing what he loved most— coaching high school football. He had worked some odd jobs for the past few years but lost his most recent one when the pandemic began. I wrote a few phrases down in my notebook and then glanced over to the other medical student to make sure nothing had gone horribly wrong. Hesitating, I told him that I read about his previous clinic visit, in which he reported feeling hopeless and depressed. I asked him how he was doing now.  

Silence pierced the room like needles.

He looked down at the folded-up piece of paper that was now in his hands. He told me he started seeing a mental health professional, which helped some. He started going to occupational therapy to work on his arm right here at the clinic, and he was making remarkable progress. He thrust the piece of paper towards me. It was a letter explaining that Herbert attended all his OT appointments and was on track to recovery. Excitedly, he began to show me some of the exercises he had learned to do. I told him I was impressed, and I could see the corners of his mask lift up as he smiled. I asked him what kept him motivated during the craziness of the pandemic.

Without hesitation: “I want to play catch and run around with my granddaughter someday”

The rest of the exam (featuring broken Q-tips, funny faces, and a short stroll around the exam room) was uneventful. We brought in the attending physician to meet Herbert, examine him, and answer any questions. Herbert knew what he wanted—he had heard at his last visit that an injection could help him with his spasticity and asked when he could get the shot scheduled. As we wrapped up the visit, I encouraged him to keep pushing through at his OT appointments. He looked at me as if I had said something profoundly obvious. And perhaps I had.

Herbert was a reminder that there were countless reasons to stay put and countless others to trudge on. He aligned his efforts around his central purpose, to one day be physically strong enough to play with his grandchildren. In the face of a stroke that drastically altered the trajectory of his life, Herbert chose with conviction to mold his fate. At times, as he worked through depressive episodes and thoughts of self-harm, this was difficult. But every day, he took a few steps forward. I was inspired by both his strength and his vulnerability.

Taking a page out of Herbert’s book, I have a note to myself written on a wrinkled post-it note on my desk, my central purpose for now. I hope that it will get me through tough times, give me a broader perspective, and empower me to take steps forward, however small they may be. As we face the challenges and incredible losses that COVID-19 has brought, I hope that we find many more reasons to trudge on. Whatever the source of our strength, we will endure.