Physicians, the unknown, and Long COVID
One of the reasons COVID has affected physicians deeply (aside from the soul shattering moral injury, repeated trauma, and exhaustion-- since those aren't enough)- is because we are learning an entire pathogen and illness from scratch.
One of the reasons COVID has affected physicians deeply (aside from the soul shattering moral injury, repeated trauma, and exhaustion-- since those aren't enough)- is because we are learning an entire pathogen and illness from scratch.
Only now are we starting to understand some of the inflammatory cascade that COVID causes and trying to target our therapies towards lessening this effect.
What we know even less about is long COVID. In early 2020, we thought we were going to see an incredible amount of pulmonary sequelae, lingering lung disease.
And while we do see this, overwhelmingly we are seeing a neurocognitive effect, severe fatigue, neuroinflammation presenting with a variety of motor and sensory symptoms.
We are also seeing depression, anxiety, PTSD from the infection itself, from the longevity of long haul COVID, the progressiveness of it, and due to the lack of solid treatment just yet. Because we are still learning, trialing, collecting data.
As physicians, we are not used to the unknown. We like control, order, algorithms, guidelines, pathways (oh do we love pathways)... And COVID has challenged this.
I have begun to dedicate part of my outpatient practice to Long COVID, and I have found myself saying "You know, I don't know, but we are going to work together on this" more times than I care to admit.
However, maybe not all that surprising (since humans are generally good), I'm always met with "Thank you for being honest. And for validating me. Even if you don't have the answer yet."
If there is anything I hope my physician colleagues take from this pandemic, it is that we don't know everything--- but we can continue to learn.
And having the humility to say "I don't know" or "I was wrong" does not make you less of a physician. It makes you a compassionate human who, like every other human on this planet, is learning to live with a new disease, a global shift that none of us ever prepared for.
And to the long COVID patients out there... You are seen, heard, and cared for.
#COVID19AB
#COVID19AB
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