Tragic optimism in the time of COVID-19

Whispers of fluctuating rumors had filled our ears for the last week; group messages were exploding with controversy — the invisible threat, COVID-19, had reached the Texas Medical Center. All meetings for over 25 people were canceled, effective immediately. Suddenly, during the season when as a third-year medical student, I was supposed to be rotating through clinical electives, learning how to become the pediatrician I always dreamed of being, all medical students were removed from clinical duties.

As the gravity of the COVID-19 pandemic unfolded, my preoccupation rapidly shifted from the disruption that it caused in my daily life to the devastation that it was causing my community. Not only were COVID-19 patients filling ICU’s around the country, but the pandemic was also collapsing the economy and leaving numerous people without income — including my family, who rely on the business of spring wildflower tourists at their retail stores in rural Texas.

During a phone call with my mom, she mentioned how while seeking hope, she had started rereading Man’s Search for Meaning by Dr. Victor Frankl, a book that I had read during my freshman year of college. The worn pages of the library copy had inspired me to explore my purpose and to continue my pursuit of medicine despite the challenges of becoming a first-generation graduate student. Frankl introduces the idea of “Tragic Optimism,” challenging humanity to take circumstances encompassed by the “tragic triad” of pain, guilt, and death and use our human potential to find optimism through “1. turning suffering into a human achievement and accomplishment; 2. deriving from guilt the opportunity to change oneself for the better; and, 3. deriving from life’s transitoriness an incentive to take responsible action.”

Frankl wrote this after enduring the sickening genocide of the Holocaust. Nevertheless, his message applies to our current circumstances. How was I going to find meaning out of this tragedy?

Turning suffering into a human achievement and accomplishment

This pandemic has revealed the best of humanity’s teamwork, creativity, and strength; building infrastructure and familiarity with telemedicine, innovating new strategies for PPE and respiratory support, and uniting mankind to fight a common enemy. On a minuscule scale compared to the fight against the pandemic, this time away from clinical duties provided space for me to reconnect with my passion for medicine through volunteer and advocacy projects. As Texans face an economic and health crisis, working with a team of pediatricians to write a policy brief recommending 12 months of continuous coverage for children on Medicaid took on profound importance.

This time holds potential growth for everyone. As I take simple walks around Hermann Park to foster gratitude and resilience, the colorful blooms of spring remind me to process the changes this season has brought. I have learned that anxiety and gratitude are not mutually exclusive. I can grieve the changes that the coronavirus has brought to my life while also appreciating those on the front lines – first responders, healthcare workers, and grocery store employees. When we return to clinical medicine, our colleagues will need renewed energy, not bitterness and burnout.

Deriving from guilt the opportunity to change oneself for the better

Individuals who pursue medicine are inherently passionate and compassionate humans. I had signed up for trauma, codes, and death when I applied to medical school. Be that as it may, the role of the modern medical student in a global pandemic? Uncharted territory. Nonetheless, when medical students are sent home to social distance in the midst of a medical crisis, guilt hits. We imagine our colleagues, our new medical family – attendings, residents, nurses, support staff – taking the daily risk of potentially exposing themselves to the coronavirus and enduring the emotional burden of being on the front line, and we feel ashamed for being safe at home. However, staying home is how we support them, saving a COVID-19 test or a bed in the ICU for a community member.

The absence of medical students in the hospitals and clinics of the Texas Medical Center means that patients have a little less human connection when they perhaps need it the most. Countless times over the last year, I spent extra time sitting at my patient’s bedside, listening to hopes, fears, and life experiences. Due to strict and necessary restrictions on visitors, I now imagine so many patients are lacking company and wish I could sit next to them, providing the warmth of humanity. When I return to clinical rotations, visiting with my patients one more time before going home after a long day will take on a new meaning. I will remember this time when I craved the chance to emotionally support patients, and I will go to the bedside, ready to listen.

Deriving from life’s transitoriness an incentive to take responsible action

The values of service, dedication, and perseverance in the hearts of medical students will always manifest. As the grim realities of the pandemic surfaced, and we realized we had at least two months away from clinical responsibilities, medical students around the country stepped up. Thousands of collective hours have been spent serving the Houston community through volunteering; medical students are sorting items at the Houston Food Bank, staffing the county’s COVID call center, collecting PPE through a community drive, and babysitting and tutoring healthcare workers’ children.

At the food bank, as I pack disaster boxes full of shelf-stable food, I think of the home that each box will reach, the individual that each meal will feed. I’m thankful for the time and ability to give back to the community that has supported me. Finding optimism is not an easy task, especially as we face tragedy and weather the impact of this pandemic on our livelihood. However, deriving solace and meaning from fear and suffering is a powerful, essential capacity we have as humans. As I transition into fourth year, I rest knowing that this time will make me a more resilient, optimistic physician.