{"componentChunkName":"component---src-templates-article-tsx","path":"/medstudentupdate","result":{"data":{"primeArticle":{"slug":"medstudentupdate","excerpt":"Last year, writer Zinnia Finn spoke to recent medical school graduates starting their residencies during the COVID-19 pandemic. Now, they reflect on the unprecedented year.","headline":"Crossing uncharted territory","author":"Zinnia Finn","authorbio":"","authoremail":"","authortwitter":"","coverimg":"https://assets3.dailybruin.com/images/medstudentupdate/web.prime.medstudentupdate.LK1.-01eca277ad4ed6742ea770851c57afd9.jpg","covercred":"Lauren Kim","coveralt":"Photo of Chris DeMatteo","articleType":"article","updated":null,"content":[{"type":"text","value":"Medical students who matched to residency programs in 2020 just finished their intern year – entirely in a pandemic."},{"type":"text","value":"As the rest of the world shut down over a year ago, hospitals became crammed with COVID-19 cases and patients and physicians were thrust into uncharted territory. Seasoned professionals and green residents alike were faced with steep learning curves, and first-year interns prepared for the loftiest climb."},{"type":"text","value":"Last year, I spoke with recent David Geffen School of Medicine graduate Chris DeMatteo as he was preparing to begin his residency in emergency medicine. He had just graduated, capping off his time at UCLA with a virtual match day ceremony that paired him with a residency program. He was worried and excited for a difficult year ahead and was still coming to terms with the abrupt end to his medical school journey."},{"type":"text","value":"DeMatteo was paired with Mount Sinai Health System in New York and has spent the past 12 months there. He said the last year has been the most challenging year of his life but it has reaffirmed his interest in medicine and kept his days from feeling the slightest bit stagnant."},{"type":"text","value":"“In some ways, it's kind of nice to be a health care worker because you had to keep living your life,” DeMatteo said. “You had to keep going to work.”"},{"type":"text","value":"Work, however, looked much different during the COVID-19 pandemic. DeMatteo had a strict sanitation routine after he returned home, dropping his scrubs at the door and immediately taking a shower. Meetings with fellow residents were few and far between. Once the second wave hit in the winter, there was a COVID-19 outbreak among his class."},{"type":"pull","value":"{\"caption\":\"In some ways, it's kind of nice to be a health care worker because you had to keep living your life,” DeMatteo said. “You had to keep going to work.”\"}"},{"type":"text","value":"In addition to anxiety about contracting COVID-19, a year ago DeMatteo told me he was concerned about the pandemic’s collateral effects on the emergency room. He hypothesized there would be an increase in upper respiratory pathologies, many of which would be identified and treated as coronavirus cases. He also predicted this increase of COVID-19 would be accompanied by a decrease in other types of emergency room ailments, such as trauma and less-acute illnesses."},{"type":"text","value":"But despite the extent of the pandemic, he now says this surprisingly wasn’t the case – people may have been distancing and isolating, but there was still a notable amount of the typical out-and-about injuries."},{"type":"text","value":"“We still see a massive diversity of cases, and we still see all the things we need to see in emergency medicine,” DeMatteo said. “To an extent, we actually ended up seeing more of the other non-COVID emergencies than I was expecting.”"},{"type":"text","value":"Gun violence was still prevalent in Mount Sinai’s emergency room, and the stabbing rate inexplicably spiked over the summer compared to the region’s historical average. DeMatteo said there were also more penetrative trauma cases than in previous years, something which he initially assumed would decline in step with the pandemic’s rise."},{"type":"text","value":"On the opposite coast, however, School of Medicine alumnus Dr. Haley Vertelney experienced an entirely different emergency room. Having matched to the UC San Francisco in February 2020, she said her first year of residency was characterized by many COVID-19 patients and a rush to learn how to treat other pathologies. As the city moved through ebbs and flows of cases, she said the changes were barely visible within the walls of the hospital."},{"type":"image","value":"{\"alt\":\"Photo of Vertelney.\",\"url\":\"https://assets3.dailybruin.com/images/medstudentupdate/medstudentupdate2courtesy.1-396f3b5c06af97dc70370788e9aa2306.jpg\",\"credit\":\"Courtesy of Dr. Haley Vertelney\",\"caption\":\"\"}"},{"type":"text","value":"“I didn't really perceive peaks and troughs as (COVID-19) was peaking in the community,” Vertelney said. “It honestly seems like there was constantly a lot of COVID … it was just kind of a constant presence.”"},{"type":"text","value":"She said the effects of the COVID-19 pandemic on hospital life were noticeable in a surprising way: many wings were eerily empty. This included departments like pediatric emergency medicine, where patients may not have felt the urgency to come in to seek treatments because they feared catching COVID-19 at the hospital."},{"type":"pull","value":"{\"caption\":\"I didn't really perceive peaks and troughs as (COVID-19) was peaking in the community,” Vertelney said. “It honestly seems like there was constantly a lot of COVID … it was just kind of a constant presence.”\"}"},{"type":"text","value":"Sitting around for eight hours but treating no patients left Vertelney concerned about the quality of her training, especially because there is no real substitute for hands-on experience, she said. She noticed the general number of trauma patients also decreased, and when there was an incident involving trauma, there was a competitive rush among residents to do the procedures."},{"type":"text","value":"With the majority of her patients being COVID-19 cases, Vertelney said she quickly reached a point where she became less afraid of the virus and expected to get sick because of the sheer number of patients she would be encountering – something she had been anticipating for months before the start of residency. Weeks into her residency, she was barely afraid of COVID-19, partially because of the daily trust she put in her personal protective equipment. This numbness, she said, was most perceptible when she was surrounded by friends who weren’t in the medical field."},{"type":"text","value":"“Eventually I felt like I was less anxious than most people because I would spend a lot of time in rooms in very close proximity with known positive COVID patients,” she said."},{"type":"text","value":"As a fellow emergency medicine resident, DeMatteo experienced a similar fear of COVID-19 at Mount Sinai. Even when cases weren’t confirmed, he knew the hospital was constantly filled with COVID-19 patients and the only thing preventing him from contracting the disease was his PPE."},{"type":"text","value":"“Every day you would go into your patient knowing that they have COVID, or just knowing that they have a respiratory complaint that's likely COVID,” DeMatteo said. “And every day you think to yourself, is this the day that my mask has a leak, and this is the day that I finally get COVID?”"},{"type":"text","value":"In addition to ambient anxieties around entering their first year of residency, both Vertelney and DeMatteo carried individual concerns this time last year. When I spoke to Vertelney last year, she had just moved her belongings into her new apartment. Renting a one-bedroom apartment in a new city, she was worried the pandemic would render her stuck in a lonely cycle going between work and home."},{"type":"pull","value":"{\"caption\":\"And every day you think to yourself, is this the day that my mask has a leak, and this is the day that I finally get COVID?”\"}"},{"type":"text","value":"“You go to work forever, and then I’m going to go to my one-bedroom apartment and be alone until I go to work again,” Vertelney said last year."},{"type":"text","value":"Luckily, this was not the case. A year later, she said her initial worries were a catastrophic view of what could happen – although there were times when she felt isolated, there was still time to get out of the house and socialize. She felt lucky to be in California, where the temperature allowed for socially distanced outdoor activities nearly year-round. UCSF is also right next to Golden Gate Park, and San Francisco itself is across the bridge from mountainous Marin County, so Vertelney was able to escape her apartment to bike and run in slivers of spare time, she said."},{"type":"text","value":"“There were definitely times where I felt (lonely) especially on rotations where the hours were longer,” she said. “But the reality of it was like, yeah, my social interactions were limited like everybody else's, but I also found ways to be with people and connect with people.”"},{"type":"text","value":"DeMatteo shared Vertelney’s concerns about isolation, starting his intern year specifically worried about his distance from family. He had matched to a residency far away from his home in Moraga, California, but said he may have prioritized closer schools if he had knowledge of the COVID-19 pandemic when he was ranking his choices."},{"type":"text","value":"His family has stayed healthy, something which provided him with gratitude and hope, he said. However, he hasn’t been able to see them for a year. Due to the risk of contracting COVID-19 and passing it on to them, he hasn’t flown back home. Holidays have been over Zoom and he still doesn’t know when he will be able to see his family in person again."},{"type":"text","value":"“That's been the hardest part of this year for me, not seeing my family,” DeMatteo said."},{"type":"text","value":"In addition to personal worries, incoming residents like DeMatteo and Vertelney were highly concerned about the potential for burnout. A year ago, DeMatteo hypothesized that COVID-19 would increase the burden of exhaustion that residents face, which could have serious mental health consequences down the line."},{"type":"pull","value":"{\"caption\":\"That's been the hardest part of this year for me, not seeing my family.”\"}"},{"type":"text","value":"“In much the same way that this pandemic has disrupted the shape of American society, I think the burnout pandemic is going to disrupt the shape of the health care industry,” DeMatteo said last year."},{"type":"text","value":"A year later, DeMatteo has experienced burnout himself, he said, especially during his work in the intensive care unit. He said there were times when the ICU made it difficult to get excited about his job – he saw the sickest patients in the hospital and made calls to families to tell them they had lost loved ones. These kinds of things never get easier, he said. Hospital programs hand out sweet treats to health care workers as tokens of appreciation, but this may not be able to combat the long term effects of such difficult and draining situations, he added."},{"type":"text","value":"“I'm not going to lie, getting a cupcake in the middle of a workday, it helps,” DeMatteo said. “I feel better, but it's obviously not enough to address the serious mental health issues that medical professionals deal with.”"},{"type":"text","value":"Vertelney said her burnout has been near what she expected but perhaps due more to isolation than overworking. She would show up everyday and not know anyone, something which was not made easier by the immense amounts of PPE that rendered it impossible to remember someone’s face. She said she has felt more connected as the year has continued, but the impact of the pandemic on her residency class community did not go unnoticed."},{"type":"text","value":"This lack of connection was not unique to the physicians – Vertelney said it extended to her patients as well. One of the most essential parts of health care is the trust and connection between a patient and their physician upon which treatment is built. That foundation was more difficult to achieve due to PPE, she said, as it is difficult to convey emotion through layers of plastic, paper and fabric."},{"type":"text","value":"“I have an N95 under a surgical mask with an eye shield,” Vertelney said. “There's a lot of layers … obviously it's impossible to convey facial expression through that … empathy, or any kind of emotion, really.”"},{"type":"text","value":"The logistics of the emergency room may also remain permanently altered. Vertelney hypothesized that masks may become a permanent staple in urgent care to cut down on general disease transmission. Additionally, DeMatteo said he has already added COVID-19 exposure to the list of preexisting health conditions he asks his patients upon check-in, a parameter which may stay for the foreseeable future."},{"type":"text","value":"Another question that can be added to his list is if patients have received their COVID-19 vaccine. Now, as he starts to hear more patients answer “yes” to this question, he is becoming hopeful that the end of the pandemic is in sight."},{"type":"text","value":"As for Vertelney and DeMatteo, they received their shots in early and late December respectively, as they were included in phase 1A of the vaccine rollout as health care professionals."},{"type":"text","value":"“Honestly, that was probably the happiest day of the past year for me,” DeMatteo said. “Yeah, I’ll say that – the day I got vaccinated was the best day of intern year.”"}]}},"pageContext":{"term":"summer21","slug":"medstudentupdate"}},"staticQueryHashes":[]}