Time to Come Together

October 03, 2021

by Mark David Siegel

Hi everyone,

COVID-19 feels like a dog clinging to our collective ankles, at least in Connecticut. It won’t let go. In other states, particularly those with low vaccination rates, it’s still a ferocious beast. Even in our state, we still have too many unvaccinated patients fighting to survive.

But we’ve come a long way: 69% of Connecticut’s population is fully vaccinated, placing us second in the nation. For healthy people, vaccination largely prevents serious illness. Because of vaccine mandates, the chances of getting sick at work are extremely low, especially with universal masking.

Given our progress, I’m starting to wonder if we’re taking unnecessary precautions, particularly when it comes to teaching conferences. It’s been 18 months since we last met in person for Report. The university and medical school have largely returned to in-person learning, but most of our teaching remains virtual.

Before we had vaccines, and before we knew how COVID was spread, virtual learning saved our teaching program. Except for a brief hiatus, we held Report, didactics, and Grand rounds. We created new opportunities, such as combined Yale and VA Report. Residents were able to attend from remote sites, even the beach! The Zoom chat function fostered lively discussions and allowed more people to share their thoughts. But there’s a huge downside to virtual learning. For reasons that confound me, most people turn their cameras off, so we can’t see faces. Teachers can’t tell if learners understand what’s being said, or if they’re even engaged. The chat function is no substitute for hearing each other’s voices, let alone detect nuance or emotion. Without a scribe or white board, it’s harder to follow presentations or diverge from prepared PowerPoints.

The biggest loss is social. What do we lose when we’re not coming together in shared spaces, seeing friends, laughing, schmoozing, drinking coffee, or gazing out the window as birds take flight from the library’s dome, or as sunlight reflects off the surface of the Long Island Sound? Wouldn’t it be wonderful to see Dr. Kantor and Dr. Duffy sitting by the wall again, or return to showing third-year students what we love about medicine?

I know I don’t speak for everyone on this topic. We’re a large residency and people have different levels of risk tolerance and some have personal vulnerabilities that require them to take extra precautions. But we should be realistic about risk, particularly with everyone vaccinated and masked up, and knowing that when we don’t congregate in conference rooms, people just congregate elsewhere, like workrooms, which doesn’t change the risk calculation.

We’re lucky to have gotten this far in the pandemic without any resident developing serious illness. This happened because you’re largely young, healthy, and careful. But let’s acknowledge the risk posed by excessive social distancing, particularly if the benefits are negligible. We need to see and hear each other in ways that can’t happen on a screen.

With the pandemic coming under better control, and with everyone masked and vaccinated, we need to discuss when and how to return to in-person learning. There are details to consider, particularly how to maintain access for those who can’t attend in person and how to address the concerns of those with personal and family vulnerabilities. COVID won’t be going away anytime soon and may never go away completely. We can’t let that reality keep us apart. We have a basic human need to share spaces, and teaching in person is indispensable to the health of our residency. Let’s discuss how to do this. Tell me what you think.

I’m going out for bike ride today before confronting a mountain of residency applications- nearly 5000 so far!

Enjoy your Sunday, everyone.

Mark

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Mark David Siegel, MD
Professor of Medicine (Pulmonary); Program Director, Internal Medicine Traditional Residency Program