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MEDICAL YEAR
IN REVIEW

COVID-19 Generation

of Residents

By Alexis Ramos, MD
T
oday is my first day of residency, the day all medical students
dream about. I imagined waltzing into the obstetrical
wards for my first rotation, donning a long white coat
and a new pager. My patients would ask me medical ques-
tions, and I would shake their hands and greet them with a
smile, responding with confidence.
Times are vastly different. Instead of a white coat, I wear
scrubs, which are easier to wash off the day. Instead of heal-
ing and rebuilding, we are living in a declared health
emergency.
Entering the wards for the first time was not
exactly how I envisioned. I am greeted by
nurses asking for my signature to prescribe
medications. The upper-level residents are busy
in deliveries, and four of my patients need discharge
orders in the computer system. The sense of urgency and stress are en-
tangled in the air. I breathe in the large expectation to retain knowledge know they all cannot be present for the birth because she is only al-
quickly and perform efficiently, which is even more pressing in the lowed one visitor. I assure her we have great doctors here who perform
COVID-19 generation of residents. We can’t escape the vast differences routine deliveries around the clock, but that does not seem to ease her
of social distancing COVID-19 has created, even at work. We are con- fear. I exit the room and place quick admission orders. She is whisked
stantly reminded by the screening nurses that take our temperature be- away to a labor room. The day continues and when I look up, it is past
fore each shift, by the increasingly high patient volume with masks and my time to leave.
personal protective equipment (PPE) and by the code blues that ring I leave, feeling that I am bringing the unknown to my family and un-
throughout the hospital. suspecting cat. I shower as soon as I get home, using Lysol on my shoes
All of this sets the stage as I start work in the obstetrical emergency and book bag. I have just enough time to eat dinner and prepare my pa-
room. Two patients in active labor burst through the double doors. tients’ notes for the next day in order to get a solid six hours of sleep. I
The experienced resident tends to one and I am assigned the other. I remind myself it is okay to grieve the loss of normalcy. The uncertainty
freeze. I clumsily flip through a few stacks of paper that outline the in duration is what truly unsettles me. How long will the state of emer-
crucial steps and common orders to place: Normal saline, UA, CBC gency last? The notion of taking each 24 hours as they come has become
and a COVID screen. The nurse and I quickly initiate a digital exam. my mantra. I open the remote-access charting system to begin looking
The patient is dilated to 8 cm. She is visibly scared. I cannot tell at the postpartum patients for tomorrow. My mind wanders back to the
whether her emotion is moving through me or if I am transferring my kind lady who came through the obstetrical emergency room. I notice
emotion onto her. a red flag next to her lab values; positive for COVID-19.
I sit on the edge of the bed and express as much understanding as
possible with two thirds of my face covered by a mask. We cycle Alexis Ramos, MD is a second-year family and community
through some deep breathing exercises. I also attempt to distract her medicine resident at UT Health San Antonio. She is a resident
with small talk about her husband at home and their two children. I member of the Bexar County Medical Society.

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