How has COVID-19 changed medicine as a practice?

Connection is hard behind a mask.

I went to see a patient a few days ago that had an awful lower leg injury. He is otherwise not in good health and is not a candidate for a free flap to cover the wound. A free flap is where we take muscle and skin from one area of the body and use it to cover the wound by sewing the blood vessels under a microscope. As I was having to explain to him that the only way to help him get better was for him to have an amputation and to lose that leg, it occurred to me that I would have done that differently in the days before COVID-19. I would have sat on his bed and talked to him face to face. I would have made sure that my body language expressed the sincerity and empathy that I was feeling. I would have made sure that my body was lower than his and that my face showed him that I cared about him and I was sorry he was going through this. My mask and the social distancing rules prevented me from being the kind of doctor I would usually be. The other part of the current situation that makes me sad is that I am not able to interact with families in the hospital. Currently, family members are not allowed to be with the patient in the hospital. So often our “patient” is more than the person being treated for the injury or illness. We are called to help the family through the situation as well. Being forthright, honest and giving hope when appropriate is crucial in how the patient is able to be supported through their recovery.

There are other barriers COVID presents to how I am able to be the best doctor I can be. Even though we have had a great response to our telehealth consults, it is just different than sitting in a room with someone who has been given the diagnosis of breast cancer. It different than being able to touch their shoulder or hand them a tissue when it gets overwhelming. There is no doubt that human touch can be both reassuring and healing. I have always been very deliberate about how I interact with people and none more than those who are going through something traumatic or difficult. I am intentional about how I speak, my attention and eye contact, and my body position. These are all less effective when I am speaking to someone through a computer.

Even more than just in the hospital, I notice that our human connection is very hard these days. The only times I get out of my house are to go to the hospital to work, to go to the grocery, and to take my dog Wyatt for a walk. Whenever I see someone in the grocery, I am more exuberant with my smiles, so people can see it in my eyes. I make a point to verbally say hello to people now rather than just wave. I think these kind of connections are very important for us all. In the days of COVID, it gives us the opportunity to be deliberate about how we express our humanity. I hope you give it some thought too.

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At Nashville Plastic Surgery, we have a deep understanding of the important role that physical image plays in life, yet we never lose sight of emotional well being. Our approach to plastic and reconstructive surgery integrates these fundamental principles to promote overall health.