Joseph Kaizer, DMA
Wake Forest School of Medicine
I am a classical cellist and a 42-year-old medical student living during the COVID-19 crisis.
Recently, our medical school class received notice that our fourth-year rotations were suspended indefinitely, including board exams and other requirements needed to graduate. "#StayAtHome" and "#FlattenTheCurve" are the slogans buzzing around social media. We are in the midst of a pandemic. My inbox gets flooded with daily updates from the hospital and school. Scores of emails arrive from administrators. Every day the rules change, and some of those changes are vague or even contradictory. We never know what to expect and the uncertainty is unsettling. Amid self-isolation and silence, the sound of chaos is alive and well—it's a symphony of alerts from social media, the news, and other notifications on my phone that I can't seem to escape from. A news pop-up appears on my phone screen hourly— "Ugh, how many are infected this time?" I think to myself. Life is uncertain; many feel helpless, and the anxiety and fear that follow are palpable. Another crisis places my life on hold.
March 20, 2016, 6 AM Pacific Standard Time. I received a phone call from the Dean of Admissions congratulating me on my acceptance to medical school. I was 38 years old. Gentle blue and silver tones of dawn reflected on my face as my eyes began to well up. I clutched my phone tightly against my chest in a daze of shock. I could not believe it. It was a monumental day, not only for myself but for my family who had been so supportive of my dreams of becoming a different type of doctor – a medical doctor.
Five years prior to my acceptance, my mother was diagnosed with Alzheimer's disease while I was completing my doctoral studies in music at Indiana University. Her diagnosis shook our whole family. "How will this end?" my mother would often ask my father. My father, a naturally optimistic, jovial and buoyant man even during the worst of times, found himself at a loss for words. We all were.
My mom faced overwhelming anxiety and depression after learning of her diagnosis. But as a family of musicians with little knowledge of healthcare, we found ourselves faced with the challenges of finding affordable and adequate mental health care for my mom while her disease progressed. We eventually did establish care with a dedicated psychiatrist, and with his support, we were able to manage her mental health needs as she navigated through the stress, angst, and worries about her diagnosis. The role of my mother's psychiatrist in our life played a pivotal role in my decision to leave my career as a professional cellist and pursue a life in behavioral health. I felt called to serve the behavioral health needs of patients and their families, in the same way, my mother's psychiatrist provided such care for ours.
As if the transition to a new chapter in medicine was not met with enough challenges, the evening before I started my first day of medical school, my mother (for the first time in my 38 years of life) had forgotten who I was. It is difficult to express the grief one feels the first time a loved one forgets your existence. "Hello, who is this...Joe who...?" she said on the phone. I played along as if nothing were wrong, but at that moment, I felt as if my world had collapsed. I felt that a part of my identity had been robbed by this disease, and there was nothing I could do about it. I didn't sleep very much that night, and the next day I woke up to go to my very first course in medical school—Human Anatomy.
Anatomy is a rite of passage for medical school students as they are given the task of learning the intricacies and nuances of the human body by doing full dissections, studying every vessel, muscle and nerve in great detail. My previous knowledge of anatomy was limited to my experience on the cello—the anatomy of the bow arm as it executes smooth string crossings with the wrist, and the fingers of the left hand as it glides effortlessly along the fingerboard. The more comprehensive study of anatomy was as fascinating as it was overwhelming. Though my studies were challenging and rigorous, I found that in many ways the time focused on my studies served as a distraction—an escape from the indolent and agonizing disease that brought so much uncertainty and chaos to our family.
Towards the end of my second year, my family decided it would be necessary to admit my mother to hospice. Her disease was complicated by multiple falls, strokes, numerous episodes of psychosis, and finally, pneumonia. It was a losing battle, and we knew it was the right time to begin focusing on comfort care. I decided to put my medical education on hold to be with my family during the last months of my mother's life. I remember the day I signed my personal leave of absence form. My dream of becoming a medical doctor was placed on hold, but I knew that despite these hardships, my experience of family crisis would someday allow me to practice medicine with heightened empathy and compassion for my patients.
I was grateful for the overwhelming generosity of family, friends, and members of our community during our time of crisis following my mother's passing. The silence left by the void of my mother’s passing, allowed me to reach new depths of understanding about the fragility of life and the importance of practicing gratefulness in every moment. The practice of gratitude will never wash away the difficult memories of my mom's suffering through the fading of her memories, nor will it fill the void that will always exist without her presence in our family. But this experience has taught me something that I believe I would have never gained without her loss--how to live purposefully in every moment, to cherish every relationship with others, and to respond in times of crisis with grace, gratitude, and generosity.
It has now been a little over a year since my mother's passing, and I have completed my clinical rotations. I wait for the final year of medical school, but I again find my journey at a standstill--this time ushered in by the Coronavirus outbreak. Streets are now empty, community parks that were once full are now barren. Traffic lights sway back and forth above empty streets without any cars to direct.
I have been here before. It is the silence amid crisis. It's not my first and will not be my last. For those who are not fighting on the frontlines of COVID-19, it is a time of solitude. But just as I did during my first crisis, I have found that these times also hold moments of hope. Neighbors reach out to others offering food and supplies to those who have none, and supermarkets create special hours for those most vulnerable. There is increased time for self-reflection, family, and extended and meaningful conversations with loved ones. It is a feeling similar to that which followed my mother's passing. Our family grew closer, cherished each moment together, and we found ourselves returning to a less distracted and fragmented existence.
Whether it is helping a loved one face the unknown future of a terminal illness or a pandemic virus, crisis may affect us all. As we venture into the uncharted waters of COVID-19, we should share some very important things: we must find gratitude in the seemingly ordinary objects and acts of kindness that we so often overlook in our daily lives. Crisis, from the Greek word, "krisis," which forms from the verb krienen, literally means to "to separate." While most of us are physically separated from our friends and family through social distancing, we can help overcome this crisis with unity and support for each other. There is absolutely no room in our world for fear, hate, or racism, but there is more than enough room for kindness, love, and generosity. As Etty Hellesum once said, "As life becomes harder and more threatening, it also becomes richer, because the fewer expectations we have, the more the good things of life become unexpected gifts that we accept with gratitude." It is difficult being a fourth-year medical student during this time. In many ways I feel helpless, as I am not board-certified to serve on the frontline of this battle that I so wish to confront with my community. However, I can do my part by sharing my personal stories of crisis, showing generosity to those most vulnerable, and staying united with others in both heart and mind.