The first time I called time of death, I thought, “This is the absolute worst part of my job and I never want to do this again.” I was out of breath, having just run back up the stairs after getting a frantic phone call from the nurse. I had just left my patient’s room moments ago; she was in stable condition with her five sisters and her mother by her side. When I returned, they were in tears and the mother was on the verge of passing out. After they left the room, I performed a careful death exam, struggling to listen for absent heart sounds over the wailing cries of her sisters in the hallway. “Time of death, 3:22 p.m.” I stumbled through some version of “I’m so sorry for your loss” before I ran to the supply station to find an oxygen tank for the now pale mother. As a second-year family medicine resident, it was an awful experience.
Fast-forward to several months deep into the COVID-19 pandemic. As a new attending physician supervising residents in training on the inpatient wards, I soon learned that in fact, the death exam is one of the more straightforward parts of my job. The actual worst parts of my job are the daily roadblocks that prevent me from practicing the art of medicine. Every physician has a superpower; mine is connection and empathy. When the reality of the triple-layer of N95 mask, surgical mask, and face shield started interfering with my ability to utilize my superpowers, I quickly suffered one moral injury after another.
Moral injury in physicians happens when one is prevented from achieving his or her purpose. Many physicians look to the updated version of the Hippocratic Oath, penned by Dr. Louis Lasagna, for inspiration and guidance in defining their purpose: “I...