Early on in the COVID-19 pandemic, I received an e-mail from a student who had done a month at the VCU clinic where I work. I had prayed in the morning with the nurses when he was with us. In his e-mail, after affirming me as a man of faith, he wrote that he was afraid, that he hadn’t really thought about the inherent risk involved in going into medicine until now. I called him and we talked about anxiety, mortality, faith, and hope.
After many subsequent conversations with students about risk, none could recall any discussion during their training about the inherent assumption of personal risk involved in the practice of medicine. There had been discussion about the risk of being sued, about risk management, about VCU being a risk-averse institution. But what about the acceptance of, even embrace of risk in medicine out of love for our patients? Until now, it seems to have been a remote concept in the minds of our medical educators.
Risk was not a remote concept during the International Medical Mission Elective in Zimbabwe in Jan/Feb 2020. The five students and residents who accompanied me to Karanda Mission Hospital near the border with Mozambique rounded daily in wards full of patients with AIDs, tuberculosis, typhoid and an array of other communicable diseases. Perhaps 30% of the inpatients were HIV positive and the TB rooms, adjacent to the open wards, in which we put known active TB patients, were simply separate rooms without negative pressure systems, without any expected or standardized means of personal protection. We did what we could, turning away the head of the patient when we listened to their chest in case of a cough, wearing the masks we had brought, etc. It seemed meager compared to the effort made in a resource-rich institution like VCU. We talked about the fact that there were simply not the means for the type of protection mandated in the US.
For Zimbabwe’s 14.8 million people there are an estimated 25 ventilators. Should this pandemic reach rural Zimbabwe and the wards of Karanda Mission Hospital, those national and missionary staff must weather this storm with the same courage and faith in Christ with which they face each day.
Just as the month in Zimbabwe was formative in the lives of our CMDA students/residents, this pandemic and how we process it as followers of Jesus will no doubt be formative in the lives of the students we at CMDA serve. Issues such as risk, common to the experience of those in missionary medicine, now must be faced in the US. May God use this massive, global, unexpected disruption in our lives and cultures to expose our idols, think more clearly about our mortality, dependence, and powerlessness, and delve more deeply into the meaning and motive of caring for our neighbor.
For the Glory of Christ,
Scott Armistead, M.D