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Brian Lehrer: Brian Lehrer on WNYC and this is graduation season among other things. For so many new doctors and other health professionals, the time leading up to graduation from med school or nursing school or other training is a time of celebration usually but in March 2020, March of last year, medical schools across the country gave their soon to be graduates the option to fast-track graduation and join the fight against the pandemic. While so many of us retreated to our homes for months of lockdowns, those students turned doctors were rushed to the front lines without so much as a tip of the tassel. Here to tell us some of their stories and collect some of yours on the phones is Emma Goldberg and editorial assistant at the New York Times and author of a new book called Life on the Line: Young Doctors Come of Age in a Pandemic. Hi Emma, thank you so much for joining us.

Emma Goldberg: Thank you so much for having me on. It's great to be here, Brian.

Brian Lehrer: Let's start with a story. Your book begins with an introduction featuring Sam, a graduate from NYU and you mentioned how from the morning he picked up his badge to the next morning when he began work at Bellevue, New York State lost 778 people to COVID-19 in those 24 hours. How did such an influx of death affect Sam to start with one person's story on his day one?

Emma Goldberg: That's a great question, Brian. First of all, thank you so much for having me on and I'm glad that we're starting with Sam because it's really an inspiring story. You may remember that last spring in New York was a challenging time. The streets were empty, the hospitals were full and as you mentioned, every day, New York was losing close to a thousand people to COVID-19 and young people like Sam stepped up at that moment and they mobilized to be of service to their community and to the hospitals and certainly it affected them.

Certainly, there was a lot of trauma there, but I think it was also a really inspiring moment for young people like Sam, who you mentioned, who were able to step up and put their skills to use, to join the front lines, and help the hospitals that were being overwhelmed and really besieged by COVID patients.

Brian Lehrer: A big reason that Sam himself went into medicine was because of the effects that the HIV/AIDS epidemic and on the LGBTQ+ community. As a gay man living in New York City, did Sam speak on the mental health effects of another unknown virus spreading rapidly on him?

Emma Goldberg: Yes, I think there were really two sides of the coin there. On the one hand, there's a certain level of trauma and fear, particularly for young LGBTQ doctors who came of age in the past few years, learn the of how their own communities were devastated by the AIDS crisis not that long ago and how, in some cases, people like them, young people were dying again of an unknown virus and weren't even able to really get medical help. There wasn't a lot known.

Some doctors were even really afraid to treat HIV patients. On the other hand, I think for young doctors who are from that community, it's a real life-affirming thing to be able to step up now and be on the front lines of another pandemic of another epidemic and to treat again communities who are being ravaged by a disease, but this time they're able to be of service, they're able to step up and ultimately we even had this time more protective gear and there was more known about how doctors could prevent themselves from getting infected.

Brian Lehrer: I see your interest in the medical profession began before the pandemic brought so much media attention to it. Can you tell us knows about the story you worked on for the Times about the barriers to entering medicine and what you learned from those you spoke to back then?

Emma Goldberg: Absolutely. My interest in covering the culture of medicine really started when I got a call from a friend in medical school who noted that there are all these invisible costs to becoming a doctor. There is study guides that cost hundreds, even thousands of dollars. There's a cost of flying around the country to interview at medical schools and then residency programs. What we began to discuss is that the homogeneity of medicine and the pipeline that looks so white and so wealthy ends up affecting patients because patients benefit when they're able to get medical care from doctors who look like them and who understand their communities and their perspectives.

All of us benefit when there's real diversity in medicine, whether racially or socioeconomically. I got interested in covering both the hurdles to entering medicine when you're coming from a community of color or a low-income community, as well as the benefits to patients when we're able to ease the road into medicine for doctors of color and for low-income doctors. I wrote a story for the New York Times about that and kept covering it ever since.

Brian Lehrer: That led in some way to the premise of this book, about young doctors in the pandemic?

Emma Goldberg: Exactly. When I heard that medical schools, both in New York and Massachusetts were graduating students early in sending them to the front lines. I knew that it was a story that I wanted to cover, and I thought it was a real inspiring story for readers, really because in the midst of the crisis, there were people who were tapping into deep reserves of courage and mobilizing to serve their communities.

Brian Lehrer: How did you narrow it down to the six particular young doctors you decided to feature?

Emma Goldberg: I wanted to choose a group of doctors who represented a new face of medicine and a new generation and each of the doctors I followed represents, I think, a real new perspective in the field. We had a young woman who is a first-generation American and her parents had some fear and reserves about the US medical system and they actually worked in traditional Chinese medicine.

I followed a young, modern, Orthodox Jewish woman who was in some ways wrestling with serving her patients, on the Sabbath and decided ultimately to do that because she felt that lifesaving work was even more important than religious observance. Each of them were grappling with a challenge that I thought represented really a new generation of doctors and might speak to readers in terms of the shifts that the field of medicine is undergoing.

Brian Lehrer: Listeners we're going to open up the phones now, and we're especially interested in hearing your stories if you fit into this category. Was anybody listening right now a recent medical school, or really any other, a new health professional, med school graduate or other new health professional last year and you found yourself working on the front lines of the pandemic?

646-435-7280, first-year nurses, doctors, paramedics, anyone else we want to hear about your experiences and I'm sure you're still processing both the emotional/mental health side of what you've gone through as well as what you learned about being a doctor in such an emergency circumstance, 646-435-7280, 646-435-7280. How do you think your trial by fire right into the deep end of the pool, use whatever cliché you want might affect your career path choices going forward within the health professions or the way you view your chosen field? 646-435-7280.

What about the mismatch between who was getting COVID disproportionately and those who tend to be health professionals, 646-435-7280. What did you learn from that? What did you become more committed to from that? 646-435-7280, or maybe you're an educator or a more experienced medical professional who worked closely with the class of 2020 and want to share something that you saw, or even a parent or relative of a new medical professional, who wasn't able to see their loved one while they were helping to fight the pandemic and kept socially distant from you. 646-435-7280.

Share your stories. It'll probably be good for you, it'll probably be good for the world to hear these stories along with our guests, Emma Goldberg, author of the book, Life on the Line: Young Doctors Come of Age in a Pandemic. Let's take another of the people you followed, Iris, a Chinese American doctor who remembers her family's aversion to American hospitals growing up that fear is a big problem in BIPOC communities and was especially apparent during the pandemic. You're right, did she mention any racism she experienced while working early in the pandemic as a Chinese American doctor? Or where would you start with Iris?

Emma Goldberg: What I really say about Iris is that I think there was a real level of empowerment in her being able to go in and thrive in a hospital when she had growing up, seeing her own immigrant parents have some fears around going into New York and American hospitals because they worried about not necessarily being able to communicate effectively and she knew now that as a medical school graduate, she could go into these hallways and thrive and serve patients, patients from all different communities.

One of the most inspiring moments with her was also hearing about how she joined protests around the city and particularly in the Bronx near the hospital where she was working after the killing of George Floyd because as a young Asian American woman, she wanted to stand with other communities of color and protest against racial injustice. I think that was a really empowering moment for her to be able to go from treating patients from communities of color to marching with communities of color, and feeling like on all different fronts while there were all different levels of trauma that were being processed, but she could be of service in many different ways.

Brian Lehrer: Let's take a call. Our first caller is going to be an older doctor with a perspective on this. Ruth in Monmouth, you're on WNYC. Hi, Ruth.

Ruth: Hi, how are you? Thank you so much for caring enough to present the issues that the young health care workers in our nation and all over the world have to deal with. I appreciate it. I'm in my 60s, and we dealt with the AIDS crisis. I have to tell you, we were not as frightened as the healthcare workers justifiably have been frightened, now with COVID. No one used gloves in my day nor mask really unless somebody had tuberculosis. It's a very different world but we always spoke supported by our team. I think the thing that I'm most concerned about is I feel that these beautiful young souls who are entering healthcare, whether they're nurses or young physicians, they are not supported by the administrations of the hospitals.

They are really literally mostly abandoned. They are brought in, really herded in to take care of the workload that needs to be done with no thought about what's happening to them physically and emotionally. They still have to fight during the pandemic, as we all know, with limited PPE, they have too big to get N95 masks, the nurses struggled even more than the young physicians, the residents. They were burdened with more patients than they legitimately should be taken care of because the onslaught on the hospital's quite understandable if the government controls how many residents a given hospital can hire, but there was just not enough people to go around so really, their training suffered.

Their training was primarily for COVID patients, and really did not get a broad spectrum of their training that they needed, they got ill themselves. They were quite frankly just abandoned by the hospital administration and through the years, there have been problems even without the pandemic, where they try and teach wellness to physicians and try and teach them resilience. However, the suicide rate among young physicians as well as more senior physicians is quite high. Some people even argue that it's higher than our wonderful veterans. I think it's a big problem that we're facing here is that while we're getting these wonderful, dedicated souls, they are burning out and burning out very quickly, because the hospitals abused them. I think it's the entire hospital system. I think we're the janitors up to the physicians, but when you're taking these young kids who work so hard, and then enter this world, it's really horrific, what's going on, and a lot of them are seeking to just leave medicine.

Brian Lehrer: Why would hospitals do that to their prized staff?

Ruth: Because it's all about economics. They're spending, the residents are spending time, they're not spending enough money on hiring social workers, and ancillary staff. Residents, instead of just taking care of their wonderful patients, they're doing a lot of, it's not paperwork, since it's all EMR nowadays, but doing the social work and doing this and there's just not enough time for them to learn to, they're working, hospitals will say it's not true, but it is true. They're working 70 to 80 plus hour weeks, they are physically exhausted. It's really sad and so the hospitals should be hiring more Medicare, the government should be allowing for more, they regulate how many residents the hospital is allowed to have so that dictates the workload on the residents and then the hospital dictates how many ancillary staff they're going to hire. The same thing with nurses.

Brian Lehrer: Yes, Ruth, doctor, thank you very much for your call and your perspective on that. Wow, Emma, did you hear a lot of stories like that from the young doctors you profile for your book? Did they feel abandoned by the hospital administrations?

Emma Goldberg: I wouldn't say that was the perspective that I heard from them. What I do think is that coming out of the last year, when physicians at every level of seniority have witnessed unimaginable loss and death. I think that it's going to force the real reckoning with the role of mental health in the profession. We all need to be asking ourselves, what does it mean to take care of the caretakers and provide sufficient mental health support for physicians who have just witnessed unimaginable, unprecedented levels of death. I think historically there has been and to some degree stigmatization of seeking psychiatric or mental health help in the medical field. I think removing that stigma and ensuring that every doctor, every nurse, and every other frontline provider has a network of support around them and resources that they can seek out. That's going to be critical as we move forward into the next phase of pandemic response.

Brian Lehrer: Kelly, a new nurse I see you calling in. Peter, a new paramedic I see you calling in. We're going to try to get to both of you right after this break. Brian Lehrer on WNYC.

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Brian Lehrer: Brian Lehrer on WNYC. As we continue with Emma Goldberg, author of Life on the Line: Young Doctors Come of Age in a Pandemic. Kelly in Hoboken, you're on WNYC. Hi, Kelly.

Kelly: Hey, how are you guys today?

Brian Lehrer: Doing all right, so you became a nurse just last year, is that correct?

Kelly: That's correct. I graduated in the summer of 2019 and started working as a nurse in October of 2019. I had a few months in before the pandemic hit [laughs].

Brian Lehrer: Still you were so new, how much of a shock was it?

Kelly: I think that it's one of those trauma things where you don't really realize the impact until later. I think coming in, it was just like, every day, I watched the news and be like, "Oh, my God, okay, now what?" I definitely remember when we had our first possible COVID patients, and no one really knew what to do [laughs]. There weren't really any guidelines in place so we were all winging it, trying to figure out how to handle it, and then next thing, you know, we had a whole unit devoted for COVID. I remember the first day working on that unit.

The good thing was at that time, we had PPE. It was this wonderful amount of PPE but that went away, quite quickly. I think just the, once I hit that one COVID unit, the entire hospital, every patient was COVID and then it just became a way of life for quite some time. I went into robot mode, I guess. You just woke up and do what you had to do and I think that I put not blinders, but just put all my emotions to the side, just to get the job done at the time and just to get through each day.

Brian Lehrer: Robot mode is quite an image, especially when you're talking about your emotional state. Do you think having been through it to this point, that starting your career as a nurse like that will affect what career path you choose going forward within the profession?

Kelly: Yes, definitely. I think, one of the interesting things is, I think that so many of us already are experiencing burnout. I know so many nurses that are getting out of bedside nursing, myself, I think it's changed our career path in the sense that we are looking to exit bedside nursing as quickly as possible. I know, personally, just got a job now with pediatrics. Definitely, I think that that puts that decision to go into a specialty, get outside.

Brian Lehrer: That's interesting. Away from what might be the most traumatic part of care or type of care to be involved with, I wonder Emma if you're hearing that from a lot of people who you have interviewed for the book, that could be a problem if too many people want to, not go into bedside care, because of the potential trauma down the road after the pandemic, and if that could create a shortage.

Emma Goldberg: Yes, and there already is a projected shortage in a lot of medical areas. According to estimates from the Association of American Medical Colleges, there could be a shortage of tens of thousands of physicians in the coming decades. I think there is a real concern. On the flip side, though, I will say that I did hear from a lot of frontline providers that they last year reaffirmed their commitment to wanting to be there for patients in the toughest moments. In some cases, in the COVID wards, families couldn't be there, visitors couldn't be there, it was the doctors and the nurses who were sitting with the patients and holding their hands, even as in some cases they passed away. I think for some frontline providers, there was a recognition and an affirmation that that's what they want to spend the rest of their career doing.

Brian Lehrer: Let's get one more in here. Peter in Brooklyn, a recently minted paramedic. Hi, Peter. Thanks so much for calling in. You're on WNYC.

Peter: Hi, how is it going?

Brian Lehrer: Good. Go ahead.

Peter: I was relatively new at the time. The way it works in EMS is a lot of times I'll either pair it up with more senior medics and stuff. You look to them because they've been in different situations that you haven't been. There was a moment that struck me when I was working because I worked in Brooklyn throughout the entire pandemic. I remember one of the senior guys who had worked with 9/11 [unintelligible 00:21:26] saying that he would rather go through 9/11 than go through this again.

When the senior guys are saying things like that, and the more [unintelligible 00:21:37] it made everybody really, really scared. For me, the hardest part was most of the hospitals weren't allowing visitors and stuff like that. Normally, when EMSs arrive on the scene or emergency, people were very relieved but we were taking people away and they weren't allowed to come with them and they didn't know if they ever going to see them again. We went from being lifesavers to almost like the Grim Reaper.

That was the hardest part I think for most people who worked at EMS is having to take people's loved ones away and have them not be so sure when they're going to see them again. I just liked off the comment like not reaffirming like this, like that, this is what I want to do. At the time I was new and it was very awful in March and April going through what I did, but I gained a ton of experience. I absolutely loved my job to this day. I can't really picture myself doing anything else.

Brian Lehrer: Peter, thank you for your story, and thank you very much for your commitment to your field. Thanks to all of you who called in on this to hear more about the new doctors. Gabriella, Iris, Sam, Jay, and the others profiled in the book, you'll just have to get a copy of Life on the Line: Young Doctors Come of Age in a Pandemic by Emma Goldberg who's been, my guest. Also, the Politics and Prose Bookstore is hosting a virtual live event with Emma this Thursday with New York Times columnist, Nicholas Kristof. You can find more information on politics-pros.com. Emma, congratulations again on the book, and thanks for spurring such a wonderful calling.

Emma Goldberg: Thank you so much for having me Brian, and thanks for all of those who shared their stories. For the work you did on the front lines, it's so important.

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