In his Field Notes essay titled “Facelessness” (Intima, Fall 2021), Dr. Jamie Uhrig asks: “How can I bear witness to my patients’ experience in jail in this time of facelessness?” What a word, facelessness. When I sound it out, I can feel my breath hesitate over my tongue at the backs of my teeth, an airy barrier between the inside and outside of my mouth. For weeks after reading this essay, I found myself quietly repeating the word when I put my mask on each morning. I too share Dr. Uhrig’s worry for all my own interactions with patients, although most of them are not incarcerated. How, indeed, can we share the human experience of sickness without use of our faces? Our faces are the tools we were handed as infants; we used them to express ourselves before we had words.
They are a begrudged necessity in a hospital, but the ubiquity of face masks is one of the most exhausting changes Covid has brought. I have several dangling from the gearshift in my car, sliding one onto my face as I park each morning. Among my colleagues, there’s even a quiet ranking system of the supplies available to us: flimsy, yellow masks provided by one hospital are discarded in favor of the thicker, heavier blue-and-white ones stocked at another.
In the hospital, I often long for a way to express wordless feelings. I’ve learned to chuckle with my eyes, but I have yet to master the art of most silent expressions without the use of the small muscles surrounding my cheeks and lips. In my Field Notes essay “Alice,” I tried to emphasize the divide that masks have interjected into my practice as a physician. The constant fogging of face shields, the re-circulation of air in an N95…I have never been a doctor without these new constants. In some ways, it seems almost a blessing to have never known better.
COVID has gotten in the way of so much, literally. It floods lungs with heavy fluid, making it impossible to do meaningful gas exchange. It has become unfathomably, sickly politicized, another ideological wedge between two sides of an already divided country. The currencies of medicine—vulnerability, respect, trust, among others—have become that much harder to exchange. As I read Dr. Uhrig’s beautiful “Facelessness,” I felt some of these barriers lessen in knowing I’m in good company as I think about these new dynamics.
Hannah Dischinger is a second-year Internal Medicine resident at Oregon Health & Science University, where she helps lead the IM Residency Narrative Medicine group. Writing has helped her navigate the bizarre, amazing, and sometimes isolating experience of learning to doctor amid a pandemic. Among many other things, she is interested in the roles of humanism and vulnerability in the practice of medicine. When she isn't at the hospital, you can find her picking basil in the garden, playing a board game with her partner (Andy), or napping with her cat (Yeti). Her Field Notes essay titled “Alice appears in the Fall 2021 Intima: A Journal of Narrative Medicine.