A Call To Service

I knew it was 7 p.m. Even in the suburbs of northern New Jersey, I could hear the applause and pots clanging. There was not a hospital within 10 miles of where I lived but there were still hundreds of thankful neighbors who would cheer in appreciation. I was walking with my newborn son and 2-year-old daughter, contemplating if I was lucky to be on maternity leave or if I was missing my opportunity to serve. I would scroll through the countless emails begging for physician associates/assistants (PAs), RNs, physicians, really anyone who would work in the ICU. With discontent, I would put my phone away. I would be left with this feeling that I was missing out on some call of service. At the start of the COVID-19 pandemic, I had switched from full-time orthopedic surgery to full-time faculty at Seton Hall University's PA program. I had stayed on at my practice per diem to continue my clinical skills. Unfortunately, all elective surgeries were halted. I went 9 months before I finally returned to assist in a trauma case. I would go another 5 months before operating again. At my faculty position, I found that didactic students struggled to make the transition to online learning, clinical students were being let go from rotations, and graduations were inevitably delayed. Even if students graduated on time, the job market was narrowing. What once had been a thriving industry was now burdened with layoffs, limited shifts, and unemployment. As the months passed, there was a small light at the end of the tunnel; a vaccine was on its way. This was it, what we were all told to wait for. I signed up to receive the vaccine as soon as I could. As I sat waiting for my first dose, I looked around at my peers, many of whom I had not seen in months. Many had been pulled from the OR and were working in COVID units. They sat tired but hopeful. I began to feel that same sense of guilt and desire. I should have done something. I want to do something. I knew I had missed the hardest of COVID times, but I could still feed that longing to serve my community. Shortly after that night, I signed up to volunteer at two vaccination centers, Hackensack Meridian Hospital and Essex County. Both locations were operating strictly by appointment only. Both facilities ran like well-oiled machines. The process was similar: registration, vaccinations, and monitoring. Recipients were required to wait 15 minutes following their vaccine. If a patient had a history of allergies requiring an epinephrine autoinjector or disclosed a more severe reaction to an allergen, we had them wait for 30 minutes. During the first few days of volunteering, we were vaccinating healthcare workers and first responders only. I loved meeting fellow hospital employees. I felt a sense of camaraderie and friendship. “Which floor do you work on?” “Oh, we've referred to your practice before.” “How's your census?” Everyone was in the same boat, weathering the same storm. With each first responder, firefighter, or police officer, there was an overwhelming presence of mutual respect and admiration. I left each day with a natural high of hope and promise. Shortly after I started, the vaccine became available to the public. Each state varied on who was deemed eligible for vaccination. In New Jersey, anyone age 65 years and older, and patients younger than age 65 years with preexisting medical conditions, could be vaccinated in the second tier. Although this was an exciting time, it also was a difficult transition. We were wrapped in the comfort of healthcare workers being able to fully disclose all medical conditions and history of adverse reactions. When dealing with the general population, just as in any practice, getting a clear and concise history is not always easy. There was a profound sense of anxiety in the community: Many recipients were diaphoretic before they completed registration. Patients displayed a mix of vulnerability, unrest, and skepticism. Many had some preconceived concept of the vaccine. “Will it work? Is it expired? When will I get a reaction? What if I don't get a reaction?” There were stories of heartbreak and stories of hope. A woman sat shaking and clutching a picture. I knew the answer to my next question wasn't going to be easy, but I also knew she needed this moment, so I asked her about the picture. Her father died of COVID, her husband died of COVID. She had COVID herself but was the sole survivor. She held onto their picture as tears began to fall from her eyes and mine followed shortly after. I wanted to reach out and hug her, but doing the only thing I could, I gave her a shot. With the sorrow came the promise of a better tomorrow. Recipients shared their upcoming vacation plans, plans to meet grandchildren for the first time, weddings that could finally be scheduled. Arms would wave in the air in celebration, applause would burst from behind the vaccine curtains, smiles could be felt from behind the masks. I continue to reflect on the days of early quarantine. If I were not on maternity leave, would I have volunteered for the front line? Would I have worked the COVID units? Would I have actively signed up for ICU shifts? I don't know the answer. What I do know is that it's not too late to be active. There will always be a call to service. We have an obligation as medical professionals to aid our community, to better serve our patients, and to sacrifice our time to help those in need. This does not apply only to the trenches of war. There are plenty of ways to serve the public as clinicians: vaccination centers, testing centers, hotlines, viral tracing. I encourage our professional community to get involved, give back, and restore hope. I have certainly grown from this experience, and my hope is that whoever is reading this will as well.Box 1