A magazine for friends of the Warren Alpert Medical School of Brown University.

Back in the Classroom

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Teaching during COVID times is both foreign and familiar.

I remember my first time scrubbing in for a surgical procedure as if it were yesterday. As a member of Brown’s first MD class in the modern era, I was discovering that having medical students in the operating room was a new phenomenon.

I reported to the nursing supervisor in the surgical suite as instructed. Many of the ORs were already buzzing with activity. She rattled off a litany of procedures that I was to follow, all beginning with the words “You will ….” She was just winding down when Dr. Stewart, my hosting surgeon, arrived on the scene. He winked and motioned with his head that I should join him at the scrub sink. I mimicked his every move, trying to assume a posture that told anyone who was watching that I knew what I was doing. The nursing supervisor knew better.

As Dr. Stewart finished his scrubbing ritual, I figured that I must have missed a critical step, as the faucet on his side of the sink had shut off, but as I stepped away, mine was still running. I chose to follow after my host, arms held upright like I had seen on TV and hoping that the faucet would magically shut off on its own.

As I passed through the doorway, I stepped into a strange new world. The patient, the tables, the staff, everything seemed to be draped in blue. The circulating nurse barked out, “What size gloves do you wear?” I had no idea. By way of an answer, I held my hands up for her inspection. She whipped out a pair of size 7½ latex gloves (my first and, as it turned out, my last time to wear latex gloves).

The rest is a blur. I remember feeling that I was somewhere between being on an alien spaceship and having stepped onto a moving sidewalk that had been cranked up to full speed. But it only took a few visits to get the hang of it all, and before long the scrub procedure, twirling around to get my gown ties around my waist, and announcing ahead of time that I needed latex-free gloves all became ingrained in my morning ritual.

BRAVE NEW WORLD
Fast forward 48 years. I was crossing Richmond Street to the medical education building of The Warren Alpert Medical School—my first time there since the pandemic struck. Students, faculty, and staff converged on the entrance at the same time, all boarding the spaceship. Once again, I noticed many swatches of blue in the scrub suits, masks, and (in my case) dress shirts. What was I getting myself in for? Was it still proper to hold the door open for someone else? Would everyone have a proper mask, and would they wear it correctly? Was it possible to get sick from using too much hand sanitizer? How does one correctly socially distance in the bathroom? Where was that wink from Dr. Stewart when I needed it?

My Cardiology Small Group was assigned to the open space in the Blue Academy (of course, blue!). I chose a place to sit and wiped down the table and chair with a disinfectant wipe (twice) with a healthy dose of hand sanitizer for me. As the students sauntered in, they spread out at a proper social distance, without prompting. All wore proper masks with tight fits that fully covered their noses and mouths. Phew! If they were annoyed with my instructions to wipe down their spaces at the beginning and the end of our session, they didn’t show it.

The case we discussed was a long and difficult one. The students must have felt that they had stepped onto a moving sidewalk that had been cranked up to full speed. In fact, it was. We quickly moved beyond the awkward mechanics of our new COVID-era surroundings and procedures and dove into the case. Of course, there were a few stumbles. How could I play recordings of heart sounds so that everyone could hear? How could I draw on the white board when the dry markers had actually run dry? Why were so many other students wandering through our space?

The journey continued a few days later as I met with my small group for the second year of the Doctoring course. This time we had some new challenges to solve: finding positions in the lecture hall that kept us socially distanced from each other while being acoustically distanced from the other group sharing the room. Remembering to remove the protective film from the face shield (I wondered why everything looked so foggy!). Explaining how to safely remove disposable gloves.

Things quickly settled into a routine. The students were enthusiastic, engaged, and flexible in accepting the evolving changes. The staff assisting the two courses in which I was participating were outstanding (while I expected nothing less, they far exceeded my high expectations). Course leaders seemed to be everywhere at once, acting as counselors, organizers, and cheerleaders. I could tell that even under her mask, Tiany, the security guard at the building’s front desk, grinned broadly as she waved at and welcomed people.

At the end of the week, as I descended the succinctly labeled “Stairs Down,” I stopped on the landing and paused to survey the bustling activity. Students filled the entrance atrium while still managing to stay safely distanced. Animated discussions were underway all around. Laughter, teasing, and smiles were the order of the day. It all seemed so normal. Much like adjusting to the rituals of the operating room, the new rituals brought on by the pandemic were rapidly incorporated into daily life at the Medical School. A new normal, perhaps, but normal. As I left the building, I got another smile and wave from the security guard.

I hope I didn’t leave the faucet running.

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