On Masochism: A Resident's Conflict between Sacrifice and Self-Preservation during the Covid-19 Pandemic

As a psychiatry resident working in New York City, I first saw the signs of Covid-19 in an outpatient setting. Before safety guidelines had been established, a homeless patient of mine walked in for an unplanned appointment. Hearing him coughing in the waiting room, I knew that neither of us would have a mask to wear, their being in short supply at the time. Ignoring the fact that given his living conditions and symptoms he was high risk for Covid-19, I brought him into my claustrophobic office for a session. As I heard his heart-rending description of his life in a virus-ridden shelter, I realized a little too late that I was greatly exposing myself. I questioned the obligation I had felt to see him without first taking proper precautions to protect my health. As events continued to accelerate in our hospital, I learned I was not the only resident too quick to compromise our safety. Alarmingly, it had become the status quo. As a therapy provider to other medical residents, I was gritting my teeth through one worrisome anecdote after another. My fellow residents and I were rushing into close patient contact with no protective equipment, eager to help and thinking little of our own needs. While this was undoubtedly noble and necessary in emergency situations, at other times our haste to enter a risk-filled room seemed to be coming more from an internal demand rather than from objective clinical urgency. On top of it all, we were guiltily declaring that we wanted to do even more. While it is true that the pressure from hospital administrators to sacrifice is palpable, the