This spring, more than 120 medical students offered to graduate early and join the frontline of a health care system grappling with a surge of patients during the COVID-19 pandemic. For those who served, their experiences in the clinic provided lasting lessons.
WHEN COVID-19 cases first began to surge in Indiana this spring, Gov. Eric Holcomb issued an order that cleared the way for fourth-year medical students to join the front lines of the health care system in order to meet the demand for health care workers.
At Indiana University School of Medicine, the question for many members of the Class of 2020 was not whether to answer the governor’s call for help, but what answering it might mean to their families.
When the call came, Arielle Russell was still living at home in Indianapolis with her parents as she finished medical school. She is used to volunteering. But her parents are not only older, they have other health issues that put them at a higher risk for bad outcomes should they contract the disease. Russell had questions about how she could serve, while keeping her parents safe.
All told, about one-third of the IU School of Medicine Class of 2020—124 students in all— offered to graduate early and make themselves available for COVID-19 duty. Most had questions like Russell’s—how to serve while protecting parents, spouses, or other family members from a potentially deadly disease.
Russell, whose COVID assignment was at the Richard L. Roudebush Indianapolis VA Medical Center, found reassurance when she asked about precautions in place, such as ample protective gear and limited contact with COVID patients. And she arranged to limit her contact with her parents.
Russell served in an emergency department split in half—one area for suspected COVID patients, one for everybody else. Her duties primarily involved doing medical histories and writing assessments for the attending physicians. But she saw up close the gravity of the COVID dangers, responding to a couple of patients whose condition deteriorated quickly, including one who died 30 minutes after his arrival.
“I’m still at the point where, after I see a patient that passes away, I still tear up because you know their family is hurting and you couldn’t help them,” she said. “That’s still hard and I don’t know if I will ever get past that.”
Serving alongside Russell at the VA was David Vega, who contracted COVID-19 in March, receiving his positive test for the disease on the same day he was matched to a residency at the University of Miami. Vega was still recovering from the illness when the opportunity arose to graduate early and respond to the COVID-19 surge. His parents, glad to have seen him recover, were reluctant to let him go into the fray against the disease again so quickly. But Vega thought that made him good candidate for pandemic duty.
“We’re still learning a lot about this virus but knowing that I had it—and developed some sort of immunity to it—I was a little less scared about those risks. I felt better equipped to jump in and help out during our country’s time of need,” Vega said.
Vega served for nearly a month in the VA, mostly treating patients in the non-COVID emergency room. But patient triage is not perfect, and he encountered at least one patient—a man with injuries from a fall—who tested positive for COVID-19.
Vega said the experience was a useful preparation for his residency in Miami, which has become a hot spot for a COVID-19 resurgence in Florida.
MARK FRASER was in the sixth week of a global health rotation in Eldoret, Kenya when IU personnel connected with the AMPATH program were ordered home because of the pandemic. Fraser, who studied at IU School of Medicine—South Bend, has a PhD in Integrated Biomedical Science, with a focus on immunology and infectious diseases. When the governor’s call came for help, he was eager to put what he knew to work.
His mother, however, was less excited. When she called to ask if he was planning to volunteer, Fraser was incredulous. “‘You know exactly what I am going to do,’” he told her. ‘You’re calling to confirm what I’m doing.’”
Fraser’s COVID assignment was with the palliative care team at IU Health Methodist Hospital. He worked with COVID and non-COVID patients facing poor outcomes. He facilitated some final video conversations between patients and the family members they were separated from. “I always approach anything, especially in medicine, with what can I do to help that person in front of me,” he said.
Fraser’s COVID-duty experience drove home the importance of his interest in infectious diseases. He wants to do research on anti-viral drugs, but also serve critical care patients.
CHARLES LUKE SCHEEL, then a student at IU School of Medicine—Northwest-Gary, wanted to take a spot on the front lines to potentially spare older doctors from some of the encounters of frontline work. But he thought of his wife, and the time it might cost them—before he began residency—if he came down with the illness or had to enter isolation. His wife was worried about Charles’ safety. “She knew I would say yes,” Charles said, “but she wasn’t happy about it.”
Scheel spent more than a month working from the Marram Health Center in Gary, reaching out to vulnerable populations, such as the homeless, with testing and care. The thing that stood out to him was the gratitude of his patients. “They were just so thankful to have us there testing them—to give them that peace of mind,” Scheel said. “And that was the best part of it.”
Like Scheel, Aaron Zelikovich was based at Marram. He did remote consultations and performed COVID testing at senior facilities and homeless shelters. Their goal, Zelikovich said, was to identify and get early treatment for patients who might not know they were infected.
The clinic was a 10-minute walk from the Gary campus, and at the same place Zelikovich did his family medicine rotation a year earlier. In other words, he was serving an area familiar to him. “For me, it was a very big opportunity to give back to the community that I’ve been able to be a part of for the past two years.”
Like Scheel, Zelikovich was struck by the gratitude of his patients. Now a neurology resident at New York’s Presbyterian Hospital, he knows some medical schools kept their students at home. He is glad to have been a part of the IU School of Medicine’s response to the pandemic.
“I’m proud of the school stepping up,” he said.
Each of these students were scholarship recipients at IU School of Medicine. Each saw it as their duty to give back. Now, they are taking their lessons from IU—and the pandemic—to residency programs in Indiana and elsewhere around the country.