By: Melissa Fletcher Stoeltje
This story was published in the San Antonio Express-News on June 18
Third-year medical student Mitch Parma was deep into a psychiatry rotation when the coronavirus struck.
Suddenly, Parma had time on his hands. Gone — at least temporarily — were the chock-full days of studying for exams and visiting patients during hospital rounds.
Instead of going into a holding pattern, Parma, 25, jumped into action. Along with hundreds of his fellow students at the Long School of Medicine at UT Health San Antonio, he joined the Long-COVID, a volunteer group of medical students whose aim is to help the community during the coronavirus pandemic.
Created in March by the school’s faculty in partnership with the San Antonio Metropolitan Health District and other groups, the team has put in hundreds of volunteer hours.
They’ve answered COVID hotlines, developed educational materials, contacted people who may have been exposed to the virus, collected personal protective equipment, worked in campus labs to create hand sanitizer and much more.
Parma grew up in Kerrville and graduated from an honors program at Texas A & M — a chunky Aggie ring adorns one of his fingers. He says volunteering has brought deeper meaning to his journey to doctor-hood.
“This may well be one of the most formative phases of my medical school education,” said Parma, a convivial, boyish-looking young man who sat in his white coat at an outdoor area of the school on a recent afternoon.
As a volunteer, Parma manned a Metro Health COVID hotline, created informational graphics for community health materials, assisted a palliative care team at the VA hospital and did temperature screenings on people entering buildings on the school campus.
“Hopefully, we students will look back on this time and know we gave our city everything we could,” he said.
Parma was nearing the end of his psychiatric rotation at the Audie L. Murphy Memorial Veterans Hospital when a message dropped in his email box, from Dr. Joshua T. Hanson, associate dean for student affairs. It was blunt: Clinic rotations are over for now.
‘A screeching halt’
Suddenly, Parma didn’t have to set his alarm clock. What on earth would he do? And what would happen to the trajectory of his medical school career, which up to that point had flowed seamlessly along the well-worn tracks that have propelled countless students into the healing profession?
Parma, who is something of a wordsmith, wrote an essay about his experience as a medical student in the time of COVID. It was published in San Antonio Medicine, a monthly magazine put out by the Bexar County Medical Society.
“If medical school is a high-speed train barreling toward the destination of residency,” he wrote, “the current unforeseen pandemic is the debris sprawled out on the train tracks, pulling everything to a screeching halt.”
Then other emails arrived, informing Parma and his peers that there were new ways to stay connected to helping and healing. He perused the panoply of volunteer opportunities made possible through the Long-CO and picked the ones that best matched his skills.
Answering the COVID hotline — something Parma did three days a week for over a month, working six-hour shifts — had the most impact, he said.
He used a script created by Metro Health’s public health experts. The text changed constantly as the city’s response to the virus evolved. Parma did his best to answer questions:
How long should I quarantine if my co-worker tested positive? Can my mother drive from New Orleans to help with my newborn baby? What do we do with the body of a loved one believed to have died at home from COVID-19?
In his magazine essay, Parma wrote that one of the most poignant calls was from an elderly woman whose husband suffered from cancer and chronic obstructive pulmonary disease, an inflammatory condition that obstructs airflow from the lungs.
The woman’s daughter — a single mother of four — was showing symptoms of COVID-19. What if the daughter had to go to the hospital? Who would care for the elderly woman’s grandchildren, since she couldn’t, given her husband’s health? What would happen if that burden fell on her oldest grandchild, who was only 12?
“There was so much out of her control,” Parma wrote. “I confessed to her that we are in control of very little at this time. But for the few things that we can control, I assured her, we can act with deep intention and grace. I hope she took solace in that fact. I know I did.”
He also volunteered with the VA hospital’s palliative care team, which provides pain relief for patients with serious illnesses and helps coordinate their care between medical teams.
In this role, he helped family members, many of them elderly, use technology such as FaceTime to communicate with their loved ones, whom they couldn’t visit in person.
Match made in heaven
Hanson, the associate dean, said Parma typifies the kind of hardworking student who took stock of a crisis and saw opportunity.
“Many have felt called to medicine for a long time, and when the pandemic hit, they wanted to know how they could help,” said Hanson, who estimated more than 200 students have participated in the Long-CO. “They saw a huge need in the community and became deeply engaged.”
The volunteer group was a match made in heaven, he said: A public health crisis coupled with a workforce keenly suited for the task, one that would help its members continue to develop their professional identities as doctors during a pandemic-induced lull.
Hanson credits the creation of Long-CO to Dr. Barbara Taylor, assistant dean for the MD/MPH (Master’s in Public Health) program at UT Health, and Stephanie Gutierrez, coordinator of the program. Taylor, an infectious disease specialist, leads the city/county COVID-19 Health Transition Team.
Some of the volunteerism has leveled off, now that on-campus exams and clinical training have resumed, Hanson said. (Classes will restart in the fall, in small-group settings.) But there are still plenty of student-volunteers doing the work, especially now that the spread of the coronavirus has spiked, he said.
One other upside of the volunteer project: It has given this particular crop of students a visceral knowledge of the stakes involved in public health, a subject too often viewed in the abstract, he said.
“There’s going to be a whole generation of physicians who lived and worked in this particular crisis, and they’re going to have a broad idea of what it means to be a physician during a pandemic,” he said.
As for Parma, he’s jumped back into his rotations, setting his alarm clock once again.
‘Finding a new balance’
One recent afternoon, he was nearing the end of his pediatrics rotation at University Hospital, the teaching hospital connected to the medical school. Next up: Obstetrics/gynecology. The rotations have been truncated because of the virus, he said, shortened to four weeks from the traditional six.
Soon, Parma will be a fourth-year student. That’s when students traditionally take elective classes as they home in on their medical specialties. They also complete applications and conduct interviews for their residencies, typically the last three years of their training.
Now, because of the coronavirus, those tours and interviews will have to be done virtually. It’s just another way the virus is transforming the medical school experience in 2020. Parma’s girlfriend, a 6th grade math teacher, has seen her work transformed into a virtual reality, he said. So she understands.
Parma hopes to snag a medical residency in Texas. He’s pretty sure he’ll focus on internal medicine. He’s scheduled to graduate from the Long School in May 2021.
“I can’t wait to be an advocate for my patients, to listen to their stories and kind of treat the whole person,” he said.
Parma knows he and peers will likely encounter a vastly changed medical landscape, for who knows how long, where something as simple as shaking a patient’s hand — often the first thing doctors do — may have to be re-thought.
“It’s going to be about finding a new balance,” he said.
One thing’s for sure: He and his medical school comrades have a shared experience they’ll never forget.
“It’s been really valuable just to bear witness, to see up close how scared and worried people were, instead of just watching it on the news,” he said. “Years from now, I’ll be able to tell my kids, ‘Yes, it really was that bad. No, I’m not blowing it out of proportion.’”