Did you sign up for this, too?

I will absorb this sorrow. However, I find myself wondering: Why are others of you still here?

I have been told that I signed up for this. And, for the most part, I think that's true. “Into whatsoever houses I enter, I will enter to help the sick.” Part of the physician's compact with society is that privilege comes with a duty to serve.

I do not intend to claim a cloak of nobility or imply a state of tranquility. There are times when I cannot fathom how I can be so stressed, terrified, and overtaxed at once. Our organization, like so many others, faces financial challenges; this does not mean I welcome a pay cut with open arms. I promised to treat those with contagion just the same as those without; that does not mean I ever imagined I would be seeing patients with suboptimal PPE. I practice medicine in a country that leads the world in medical technology; I never fathomed navigating a pandemic flying blind because testing utterly failed.

Nonetheless, I know why I am here. I will move forward no matter how outraged. I will maintain a grim determination to prepare for the stress and trauma that must follow. I will absorb this sorrow. However, I find myself wondering: Why are others of you still here? Did you sign up for this?

To the PCA working as a sitter on the COVID unit for the patient with dementia—delirious, impulsive, and agitated—how did you manage such a long and difficult shift in full PPE? Two and a half hours to complete rounds is an eternity. What does it feel like to be in that room for so long in so much gear?

To the PCA who sat with a dying patient, whose family opted to attend his funeral rather than quarantine after a death vigil in the COVID unit, did you know that we could tell them he didn't die alone because you sat with him? Had you attended a death before? Are you sleeping at night?

To the phlebotomist who had to go into the COVID unit for the third time that day to get a sodium level on the same patient, did you curse me for ordering it? I promise I thought about that. I promise that patient needed your service.

To the environmental services worker who had to put on a PAPR for the first time, did you feel claustrophobic? When you took a job in a hospital, did you really sign up for this? Know that I was grateful that day, and I saw your fear. I wish I had said something to help, but I failed. Know that I'm scared when I go in there too.

These moments are teaching me that no matter the empathy I thought I had, the largest knowledge gap is that no one truly knows the experiences of another. We need you all desperately but how are you bearing this? Did you take this job because you are considering nursing or medicine? Have you changed your mind? Do you keep this job because otherwise you cannot feed your family or pay your bills? Would you lose your health insurance if you quit? Are you terrified for the health of yourself or someone you love because of your job? Are you doing OK?

Words are cheap and saying thanks is too easy. Still, thank you—to each one of you. Whatever drives you to such sacrifice, we see you, and it matters. Once more unto the breach, dear friends, once more.