The Walled City of Medicine

Reflections on medicine, storytelling, and a look back at the COVID-19 pandemic.

Jun 15, 2025

Medicine and stories converge in a poignant Venn diagram. Recently, I watched Howie Severino’s documentary about his time as a patient afflicted with COVID-19. I admire his bravery in sharing his story despite his vulnerability as a patient. He was alone in the hospital for the entirety of his admission, enclosed in deafening loneliness, broken only by brief encounters with nurses and doctors dressed like astronauts. Throughout the ordeal, he forged friendships with the healthcare staff, the only human connection he had. I realized how much youth and power can fool us with an illusion of invincibility, only to be shattered by disease. Imagine being in that hospital, haunted by the looming threat of death and deprived of the comfort of loved ones. Howie also illustrated many of the unseen challenges of a world in lockdown—the stringent protocols, the lack of transportation, and the ghost-town energy of the city, so far removed from the lives we knew.

I’m glad that these stories are documented, because I know how prone we are to forget. I was brought back to the horrific era of the COVID-19 pandemic. Now, it feels like a distant horror story—uncanny, since that was only five years ago. As I walk the hallways of PGH, I struggle to recall how it all looked during that era. An entire wing was repurposed for the care of patients with COVID. The social services office used to be the universal changing area, where we left our belongings in lockers and picked up hospital-issued scrub suits that were twice my size. The hallway itself was converted into a large PPE station, where we were guided through each step of donning before we were allowed to enter the COVID wards and ICUs. It was like an assembly line we entered each day—the kind of life-changing event that you hope never to relive.

As I watched the documentary, I realized how much of that era remains unprocessed. The urgency of the moment compelled us to dive headfirst. By the time we emerged, we hardly noticed we had been gasping for air. Though we witnessed and endured so much, the words were difficult to express. Perhaps part of us wanted to abandon those thoughts in the hospital, to leave them behind for the next day, when we had to report to work yet again. It is true what they say, that we learn to sign death certificates long before we are taught to grieve. I was deeply moved and envious of the Literature and Medicine Program led by Dr. Andrea Riley and her colleagues, where healthcare workers gathered each month to read literature. If we had a system like that back then, perhaps it would have helped us find words for the experiences we couldn’t process.

Dr. Rita Charon’s TED talk on Narrative Medicine struck a similar chord. I had heard of Narrative Medicine before, and have always been amazed that such a field exists. All my life, I treated two fields separately—my doctor life belonged in the hospital, while my inclinations toward literature remained in my blogs and diary entries. I was surprised that the two could be married, but it made perfect sense. It was so refreshing to hear Dr. Rita Charon frame medicine through the perspective of storytelling, for what is medicine but stories of illness? I was especially intrigued that she used the word “honoring.” Honor is such a beautiful word—to honor stories of illness, the struggles of life, and the inevitability of death. One of her most striking lines was what she offered to her patient struggling with the fear of a returning cancer: “to stand with her in the glare of fear.”

Watching both videos led me to a related TED talk by Rachel Fleishman, a pediatrician who facilitates similar conferences with her residents. I wish we had sessions like this when I was an intern or a resident. I understand how it can be viewed as absurd or even time-consuming for some medical students, especially in a system that asks us to do so much with so little time. These experiences come to us as threads, meant to create a tapestry. But, left unprocessed, they instead become a tangled jumble of pain and grief.

As we study medicine and immerse ourselves up to our elbows in medical jargon, we subconsciously create a walled city around us, inhabited only by the ill and those who take care of the ill. In this city, there are algorithms and protocols in place to maintain order. In this city, we speak only the efficient, depersonalized language of medicine, necessary for succinct and effective communication. Left unchecked, the discipline of medicine can distance us from both ourselves and from those we are meant to heal. But through these stories of illness, I am reminded that literature has the power to show us that these walls are porous, that algorithms and jargon can coexist with compassion and empathy. I wish we, patients and healthcare workers alike, could find space to breathe and express how we are and what we’re struggling with. Illness expands beyond its biomedical realm, affecting all the nooks and crannies of our lives, and it’s important to acknowledge that. Recognizing that reminds us to treat our patients as humans, with lives and stories beyond the clinic, even if that means simply standing with them in illness, in life, and even in death.

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Ella Thinks Aloud

The Walled City of Medicine

Reflections on medicine, storytelling, and a look back at the COVID-19 pandemic.

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