A woman wearing black standing in a brightly lit city street
“They need us,” said Dr. Gabriela Ulloa ’15 in early April. “And if they need us, I’m going to be there.”

Usually, New York University medical school students graduate in a ceremony at Lincoln Center, walking across a stage in front of adoring friends and family. But on April 3 of this year, more than two months early, 52 of those students—including Gaby Mayer ’16 and Gabriela Ulloa ’15—sat in front of their computers and graduated over WebEx. Students across the country participated in similar ceremonies.

It is one thing to have our meetings online, quite another to leave school early and take a life-altering oath, something you’ve been working 
toward for at least eight years, against the inevitably blurred gallery view on your computer screen. And yet, here they were reciting the Hippocratic Oath, their words indistinguishable, jumbled and jangled, punctuated by giggles at the absurd 
dissonance between what they had thought graduation might be and what it was. As all the voices dragged to a finish at the end of the oath, there came the voice of Robert I. Grossman, dean of NYU’s Grossman School of Medicine, saying, “Congratulations, doctors!”

After perhaps the most anti-climactic ceremony ever, they were doctors, soon to report to the front lines of the largest coronavirus outbreak in the world—New York City hospitals.

For these young doctors, heading into the fire to fight the coronavirus pandemic wasn’t so much a decision as a duty. In March, when Mayer first heard government officials float the idea of letting medical students graduate early, she emailed her dean to ask how she, as a fourth-year student who had completed all of her requirements, could help. The school reached out to all fourth-years to gauge interest in graduating early and going into the hospitals. Within a day, they had enough replies to move forward.

The move isn’t completely without 
precedent—medical schools shortened programs to three years during World War II to help counter a physician shortage—but it’s certainly not usual. In fact, the 
Accreditation Council for Graduate Medical Education, which accredits residency and fellowship programs, came out against the decision in April. “Except in unusual or exigent circumstances, the ACGME does not recommend the early graduation of medical students,” they said, making it clear that as of April 3, they did not consider these to be either unusual times or exigent circumstances.

But the schools persevered, and hospital systems figured out how to thread the needle between medical student and not-yet-resident. At NYU, they are considered junior interns, while Columbia calls them Early Graduate Non-Resident Physician Voluntaries. “Your choice to join us in this fight is inspirational,” Steven B. Abramson, NYU executive vice president and vice dean, said during the graduation ceremony for Mayer and Ulloa. “We salute your courage and dedication, and we look forward to working closely with you in the coming months as members of what we now call the COVID Army.”

From the moment she learned of the program, Maggie Bogardus ’15, one of Columbia’s early graduates, “immediately felt: If I can help, I want to and I need to.”

“They need us,” added Ulloa in early April, ambulance sirens punctuating the background of our call. “And if they need me, I’m going to be there.”

Few doctors ever spend their first weeks in such an environment. For one thing, in April at Bellevue Hospital, where Mayer and Ulloa now work, every patient on their floors had COVID-19. For another, there are no daily conferences to talk through cases, no running in or out of a patient’s room if they forget something. By design, none of these new doctors is working in the ICU or assisting in the room with “super-spreader events,” such as 
resuscitations or insertions of ventilators. But even so, their 
patients are sick, and the work is vastly different from before.

As a medical student, Mayer enjoyed what she thought of as her afternoon “social” rounds—talking with patients about their lives and families. “You always learn something useful for their medical care,” she says. Visits like that don’t happen now. Before going into a patient’s room, she dons an N95 mask, a face shield, a gown and gloves. There is a newfound cognizance of how many times someone has been in a patient’s room and a collaborative effort to minimize those numbers. In their first weeks at Bellevue, Mayer and Ulloa worked with nurses to do more procedures than usual each time they went into a room, so someone else didn’t have to go in a few minutes later.

Every day, they try to make a connection with each of the four to seven patients they are in charge of. Even all geared up, her face practically hidden, Ulloa talks football with her patients; the week we spoke, the talk was of Rob Gronkowski’s trade from the Patriots to the Buccaneers to play with Tom Brady. “It’s a way of bringing some normalcy to this abnormal time,” she says. (It’s hard not to think that Gronk, football’s everyman, would enjoy that idea.)

After every patient interaction, Mayer and Ulloa spend two or three minutes “doffing” their PPE. First, the gown is torn off and rolled up inside out. The gloves are stripped off in a specified way, wrapped in the gown and thrown away. Then hands are washed or sanitized. Once the 
doctor is outside the room, the face shield is removed and wiped down on both sides. Mayer’s was constructed for her by NYU medical students, and she and others put them on upside down to dry, like the hat of “a weird pope.” Back in the on-call room, they carefully remove their masks, which they’ll reuse, and place them in paper bags with their names on them.

The precautions continue at home. Ulloa puts her shoes, badge, bike helmet and backpack into a cardboard box by the front door of the apartment she shares with her husband. She removes her scrubs and carries them with her directly to the shower. Her apartment has no washing machine, and she doesn’t want to risk exposing anyone to the virus by taking her scrubs to a laundromat or sending them out, so she washes them in the shower with her and hangs them to dry.

A woman in a green shirt standing under a city overpass with her hand on her hip
“You swing from overly idealistic, to overly scared, to right in the middle,” says Dr. Gaby Mayer ’16.

Alongside these doctors’ strong sense of duty is a healthy sense of fear. “You swing from overly idealistic, to overly scared, to right in the middle,” Mayer says. And the situation itself is constantly changing. When she accepted the position at Bellevue, for example, the hospital faced a massive shortfall of personal protective equipment. By the time she began the job, the hospital had acquired enough. “We aren’t using one mask per patient like we used to,” Mayer says. “But there are enough gowns and gloves. I used two masks last week and felt that was enough.”

Their worries are about more than coronavirus exposure. Graduation and orientation are somewhat ceremonial, of course, but they also serve as markers of transition and transformation. These doctors have moved into a new career abruptly and without formality—student one day, doctor the next. “This is the first time someone is saying you are qualified to do this, and you worry: Will I actually be helpful?” Bogardus said in April, as she waited at her parents’ home in Connecticut to find out her assignment at New York Presbyterian. (Ultimately assigned to the hospital’s analytics team, she is helping to create COVID databases that will lead to better understanding of the disease and its health effects.)

The sudden transition can be exciting, too. “I had a moment of realizing, ‘Oh my God, I’m a doctor,’” Ulloa says. “It really hit me when I was able to discharge my first patient without anyone needing to check my orders.”

When we first spoke this spring, Mayer was heading from our call to a weekly call with her seven closest Amherst friends, and then to read a 50-page Google Doc assembled by the residents at Bellevue. It included their best guesses at algorithms and protocols to guide patient treatment in a pandemic where “the apparatus that creates evidence-based medicine doesn’t work fast enough.” The virus is new, it manifests differently in every patient, and this has all happened so quickly that there is a limited body of evidence to rely upon.

Mayer expected that the practice of medicine—figuring out how best to treat COVID-19 patients—would be hard, and also that it would be tough to see these patients so sick, humbled and disoriented by their medical odyssey, especially those who’d come off ventilators. But quite often, she quickly learned, these patients’ most pressing questions are not about the intricacies of their medical care but about pedestrian concerns. She tells them, “This is amazing! You are asking when can you leave? Do you know how happy I am to have you asking about breakfast?!”

Image
A woman in a face mask wearing a black medical uniform in a city park

Ulloa feels a duty to work with medically underserved populations.

Ulloa has wanted to be a doctor since she was a kid. “There are pictures of me when I’m little with my Big Bird,” she says, “putting millions of Band-Aids all over it.” She came to Amherst for its pre-med advising and made use of the summer internship program funded by the College’s Loeb Center for Career Advancement and Planning, working in primary care, radiation oncology and finally at a clinic in Peru. Health professions adviser Richard Aronson ’69, who chose Ulloa for the Peru internship, notes that she helped start a student group, Project SALUD, that partners with the clinic.

“Amherst made me, and my colleagues, very cognizant of the duties we took on when we entered medicine,” Ulloa says. “I felt a duty I owed, especially being Hispanic,” to work with medically underserved populations—in particular, women and children. Ulloa was drawn to pediatrics in part because caring for children can run the gamut from routine to critical. “You have that population that is very resilient, very funny and also can have 
a range of emotions. And I love dealing with parents.” In late June she starts her residency at Bellevue in pediatrics.

Bogardus, in turn, will begin an obstetrics and gynecology residency at New York Presbyterian. She chose ob/gyn because of the versatility of the practice and her desire to create a substantive change in a specialty with research gaps and health care inequities. “Amherst encouraged me to think beyond the individual,” she says. “The ability to look beyond oneself and challenge what I see will have a direct impact on my patient care and help me focus on treating the person, not just what the tests say.”

Mayer believes their Amherst education has helped these new doctors quickly grasp the “art side of medicine.” She fulfilled her pre-med requirements while majoring in art history. “A lot of the things I value, who I am going to be as a doctor, the kind of career I want, started at Amherst,” Mayer says. “We talk a lot about the ways in which our Amherst education geared us up especially for working at Bellevue with underserved people and underserved communities. [It helped us] to think about the forces that shape what makes certain groups of people have significant barriers to care.” (Eighty percent of patients at Bellevue, the oldest public hospital in the United States, are from medically underserved populations. No one is ever turned away for inability to pay.)

Mayer will stay at Bellevue for her residency in internal medicine/primary care. She hopes to start a queer women’s health clinic: “Health care disparities writ large is where my eyes start to sparkle, and I start thinking about problems I can solve.”

It remains to be seen how these weeks of fighting coronavirus will affect her 
future plans. “There’s a generation of doctors—whom we learned from—who came up in the AIDS epidemic,” Mayer says. “We are the COVID generation.”

There was a moment in March and April when the world, and New York City within it, were so different from what they had been as to be almost unrecognizable. There was more demonstrable good in the world than one sometimes saw: people staying home to protect others, grocery deliveries for neighbors, an adoration for health care workers. (While Ulloa was biking home in her scrubs one night, a woman on the sidewalk yelled, “Thank you for all you are doing!”) But there was plenty of bad on view as well: governmental mistakes and infighting, gulfs between the haves and have-nots. According to APM Research Lab, black Americans are dying of COVID-19 at twice the rate of white Americans. In some states, that rate is seven times as high. The pandemic has put a stark face on health care inequalities, just as the protests that swept the nation in May and June 
following the killing of George Floyd are shining a bright and necessary light on the systemic racism that leads to police brutality and these exact inequalities. “This 
disease is showing us the cracks in our health care system,” Mayer said when we spoke in April. “If you shake things up, hopefully some good will come out of it. I’m choosing to be optimistic.”

It is hard to imagine how our society will look on the other side of this pandemic. Viruses are humbling, reminding us that, as technologically advanced as we may be, we remain physical beings, tethered to the masses of cells that make up our vulnerable bodies. Now more than ever, these bodies depend on health care workers in order to survive. Whether they are young or old, new or experienced, whether they graduated onstage or online, every doctor
working today is upholding an oath to, with all due respect to Hippocrates, fight like hell to save us. That alone feels worthy of some optimism.


Elizabeth Chiles Shelburne ’01 is the author of the 2019 novel Holding On to Nothing. Her nonfiction has appeared in The Atlantic, The Boston Globe and elsewhere.

Photographs by Beth Perkins