Jabre Millon, third-year med student at UNLV, poses for a photo at the UNLV Shadow Lane Campus Wednesday, Feb. 23, 2022.
Sunday, March 6, 2022 | 2 a.m.
Sami Mesgun trails residents and fellows at University Medical Center for his two-week rotations as a third-year medical student in UNLV’s Kirk Kerkorian School of Medicine.
Hoping to specialize in internal medicine after school, Mesgun says the immersive rotations make him privy to the practice of preventing, diagnosing and treating adult patients. The experience also gives him a firsthand look into the frustrations full-time health care workers in Las Vegas are feeling right now.
“Health care workers are having to put up with a lot of demands in their day-to-day work,” he said. “I’m more inspired and want to be a part of that change, to kind of be a part of that movement, that fight to advocate for health care workers, better treatment and ways that we can reduce burnout.”
Intensive care beds in Nevada were approximately 90% occupied in January because of the surge in cases brought on by the omicron variant of the coronavirus. Hospital staffing issues also placed Southern Nevada hospitals at “crisis” levels for four consecutive weeks, according to the Nevada Hospital Association.
Hospital workers in Southern Nevada and around the United States reported feelings of exhaustion because of the psychological trauma they bore while on the front lines in the battle against COVID-19. They cared for critically ill patients in intensive care units, were burdened by unknowingly infecting patients or family members and feared being infected themselves.
A 2020 Medscape survey found about two-thirds of American doctors were burnt out during the height of the pandemic. About the same number of U.S. responders recorded a decrease in their incomes, and several doctors reported an increase in stressed family relationships and feelings of loneliness.
As a result, there was an increase in the number of doctors quitting or retiring early. Approximately 25% of U.S. doctors in the Medscape survey said their pandemic experiences led them to quit the field.
But watching these incidents through his rotations did not deter Mesgun from the profession, he said. Rather, it reaffirmed his reason for being in medical school in the first place: to help other people.
He wants to be a gastroenterologist, he said, a profession he is concerned will be affected by patients’ fears of contracting COVID-19.
Fewer patients coming in for screenings of treatable diseases like colon cancer could create further disparities for underserved groups, he said, like Black Americans, who suffer from colon cancer at higher rates than other racial groups, according to the American Cancer Society.
“I’m looking forward to working in the hospital and collaborating with different specialties and learning from them so that I can be a better doctor myself,” Mesgun said. “It makes me sort of feel empowered to be a part of that group that tries to make a difference.”
Marc Kahn, dean of the medical school, said the students he spoke with at the start of the pandemic were frustrated they could not do more for sick patients.
“As I get older, you know, I’m going to need doctors to take care of me, and one of the rewarding parts of what I do is really training the next generation of folks that are going to care for myself and the rest of the community,” he said. “By and large, medical students go into this because of this sense of wanting to help and wanting to care.”
Other UNLV medical students feel just as driven to serve their part during the pandemic, drawing on their resolve to assist those in need. Often their hospital rotations during the pandemic directly emboldened their pursuit of the profession. For third-year medical student Jabre Millon, both cases are true.
Once medical students hit their third year, they trade the classroom for hospital hallways, participating in rotations that shift every two weeks. The students maneuver between surgery, psychiatry, pediatrics, internal medicine, family medicine and OB-GYN, and they spend four to six weeks in each specialty by the end of the year.
“Most of us can agree that we set upon this path to help people,” Millon said. “It’s hard to see, you know, the suffering and pain that people go through. At the same time, we are inspired to do our best.”
Third-year medical student Jacob Berkowitz is currently doing an infectious disease rotation at UMC, where he said he primarily worked with immunocompromised individuals. He worked at the hospital last summer, when the delta variant spiked in Clark County, he said.
“It was very interesting to see it firsthand,” he said. “You would wake up in the morning, and you’d read a news story in the Times about this or that, and then later the day, you’d see that stuff in action in the hospital.”
In March and April last year, Mesgun said that UNLV students were not permitted to work with ICU COVID patients at UMC to limit exposure. That policy was adjusted so students like Mesgun can work with patients who have COVID pneumonia, a complication of COVID-19 that hospitalizes patients but is not serious enough for ICU placement.
“You just hear stories about it and you’re seeing it in real life, how … (hospitals) are full of patients who are on ventilators,” he said. “Treating COVID, it’s a public health issue. Everyone has to be on board when it comes to the preventive and precautious measures, when it comes to trying to reduce spread of the disease and, you know, reduce your own risk of contracting severe COVID.”
Fourth-year student Kathie Velez said her rotations at UMC last year were focused on supporting patients’ mental health as well as their physical health, especially because visitors were not allowed into the hospital.
“Someone that’s sitting in a room by themselves, you know, they just kind of get depressed over time, regardless of what their physical health may be,” she said. “It was really important for us to give that extra bit of time and attention to patients because we’re able to come in and out and they’re just stuck in the hospital.”
Velez recalled conversations with peers back in March 2020, when they wished they had started medical school earlier and could be involved in tackling COVID-19 early on. Since then, she worked at the UNLV COVID-19 call center — where she and other medical students, residents and attending physicians answered calls, listened to community members’ concerns, scheduled COVID-19 testing and answered questions about the virus — a key experience when doing her rotations, she said.
“A lot of people were expressing their concerns, and they were letting me know how lonely they were and how I was the only person that they would sometimes talk to for the entire week,” she said. “I was really just there to listen, and so when I started my clinical rotations at the hospital, it was pretty similar to that, so I think it prepared me for it pretty well.”
Medical students play an important role at UMC and have excelled in these capacities, said Dr. Angie Honsberg, director of the medical ICU at UMC. Honsberg said fourth-year students, who can do ICU rotations, are in uncommon positions as medical students — where they have learned both the basic approaches to medicine as well as how to work during a pandemic.
Honsberg worked in Philadelphia as a hospital fellow in the late 1980s during the HIV epidemic. When comparing her experiences treating HIV patients with ICU COVID-19 patients from the past two years, she was struck by students’ readiness to serve, especially when treatments were unknown and vaccines were not available.
That inclination, Honsberg said, was not always the case for medical students or fellows during the HIV epidemic, when health care workers avoided treating HIV patients due to the stigma surrounding the disease and out of fear they would contract it.
In the same Medscape study, just half of U.S. respondents said it was a physician’s obligation to volunteer to treat COVID-19 patients. But Honsberg’s ICU team at UMC did not hesitate during the pandemic, and neither did the medical students, she said.
“I trained in an era where you just had to accept that there wasn’t treatment, and that there was essentially very little you could do for patients,” Honsberg said. “The students that I’ve worked with, I’ve been impressed by how willing they are to see patients, where initially we just didn’t know, how infectious is this?”
Justin Jeffries, a second year pulmonary and critical care fellow at UMC, said that when he started his fellowship, he felt a responsibility to care for COVID-19 patients — a realization that did not make the work any less frightening.
“Patients were getting ill, and we didn’t have a way to prevent it,” he said. “Some people were very cautious and were still getting very sick. It was a very tough time mentally. Now, with more options, it’s been easier.”
Honsberg also said UNLV students may be less fazed by the severity of the disease because they saw a combination of acute cases in hospitals as well as mild ones among other students, friends or family. ICU nurses and doctors, on the other hand, saw a selective pool of very sick patients, she said, a disturbing image to see constantly for two years.
For Berkowitz, the severity of the pandemic scared him at first. But, like his peers, the necessity of public service propelled him forward.
“I think, in a way, it kind of freaked me out at first because (COVID’s) very real, and it’s very serious, and if something like this happens in the future, I would have to be working during it,” he said. “But it also kind of makes you realize the doctors and the medical profession in general is very good at kind of meeting crisis head on when it needs to, and I think that’s kind of the general thought we all have.”
