Should I Go or Should I Stay?

I am sick and tired of COVID!

We are all sick and tired of COVID!

And we are all sick and tired of not seeing our friends….

So how do we decide if we should go to that big dinner or an out-of-town meeting in this complicated world of COVID-19? This is a classic ethical dilemma…and there is a tool kit* you can use to come up with an answer. 

Step 1: Assess the information. What do you know and what do you need to know?

The first question to ask is “Who are the parties involved?” If you are deciding whether to go to an event, It clearly affects you and the other people who might be going to the event, but who else will be affected by the final decision? 

The next two questions in this step are straightforward: What do you know? What else do you need to know?

Step 2: Think out of the box.

Every ethical dilemma has a “yes-no” answer, in this case to go or not to go to the event. But what other actions might be possible? Limit the number of people? Require testing and/or masks? Is there an option to participate virtually? This step should be a serious brainstorming exercise to explore ANY possible option (if you do it right, there will be some things on the list that sound almost crazy). 

Step 3: Consider the Appeals

This is a fancy way of saying how do the possible choices fit with your values and what we, as a society, think are virtues?  

Considering the appeals starts with a simple question – “Is there a rule?”  For example, does your employer have a rule limiting travel during the pandemic?  Are you traveling to a state that has a law prohibiting mask mandates? 

The second question in this process is “What could go wrong?” What are the possible consequences of each option? If one option is to pay a little extra to be able to get a refund on your plane ticket, it’s probably not going to be important in making your final decision. But if it turns out that your decision might lead you to inadvertently infect your 70-year-old mentor with COVID, that’s more serious. Once you get a list of all the possible consequences try to put them in order of significance by asking if they are serious, irreversible, and/or likely. 

The third question is “Which choices have more virtue?”. Which ones are more likely to reflect what we, as a society, think are behaviors and motivations that good human beings demonstrate? Most of us will agree that compassion, courage, self-sacrifice, legitimately protecting ourselves, integrity, and honesty are virtues, but there may be others that are important to you. Here is a link to see a long list of virtues to consider. 

Step 4: Decide

It’s time to decide. Look at all the objective data (step 1), the list of possible actions (step 2), and which of the actions has the most virtue (step 3). Some of them will have more weight for you than others. That’s not only ok, it’s important. We may come to different conclusions, but using this process, we will both know why.

Step 5: What could have been done to avoid this in the first place? 

This step won’t change your current dilemma, but it will help you and others with future decisions. 

Let’s assume you’ve been invited to speak to a group next month. It’s an honor, and it’s a talk you love to give! But we are in the middle of a pandemic… should you say yes? 

Step 1: Assess the information

Who are the parties involved?

You, the organizers, the people who will (or won’t) hear your talk, the people in your life you might infect if you get COVID, your work partners, the organization you work for.

What do you know? 

It’s an honor to be asked, so this is good for your career. You love this topic and you really want to give this talk. The number of people who will be at the meeting (based on past meetings) will be between 700 and 800. Given the demographics, it’s likely that >95% of the people at the meeting will be vaccinated. You are vaccinated and boosted. The state they are holding the meeting in has a law prohibiting mask mandates and the organization has not put out any directives about masking or testing. The state they are holding the meeting in has an unvaccinated rate of … % and a COVID prevalence of … %. (Here’s where to look up these data.) There are people in your professional and personal life who are at high risk if you were to inadvertently bring COVID back to them. 

What do you need to know?

Have the organizers addressed the issue of the mask mandate?  Are the organizers going to require masks? Testing?  Does your employer have rules or recommendations about travelling?

Step 2: Options

The obvious

  • Go to the meeting
  • Don’t go to the meeting

The not so obvious

  • Go to the meeting
    • But just for the day you are presenting and don’t attend any other sessions
    • Go but avoid social gatherings and wear a N95 all the time
  • Don’t go to the meeting
    • Ask if they would consider a hybrid meeting so you can present virtually 
    • Record your presentation so they can show it during your session

Step 3: Appeals

  • Rules/laws: The law in the state to not mandate masks should be addressed by the organizers of the meeting, but you can choose to wear a mask regardless. There aren’t any other obvious rules or laws that apply (unless your employer has restrictions on travel).
  • Consequences. If you go to the meeting you might contract COVID (possibly serious, only remotely irreversible, possible but not likely). You could bring it home to others (possibly serious, only remotely irreversible, unlikely). If you are sick there will be a burden placed on your work partners (could be serious, not that likely)  If you don’t go to the meeting you might lose your status in the organization (possibly serious, only remotely irreversible)
  • What is the most virtuous thing to do? It may make the most sense to ask if the organizers will allow a hybrid approach so you can present virtually – or if they would let you record your presentation. But if those aren’t possible, you’ll need to decide if you are going or not. If you go to the meeting you are showing integrity (You said you would do it, so you are following through) and self-sacrifice (The organizers thought you had something important to say, so you are willing to take the risk). If you don’t go to the meeting you are showing legitimate self-interest (protecting yourself), compassion (for the family and friends you might inadvertently infect).You are also showing care and respect for your work partners, who would be burdened if you were to become ill. 

So… do you go or do you stay? 

*To give credit where credit is due: The process described above is a slightly modified version of the “Ethics Workup” originally developed by the faculty of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. 

Residency Interviews Part 1: Your Suitcase

It may seem kind of strange to write a post on just suitcases, but bear with me. For many medical students, the trips they will make for residency interviews will be their first real “professional” travel. If you haven’t traveled a lot, you don’t know everything that can go wrong…. So here are some rules to help you.

p.s. I’m doing this first in a series of blog posts on how to interview in case anyone needs to drop a hint that they need a new suitcase (and possibly new clothes) as an early holiday present.

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Rule 1:  Try not to check your bags

Make it a goal that no matter where you go (or for how long ) you will always have what you need in a carry on suitcase. I went to Russia last year for two weeks – in the winter – with two carry-ons. Once you practice this, it’s not hard.

Why bother? What could go wrong? Just ask around. It won’t take long until you hear the story of someone who to ended up at an interview in New York when their bag was in Nebraska. Which brings me to rule 2.

Rule 2:  Assume you will be sitting next to the chairman of the department on the plane.

You don’t have to wear “interview clothes” on the plane but don’t have on anything that you would regret. It is really remarkable how many times you will end up sitting next to someone you will see the next day in your interview…. or someone who lives next door to your future program director.

Rule 3:  Have clothes in your small carry on bag that you could use in a pinch to interview. Ditto your toothbrush, razor, etc.

Even when you plan to carry on your suitcase, there are times you get on last and there is no room for your bag. Although it’s unlikely, it’s not impossible they will mess up and your bag isn’t there when you arrive. Think ahead. Pack your shirt, tie (or female equivalent) in a small travel “folder”. Put it in the outside pocket of your suitcase so you can grab it if your bag can’t be checked.

Rule 4:  Make a travel checklist and go over it before you leave to make sure you have everything. 

This is something you learn the first time you get to a meeting and you don’t have a jacket to put on in the cold room. I’ve put the outline of the one I use at the bottom of this post for you to modify for your use.

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The next thing to do is make sure your suitcase is appropriate. Residency interviews are often a catalyst for buying a new suitcase. This is a good time to ask for an early holiday present if you need some help to buy a good one.

Options for suitcases

The regulations for suitcases vary a little by airline, but the take home message is get a suitcase that is 22 inches tall and not too wide if you plan to carry it on the plane. There are many other options, but the two companies that have really focused on good quality, lightweight carry-ons are TravelPro and Eagle Creek. TravelPro suitcases are used by pilots and flight attendants, which tells you a lot. I personally like Eagle Creek because of their packing system. There are other companies, too, so look around.

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How to pack without wrinkles

One way is the Eagle Creek system, but there are others like wrapping your clothes around a bag with smaller items, rolling your clothes and using plastic covers, and packing little items around the bigger ones to avoid movement.

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How to get more things in the suitcase

Think of packing like a puzzle.  Put all your clothes on the bed to start with, then fill in spaces.  For example, pack your socks in your shoes.  Roll up workout clothes to pack in the edges.  But – unless you want wrinkles – don’t overpack.

Here’s a great video on how to pack more clothes with less wrinkles – seriously, watch this one.

Your “other” carry on bag

You’ll need to carry something with you when you interview for your papers and to collect the things they give you. This is a good time to carry something a little more professional than a back-pack. At a minimum, have a portfolio or a nice, small briefcase.

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For the plane, choose a carry on bag to carry your folio, the “emergency” interview clothes, whatever you are reading, your music, etc. These carry on bags, which often match the luggage, are designed to have as much room as possible but still fit under the seat.

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Travel Checklist (as promised)

Interview/meeting clothes

Suits/business wear x ___ days

Undergarments

Sweater/fleece (cold rooms?)

Heavy coat, scarf, gloves, hat?

Small purse/briefcase

Might need for some locations

? formal wear

? rain wear

? umbrella

? Passport

? Sunglasses

? cap

Toiletries

Toothbrush/toothpaste

Deodorant

Hair product

Hair brush

Razor etc

Sun screen?

? Extra glasses

? contacts

Workout

Gym wear

? Swimsuit/goggles

? exercise bands

Miscellaneous electronics

Computer/cord/plane power cord

Kindle/cord

Phone/charger

Pad/charger

(Rental car? – phone charger)

For the plane

water bottle

neck pillow

snacks

Attending Medical Conferences

When you first start going to professional meetings, it’s easy to feel a little awkward.  If you are a student or resident, you will hopefully be with a faculty who will be able to act as a guide for you.  But, if the attending doesn’t make it (or isn’t really helpful) you may find yourself on your own… so I thought some guidance might help.

Go to the meeting. 

This might seem a little obvious, but if your department or school is paying for you to attend a meeting, you should attend the meeting.  If it’s your own money… you should still attend the meeting. This is part of being a professional. Your peers have put a lot of work into their presentations.  Put yourself in their shoes – and stay to hear their talks. Stay engaged during the sessions.  Don’t be the person in the back row surfing the web on a smart phone during the entire conference. Listen actively and ask questions.  If you ask good questions, people will notice and it will reflect well on you.  However, be gracious.  Always thank the speaker for what they said, and don’t be antagonistic when you ask your question.  That will be noticed, too, and not in a positive way.

Look like a professional.

No matter where you are in your training or practice, you will be making a first impression on people who may play a role in one or more of your future position(s). Start off with a suit and tie (or the equivalent for women) the first day.  If you are a woman, make sure you dress as if you are going to an interview – not a party.  If everyone else shows up in jeans the first day, move to more casual wear… starting the second day.  Don’t dress down too much – even if everyone else is doing it.  It’s never wrong to look professional at a professional meeting.

Take advantage of the social events.

Even though it is tempting to sneak off with a couple of our friends and skip the evening reception, don’t do it.  The social events are where you meet the important people in the field.  If you have time, do a little homework about who is attending the meeting and where they are from – just to be able to start a conversation.  Most of the “celebrities” in the field are delighted to talk to people in training, so don’t be intimidated.  You’ll also meet peers at your level at these meetings who will become lifelong colleagues and friends. Introduce yourself to people you don’t know!  If you are invited to dinner or if there is a formal banquet associated with the meeting, you’ll feel awkward if you don’t know the basic rules (like what to do if there is more than two forks).   If you aren’t familiar with formal dinner etiquette, here’s a great site to learn what to do:  Dining Etiquette Guide.

Be fiscally responsible.

Just because someone else is paying shouldn’t mean you pick the most expensive restaurant and order the most expensive items. If you come in under budget people will notice. If you turn in receipts over budget, they will really notice. Save all your receipts, and turn them within a few days of returning.  It’s always a nice touch to thank the people who paid for you to attend the meeting, either in person or with a note.

Reading maketh a full man; conference a ready man; and writing an exact man  –  Francis Bacon

Attending Professional Meetings for Beginners (a previous post on Wellness Rounds)

Handy hints for attending national meetings from KevinMD.com