Unmasked and Relieved: I Can ‘See’ My Patients Again

The pandemic has affected everyone in the world in one way or another. There is probably not a single person who hasn’t had COVID-19 or knows someone who did. For health care professionals, we had additional battles.

When most medical practices went virtual and switched to telemedicine, we decided to keep our clinic open for in-person visits. It is hard to believe now that we went to work every day during the peak of the pandemic. While we did offer telemedicine visits, most people wanted to come in, as we were the only place that was doing in-person visits. We saw our volume go up as many people transferred their care to us; they preferred to wear masks than to lose human-to-human interaction. To be honest, I preferred in-person visits as well. With telemedicine visits, it was challenging to monitor the side effects of psychiatric medications. The only positive aspect of virtual visits for me was that I sometimes got additional insights into a patient's life by looking at where and how my patient lived.

Until recently, we were still wearing masks. When the decision was finally made to take off masks after meeting the clinic criteria, we saw patients’ entire faces, some for the first time, and they got to see ours too. Many of the new patients appeared completely different from what I had imagined—my brain had filled in the gaps and completed the lower half of their faces. I was shocked to find out how wrong my mental images were. I am sure patients must have had a similar reaction when they saw the bottom half of my face.

Aside from not fully knowing how a patient looked, I realized that not being able to see the lower half of the face had medical implications too. We rely on subtle facial clues to pick up medical side effects, such as tardive dyskinesia. After unmasking, I recognized many more cases of tardive dyskinesia than before. For the patients who started seeing me after the start of the pandemic, I could not confidently determine whether the symptoms were present from the beginning.

I am relieved that I can once again make full face-to-face connections with my patients. I am glad I do not have to worry about subtle clues about medication side effects. The removal of the mask taught me to be more vigilant and appreciate the beauty and art of observation that we so heavily rely on. ■