This essay is part of the Color of Long COVID series, supported by the Disability Visibility Project.
I was three hours into my internal medicine ward call when the brain fog descended like a curtain dropping mid-performance. I had just finished examining a patient with chest pain. It was a routine assessment; stable vitals, clear lungs, no red flags. I’d asked the right questions, performed a thorough exam, and reassured him we’d run tests. I walked back to the nurses’ station, sat down at the computer, and pulled up the list of patients admitted to the ward to add his clinical notes.
Blank.
The patient’s name had vanished from my mind. The clinical findings I had just evaluated were gone. I stared at the screen, heart racing, scrolling frantically through the patient list, trying to recognize which room I’d just left. I could picture his face, the afternoon light through the window. But the clinical details had evaporated in the short distance between the examination room and the desk.
I excused myself and reconstructed the encounter from fragments. The details returned in pieces. I wrote my notes and ordered investigations. But something had shifted.
For months, I had been managing symptoms I attributed to stress and burnout from the pandemic’s first wave. But at that moment in 2020, I understood that I had become the kind of doctor for whom our medical field has no infrastructure.
Medicine demands physicians be invulnerable, trained to push through exhaustion, to be helpers, never helped. But Long COVID shattered that illusion for a significant number of healthcare workers worldwide. The system lacks mechanisms to accommodate chronically ill physicians, without flexible scheduling, clear disclosure pathways, a framework for disabled doctors.
We face a choice: hide our limitations and risk our health, or disclose and risk our careers. If medicine cannot accommodate physicians disabled by the pandemic they fought, it will never truly serve disabled patients.
If medicine cannot accommodate physicians disabled by the pandemic they fought, it will never truly serve disabled patients.
The journey to a name
In March 2020 at Services Hospital, Lahore, Pakistan, wards overflowed with COVID-19 patients, alarms were relentless, colleagues were exhausted, but they pushed on. Multiple patients deteriorated within hours. I contracted COVID-19 during that first wave, then returned to work after two weeks of managing my moderate illness, believing I’d recovered. Many colleagues also contracted COVID-19. Some were hospitalized, some never fully recovered, though outcomes were rarely discussed.
A year later, in July 2021, the cognitive dysfunction began. At first, I told myself it was exhaustion from the traumatic work. But as months passed and symptoms worsened, that explanation felt increasingly insufficient. Months later, I found myself sitting at my desk, searching through medical journals. “Post-COVID brain fog.” “Persistent cognitive impairment after COVID.” “Fatigue months after infection.”
I found articles describing chronic symptoms after SARS-CoV-2 infection. The descriptions mirrored what I was experiencing: cognitive slowing, difficulty in processing information, and mental fatigue that intensified after exertion.
When I came across research from the Patient-Led Research Collaborative describing myalgic encephalomyelitis (ME) and post-exertional malaise (PEM), I recognized myself immediately — the delayed crashes after routine work, the loss of mental stamina, all Long COVID. The validation came with concern: This might be my new baseline.
The validation was accompanied by concern that this might not be resolved. It might be my new baseline. When I sought medical consultation, the response was cautious, with no definitive test. Like other medical providers with Long COVID, I was told it could be stress, burnout, or post-viral recovery. Give it time. Without clear diagnostic criteria, I received no diagnosis despite limiting symptoms. The system that trained me to diagnose couldn’t acknowledge what had happened.
The infrastructure that doesn’t exist
Medicine has no infrastructure for chronically ill physicians. I’ve learned this navigating four years across multiple institutions in Pakistan, from Services Hospital, Lahore, to Social Security Hospital, Sialkot.
In 2022, my symptoms became increasingly difficult to hide. I’d experience PEM after shifts but couldn’t change my schedule to rest. Eventually, I called in sick, telling my supervisor only that I was “unwell.” I didn’t mention Long COVID. No framework existed for explaining crashes, and I feared documentation.
I’ve never formally requested accommodations, not because I don’t need them (I do, urgently) but because there’s no clear process or established guidelines.
I have witnessed how chronic illness is discussed by other medical providers. During a break-room conversation in 2022 about a colleague whose hours were reduced due to health issues, the focus wasn’t on their well-being, but on their impact on the team. “Can they keep up with demands?” That conversation taught me that disclosure carries risk.
This does not happen only in Pakistan. In 2021, Ed Yong documented in The Atlantic how U.S. healthcare workers with Long COVID face similar dismissal. A 2012 British Medical Journal study confirms many doctors hide chronic conditions, fearing professional consequences. A 2026 study of a German hospital in Medicina found 11.8% of healthcare employees developed persistent fatigue 21 months after COVID-19 infection, with 3.2% meeting ME criteria.
When medicine frames accommodation as an inconvenience rather than a medical necessity, silence becomes self-preservation. Throughout my career, I’ve adapted informally by pacing myself, declining high-demand activities, and relying on written notes to compensate for memory issues. These self-modifications allow me to continue practicing but represent a significant decline from my pre-COVID health, requiring constant vigilance without support.
I suspect I’m not alone, though silence makes this isolating. I observe colleagues exhibiting patterns I recognize: leaning against walls during rounds, taking frequent breaks, avoiding stairs, and declining responsibilities. I cannot presume their health status. But what strikes me is how common these quiet adaptations appear, and how systematically we avoid discussing them.
What strikes me is how common these quiet adaptations appear, and how systematically we avoid discussing them.
What must change
Six years later, COVID-19 continues spreading, killing, and disabling people, but many of my colleagues ignore it. Last December, a colleague said, “We can’t keep doing this. COVID is basically over.”
This exhaustion is understandable, but it neglects those still living with consequences and the inconvenient reality of the virus. How do I request accommodation when mentioning COVID-19 makes people uncomfortable? “COVID fatigue” has made discussing Long COVID professionally unsafe.
Breaking this silence requires active institutional intervention. Medical institutions must educate staff that Long COVID is a disabling condition affecting up to 40% of healthcare workers who contracted and continue to contract COVID-19 while working in hospitals that have failed to control the spread of the virus and other pathogens.
This education must extend across all levels: integrating post-viral conditions into medical school curricula and training all staff to recognize accommodation needs. This should be mandatory, delivered through grand rounds, department meetings, and communications explicitly naming Long COVID as an occupational risk. The silence will break when institutions make it professionally safe to acknowledge COVID-19’s ongoing impact.
Medical systems must create flexible scheduling to accommodate chronic illness, allowing start time adjustments and workload modifications following symptom flares rather than expecting consistent performance. Financial protection is equally critical. We need extended paid sick leave for chronic conditions, disability insurance that recognizes Long COVID, and income protection that doesn’t force all-or-nothing choices between full capacity and departure.
Infection prevention, including improved ventilation, high-quality masks, and policies protecting healthcare workers, remains critical. COVID-19 continues to circulate, and reinfections worsen Long COVID. If medicine can’t retain healthcare workers disabled by the virus, what does that say about our commitment to those whom we serve?
We’re here, we’re still practicing, and we deserve better than silence and self-management. Medicine asked for our bodies. It’s time medicine made space for what became of them.
We’re here, we’re still practicing, and we deserve better than silence and self-management. Medicine asked for our bodies. It’s time medicine made space for what became of them.
Mustafa Talat is an internal medicine resident working in a tertiary care clinical setting in Pakistan, with more than five years of clinical experience. He is also a medical writer who creates clear, evidence-based content for clinical and healthcare audiences.
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