Finding Healing, Inspiration, and Peace of Mind Through Service

By Justin Fiala, MD
Published: April 7, 2023

Amid the wave of hospitalizations caused by the delta variant of the SARS-CoV-2 virus in the winter and spring of 2020 to 2021, I saw a familiar pattern of racial disparity among the patients coming through the intensive care unit I was working in, and it left me increasingly uneasy.

The frenetic pace of the unit served as its own distractor. I’d get through the days without much processing of the despair unfolding around me. But in my time off, I’d find myself in an increasingly dark headspace, made all the worse by the inescapable barrage of misinformation coming from all angles.

Where was the general public’s sense of empathy and altruism? And if that were too much to expect from the public, how about our elected leaders? From the vantage point of a frontline worker, the answers were bleak: Concern and accountability for others seemed to be in short supply outside the hospital.

Unsurprisingly, being a health care worker throughout the pandemic has been exhausting, frustrating, and destabilizing. And in the winter of 2020, I found myself trapped in the negativity of it all, perpetually mourning the loss of faith in societal institutions that had once seemed steadfast on top of all the tangible loss of life that continued to rage around me.

“Well, what are you doing about it?”

I sought out therapy as well as creative outlets, including rekindling a love of oil painting I’d picked up in my youth. Though they were crucial pieces of my healing process, at the time, I recall feeling like something was still missing. No doubt it helped to articulate the source of my strife and to have an artistic way to work through the frustration, but neither addressed the deep unease I felt when faced with the prospect of existing in an uncaring society.

One night while lamenting to my then-husband, he nonchalantly fired back, “Well, what are you doing about it?”

Once I got past the knee-jerk defensive response, I started ruminating on the deeper meaning of the question. If the root of the problem was a feeling that society was broken, rife with inequities, and devoid of caring people, then perhaps the onus was on me to make positive, tangible change in whatever way I could.

student and instructor looking at laptop

“Moving On,” 16 in. x 20 in. oil on canvas by Dr. Fiala

The thought spurred me to reach out to a local community clinic I had volunteered with a decade earlier as a medical student and led to the founding of a free sleep clinic, the CommunityHealth Initiative for Patient-centered Apnea Protocols (CHI-PAP), which brings comprehensive sleep care to patients who may otherwise be unable to access care.

Starting and sustaining the free sleep clinic has by no means been easy. Still, every time I’m there, I’m surrounded by other altruistically minded individuals volunteering their time to help the most vulnerable in our society—a tangible refutation of my catastrophized view of the world as being devoid of good people. Moreover, bringing sleep health (and quality of life) to people in need, all without the red tape of insurance and durable medical equipment companies, has reaffirmed my sense of purpose as a physician. For as much as I may think I hate my job on certain days, it’s generally due to nonmedical/bureaucratic issues that simply don’t exist when I’m at the free clinic. To be sure, it’s a challenge operating outside the insurance ecosystem, but I’d rather spend my time and effort figuring out work-arounds than waiting on hold for a prior authorization denial.

Perhaps most importantly, amid the unpredictability of the pandemic and the accompanying sense of helplessness that many of us still feel in its wake, being able to change an area of health inequity directly has been incredibly empowering and paradigm-shifting. This is not to say that altruism and community service are a panacea for the various ills exposed by the pandemic. Rather, it’s an acknowledgment that, for many of us, they were tenets of why we chose a career in medicine and a reminder that they can still be called upon for mooring when we feel marooned by the chaotic forces around us.

With a bit of subject matter expertise and a lot of heart, each of us can have a meaningful impact on our patients’ lives and make the world a healthier, more just place.

Providing comprehensive sleep care to Chicagoans in need

CHI-PAP works in collaboration with CommunityHealth, one of the country’s largest 100% volunteer-staffed free clinics, to provide comprehensive sleep health care to under-resourced patients in Chicago. Care includes offering at-home sleep testing to help close diagnosis gaps in sleep apnea and other sleep disorders; providing donated, recycled, or refurbished devices to uninsured or underinsured patients; and helping to preserve existing safety nets by helping to coordinate care with other providers. Learn more about recycling sleep equipment and the CHI-PAP’s four-phase treatment approach.

Dr. Justin Fiala

Dr. Justin Fiala is an assistant professor at Northwestern Medicine in Chicago, IL, with board certifications in internal, pulmonary, critical care, and sleep medicine. He splits his inpatient time between Northwestern Memorial Hospital, where he works primarily in the medical ICU, and the Shirley Ryan Ability Lab, where he co-heads the vent liberation initiative within the institution's spinal cord injury section. His outpatient focus is on chronic respiratory failure and home mechanical ventilation, and his favorite part of his job is giving people their voice back following tracheostomy placement.