With Texas hospitals nearly at capacity, this past Tuesday, the state saw its highest single-day increase in COVID-19 cases (10,859). There are now 281,085 known cases statewide. The same day, three top officials in the Center for Disease Control (CDC) published a commentary in the Journal of the American Medical Association calling for all Americans to wear face masks in public to combat Coronavirus transmission. They observed that, although community use of face coverings has increased substantially, resistance to wearing them continues.

By now, everyone understands the challenges of wearing a face mask. Even if it protects from Coronavirus, I know that it negatively affects the care of my patients in other ways.  It’s hard to make a personal connection with a patient when you are wearing a mask, hard of hearing patients simply cannot understand what I am saying, and I am not sure I could recognize some of my patients if I needed to identify them. However, the struggle over wearing a face mask is not just about convenience.

I spent the last ten years caring for a man with progressive dementia and as anyone who has done this knows, there’s also a progressive loss of freedom. First you limit where you eat out and then you stop going out entirely; you stop traveling for vacation, then you stop traveling for work, and eventually you can’t go see your mother for the weekend; you stop connecting with friends and then stop going to church; you find you can’t go shopping and eventually you can’t even go to the grocery store. When the ordeal was over and I had gotten through the trauma of selling the house and moving, I thought I’d be able to emerge from my very restricted life, but then COVID-19 hit. When Texas went into lockdown, I confess that having to wear a mask felt like the final loss of personal freedom.

I lived briefly in a country in which some women chose to veil their faces for religious reasons. I got to know one woman well enough to speak about personal things, and I found it interesting that she felt that wearing a veil was liberating. That’s hard for a western woman to understand. Covering my face makes me feel like I’ve lost some of my identity.

Last week as I struggled yet again to connect with a new patient while half of my face was covered, I thought about C.S. Lewis’ last work of fiction, Till We Have Faces. It is quite unlike any of his other allegorical works, and I can’t possibly do justice to the nuanced retelling of the 2nd-century story of Cupid and Psyche. The main character chooses to go through life with her face veiled, a metaphor for her lack of personal insight. “Having a face,” means, at least in part, facing our shortcomings and selfish motivations as well as accepting the results of our actions.

Truthfully, when I think about the struggle I had with my husband’s dementia, the real battle was with my own selfishness. He was suffering horribly and often my thoughts were focused on how it affected ME. I think that’s what Lewis was trying to convey about a covered face.

I do understand the collective frustration over mask-wearing — it is miserable. However, everyone should be wearing masks, as not wearing a mask has potentially serious consequences to others around us. It’s really a battle over selfishness and taking responsibility for our actions. Still, I long for the day that we all have faces again.

Caroline Fife, M.D.

Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos