Life as a Public Health (PhD) Student during the Global Health Crisis

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Aula Medica, Karolinska Institutet in winter.

Pursuing a doctoral degree itself is a challenging journey, not to mention in this isolated time during Covid-19 pandemic. In this article, Alicia Nevriana, a PhD student at Karolinska Institutet, shares her experiences on how to navigate through the ups and down of doctoral study, and how to stay resilient especially during this pandemic. 


How I Adapt to Changes because of the Pandemic

When the COVID-19 pandemic hit the world, particularly when the cases started being detected in Sweden, I knew right there and then that we would be in this for a long time. Exactly how long, I did not know. But mentally I prepared myself that things would not be the same for the upcoming 5 years.

Älvsjöskogens naturreservat - a forest close by that I visited after 3 weeks of isolation
Älvsjöskogens naturreservat – a forest close by that I visited after 3 weeks of isolation.

What happened during and after March 2020 was a mixture of blur and chaos. One day I was having dinner with a friend, and the next thing I knew, I no longer met him for the next 2 months, even though we lived in the same city. No, Sweden did not go into a ’lockdown’. But I was trying my best to follow all the restrictions that were put in place, including only travel when it was absolutely necessary.

The university remained ’open’, so that anyone who needed, could come and work there. For me, it makes sense, given that as a medical university, there was, and still is, a lot of work within the labs, which, I imagine, might need to be taken care of and could not be terminated at a short notice. But other than that, everyone should work from home.

Doctoral courses became online, but some course directors decided to cancel the courses for the semester given the difficulties to transform them to be online at such short notice.

During this period, I had 2 courses cancelled, one of which I was supposed to assist in the teaching. And I needed the credit. But of course, nothing much could be done and I could only hope that the course(s) would be offered in the upcoming year (spoiler: yes, they were offered online in the following year).

While my research does not involve any experiment in the lab, working from home was proven to be more challenging than I expected it to be. I did not realise it at first, because I usually have no problem using the internet at home. But when I had to connect to the office’s VPN to conduct statistical analysis on the huge datasets – that’s when the real trouble began.

Imagine that you have waited hours to load a dataset (which usually took just a couple of seconds), and you started running the analysis, which regularly could take another couple of hours. You left your computer for the night, hoping that it would spit out the results the next morning, only to find out that the VPN was automatically disconnected after 8 hours, meaning that no analysis was successfully performed, and all your efforts on the previous day were useless. Therefore after trying to deal with this for a couple of weeks, I decided that there was no way I could get my work done at home, and start coming back to the office to perform this specific task. Luckily, the office was almost always empty when I came, so I felt a little bit relieved working there (yes, people did work from home to a huge extent – in my department, at least).

Halfway through my doctoral education, I am supposed to arrange a half-time seminar – a kind of mini defence where you are supposed to present and discuss your work in front of a review committee and the public. For better or worse, this was scheduled just a month after the pandemic was declared. I have written a bit about it here, but, what I did not mention there was the mental health struggle I experienced on the way leading up to the day.

How I Coped with Panic Attack

You see, when we were told to work from home, not travel unless necessary, I did isolate myself for three weeks straight. Like, really. I did not go anywhere. No meeting with friends, no working from the office, no walking to the park, nada. I was completely alone when I worked on my half-time report. Alone when I started receiving news of the death of people I knew back home. And then, sometime within this period, every morning, I would suddenly struggle to breathe. This was then followed by the urge to puke. And then it would disappear. For the first time in my life, I was having panic attacks.

I told my supervisor about this (she’s a psychiatrist, by the way). And she ‘ordered’ me to start going out again. To the park, at least. Do some physical activity. You need to have a balance between physical and mental health. But it is challenging in the ‘normal days’, let alone during a global pandemic when you have to calculate the risk-benefit balance of every action that you do. I am extremely privileged to live in a suburb where a green area is easily accessible, with lots of space for everyone to keep their distance. And indeed, I felt much better afterwards.

But I know that it is not the reality for everybody. I am not going to start discussing here what we should and should not do in this situation, but I am just going to emphasise how important it is for us to be aware of the privilege that we have, and have empathy and solidarity for others who are not in the same positions.

How the University Supports the Students

The university did try to provide some supports while everybody was required to work from home.

During the first months, the director of doctoral education in my department invited us, the doctoral students, for a weekly ‘fika’ (sort of a coffee break) so that we could catch up on the latest updates or express our concerns. After the situation stabilised a bit, my friends and I who were currently acting as student representatives continued to arrange the fika, just so that we could still have social activities within ourselves.

My friend and I - planning for the online fika for spring 2021.
My friend and I – planning for the online fika for spring 2021.

The department also arranged regular online breakfast meetings (often included online exercises), and even online chocolate tasting, where we were sent a box of chocolates to be enjoyed together.

At some point, we even created departmental recipe books, which were sent to everybody around Christmas. Given that we were not able to have our annual Christmas gathering, our research group leader and coordinator also made an effort to send everyone a little Christmas gift. However, these gifts were not the only things I received in my mailbox during this time.

The department’s recipe book and my nasi goreng recipe. Just realised how difficult it was to write a recipe with exact measurement when you’re used to using your feelings when cooking .
The department’s recipe book and my nasi goreng recipe. Just realised how difficult it was to write a recipe with exact measurement when you’re used to using your feelings when cooking .

Towards the end of 2020, I started receiving some of my friends’ most important work during the PhD: the thesis.

Christmas present from the research group, sent by post (Left) and Some of my friends’ theses that I received throughout the pandemic. Soon it will be my turn, too. Wish me luck! (Right)
Christmas present from the research group, sent by post (Left) and Some of my friends’ theses that I received throughout the pandemic. Soon it will be my turn, too. Wish me luck! (Right)

How the Thesis Defence Changes

Attending my friends’ thesis nailing: online (above) and on campus (below). Each department might have a different nailing tradition. In my department (above), we have dedicated space for thesis nailing and PhD students often opt to do it there. In other departments, PhD students might choose to do the nailing at the library (below).
Attending my friends’ thesis nailing: online (above) and on campus (below). Each department might have a different nailing tradition. In my department (above), we have dedicated space for thesis nailing and PhD students often opt to do it there. In other departments, PhD students might choose to do the nailing at the library (below).

A thesis defence is a pretty big deal in my university (well, I guess everywhere, too). After conducting 3-6 individual studies during our PhD (depending on your field/project), we are now obliged to write the thesis, a summary of our work, or kappa in Swedish (literally means coat). Approximately 3 weeks before the defence date, we will announce the defence date and make the thesis publicly available in a special ceremony called ‘thesis nailing’ (where we also literally nail the thesis with… well, with a nail on a wooden board). It is also customary for us to send the thesis to our colleagues and friends, often with short, hand-written greetings. We will then defend the thesis in public (everyone could attend). An opponent will usually give an overview of our research area, followed by our results’ presentation, discussion with the opponent, discussion with 3 members of the examination board, then with the audience (in case anyone has any questions). Mind you, there is no time limit for the defence and it could go as fast as 2.5 hours or as long as 5 hours (at least the ones I attended).

Afterwards, the opponent and examination board will gather to decide the fate of the doctoral students (usually they will pass, though, and we are not usually required to revise and resubmit the thesis – a huge relief). The defence is usually followed by some sort of celebration(s), both at the university and privately later. It’s almost like a wedding, actually. There will be speech, food, gifts, etc.

Now with the pandemic, some adaptations are of course required. Your colleagues are encouraged to follow the thesis nailing and defence online, although a limited number of the audiences might still be allowed on site. Naturally, no big celebrations afterwards either, although you can still choose to celebrate with your closest friends and families (depending on the restrictions on the number of people that could gather).

While these measures are necessary, I could not help but feel… sorry. This is probably the last time you are going to be ‘students’ (unless you decide to take another master or PhD in the future) and you have worked very hard to be at this point. It is sad, not to be able to share this moment with people you care about – people you encounter along the way, who have made this entire journey possible. And this is probably the reality that I am going to face in half a year or so, depending on the situation.

Attending my friends’ thesis defence: online (above) and on campus (below). To minimise the risk of crowding, nowadays the PhD students usually made a list of people who might attend the defence on campus in advance. In my friend’s case (below), only the defence chair, supervisors, one board member, and I attended on site.
Attending my friends’ thesis defence: online (above) and on campus (below). To minimise the risk of crowding, nowadays the PhD students usually made a list of people who might attend the defence on campus in advance. In my friend’s case (below), only the defence chair, supervisors, one board member, and I attended on site.

Yes, we have the vaccines now, and I sincerely hope that anyone reading this is contributing to halt the progression of the pandemic by getting vaccinated. And of course, adhering to the health measures within the region to the best of their ability. Simply because that is the right thing to do.

This pandemic affects everyone, but it certainly affects everyone differently. As (PhD) students, we might still be required to do certain things even during this time (i.e. finish your studies!). However, it is important to remember that this is an extraordinary circumstances and adaptations are sometimes necessary. Therefore, be kind to yourself and know when to seek help, if needed. As one public health campaign here said,

“Don’t bite the bullet – seek care if needed.”

So… let’s do our best to get through this, shall we?

*All photos were provided by author.

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