I Treated COVID Patients Last Spring. What If I've Seen Too Much To Ever Feel Normal Again?
I haven’t worn my wedding ring since the beginning of March.
Wearing the ring used to be part of my routine. I’d put it on, along with my ID and pager before I left for work. Before the pandemic, it was a symbol of love and dedication to my wife. Now, it serves only as a fomite, a vector for infection. Every morning I am tempted to wear it, but I don’t. Instead it lies gathering dust, untouched in my apartment.
For similar reasons, I haven’t worn a necktie, shirt or pants to work in months. My daily uniform consists of hospital dispensed scrubs — light blue, machine washed.
When I arrive home now we go through the same disinfectant process we started when the pandemic began. I stop in the foyer, stripping off my scrubs and placing them in a sealed bag. I hand my phone and pager to my wife; fully gloved, she disinfectants them with an alcohol wipe. While we know the majority of coronavirus infections spread via droplets, our small apartment doesn’t afford us much leeway and we still take as many precautions as we can against the virus.
Our routine hasn’t changed much either. My wife and I still minimize time outside our apartment. We avoid restaurants and confined spaces. If we do venture out, it’s for groceries or other essentials. We have started to hike, trying to enjoy nature in solitude, without the presence of other humans.
We prepare for the second wave of COVID-19, but we’re not sure when, or if, it will hit.
I work at the Brigham, Mass. General and Dana-Farber. In the hospitals these days, an uneasy calm pervades. We prepare for the second wave of COVID-19, but we’re not sure when, or if, it will hit. Every morning I look at the new daily number of infections in Massachusetts. Once we hit a certain number of hospitalizations, my colleagues and I will be redeployed to take care of COVID-19 patients, just as we were during the first wave last March.
As a neuro-oncologist, I take care of patients with brain tumors. In the late spring, I returned to my normal schedule, but now I’m waiting for the call reassigning me to the COVID-19 wards once again. The mental fatigue and uncertainty takes a toll.
Every little mishap at work could contribute to the spread of infection. Did I just touch my nose? Did I forget to clean my goggles? Did I tie my gown incorrectly? We check and double-check, but inevitably we miss something. When we slip up, it doesn’t go unnoticed.
In March and April, our mandate was clear. We had one goal in mind — to fight COVID-19. We were scared but determined. Boston’s mighty hospitals stood united, sharing resources and knowledge, and we had the city and the people behind us. But fatigue set in. Some of our colleagues got sick and died. While we were treating our own patients, many of us could not visit our own sick relatives and family members. We were never given all the resources required to fight the virus — like adequate contact tracing, workspaces and testing. Although hospitals in Boston had the resources to secure adequate PPE, there is still a nationwide shortage of critical equipment.
While athletes and politicians and some college students had seemingly unlimited access to testing, frontline workers had to plead to get tested. We know that asymptomatic and presymptomatic spread exists, but still we do not routinely test healthcare workers. I have worked weeks in COVID-19 wards, traveled between three hospitals, and I have only been tested for COVID-19 once, during the recent cluster at the Brigham.
Meanwhile, the virus has become even more politicized. Science is questioned; common-sense public health practices like mask-wearing and social distancing are somehow hot button issues. The White House hosted a superspreader event, and declined to immediately implement contact tracing. Mistrust, about testing, about the promises of a vaccine, about federal guidance, abounds.
What I fear is that this will become my new normal. That even when the pandemic is finally over, I will never be the same.
So many parts of the country have gone back to normal. Restaurants, movie theaters, theme parks — they’re opening.
But, it is hard for us doctors to go back to normal.
I can’t forget the hundreds of intubated patients, the multiple code blues and deaths per day, and the raspy sound of a patient struggling for breath. Every day, I verify whether I have symptoms of the virus. Every patient encounter requires goggles and a mask. Any type of personal travel is strongly discouraged.
With these new rules and restrictions come new challenges. I’ve learned, for example, that I’m soft spoken — I didn’t realize how much my patients used lip-reading to understand me. With masks, I have to talk more slowly. Sometimes, I shout to be heard. This is not the way I envisioned diagnosing and counseling my patients about their brain tumors.
What I fear is that this will become my new normal. That even when the pandemic is finally over, I will never be the same. That I’ll never again go to the movies, or concerts, or large gatherings of any kind. That my patients, who are diagnosed with incurable tumors, will not be able to have family or friends with them during the time of diagnosis. That I will not be able to hold the hand of my dying patient.
The president tells us not to let the virus dominate our lives. How can we stop the virus from dominating our lives when it has become our lives?
Every day, I look at my wedding ring before I leave for work. I’m tempted to put it on, just for one day. I know that it would probably be OK. But I don’t -- I’m not ready, not yet. I’ve seen too much.