“Doctor, how are you doing?” I’m really so grateful when people take the time to ask this. But when I respond, candidly, that it’s been tough and I’m definitely not doing great, I often hear, “But you haven’t had any patients who have died from COVID, have you? And you got the vaccine, didn’t you?” Fortunately, no (not yet) and yes. My heart goes out to our ICU, inpatient, and ER teams who see the sickest patients and deal with loss regularly. But they are not the only members of our health care system who are struggling and overwhelmed. Here’s what, as a busy primary care doctor in a large academic health system, I am facing. I answer many daily questions (and complaints) about exposure, travel, testing, and vaccines. I manage my patients with COVID until they either recover or get sick enough to be hospitalized. I adapt weekly to new PPE policies, now requiring masking and eye protection during my entire time at work. I don’t eat or drink enough because there is no safe place to do so. My colleagues and I wolf down lunch in five unmasked minutes to expose each other excessively. I get tested on my own time. At the start of the pandemic, overnight I adapted to telemedicine and learned how to care for patients safely without seeing them in person; even when I should they are often reluctant to come in. I navigate faulty technology and spend excessive amounts of time just trying to connect with patients. My phone calls and emails have increased dramatically. I counsel patients and families about how to stay healthy and sane despite isolation, fear, and way too much together time. Of course, this is on top of continuing the regular care for my large patient panel that preceded the pandemic – new cancer diagnoses, diabetes management, scary bumps and lumps, weird rashes, and general well care. And still, my department holds me personally accountable (with financial consequence) to maintain my productivity and ensure all of my patients are getting their screening tests, like colonoscopies. Meanwhile, I am striving to adapt my personal and our system’s practices to better address health inequities throughout our most vulnerable populations. I pursue new research endeavors. I continue to teach medical students, residents, and other health professionals – learning along with the rest of the world about how to do this effectively over Zoom, as well as in the clinic. I spend most of my lunch breaks in Zoom meetings. Days are longer and unrelenting. There is no downtime. Let me be clear, however – I believe my health system has done an excellent job responding to this pandemic. Our system is in no way unique, and I have better working conditions than many. There is simply no space in what we do for this pandemic – yet here it is. Through this, like everyone else, I am trying to help my own family survive. I see every day the possible consequences of each small decision. When my teenagers ask if they can see a friend, I conjure my young patients who have been so socially isolated they are contemplating suicide, as well as the families who have lost loved ones because they were not restrictive enough. My kids cannot grasp how much these seemingly innocent requests fracture my psyche. And my darling husband, whose breath of life is social contact, is somehow standing strong amidst this isolation, and I want desperately to show up for him. I miss hugs. I miss entering into another person’s home. I miss petting someone else’s dog. I miss being in the bleachers at my kids’ sports events. I miss traveling to see my family. I continue to be just as human as everyone else. So please, whenever you encounter folks who are any part of our country’s health system, be kind and patient. Just give them a space to be struggling. And understand why, when we hear that people are tired of restrictions, we beg you to press on. The tunnel has been long and twisty, but the light at the end is beckoning. Amy K. Weimer is an internal medicine-pediatrics physician. Source
