Coronavirus Has Slowly But Surely Made Its Way To Middle America

Coronavirus disease (COVID-19) has slowly but surely made its way to Middle America, stowing away on well-meaning citizens who have traveled to the coasts or overseas for one reason or another. It has sneakily hitchhiked its way into Creighton University basketball games, pub crawls, and several area Walmarts. A few patients have been seriously ill, but the majority of the physical, intellectual, and emotional time, effort, and energy spent in my city so far has been for planning purposes — trying to take the lessons that have been learned elsewhere and somehow manufacture a different outcome despite having the same deeply flawed inadequate and tools.

We are caught in the eerily quiet moments, days, maybe even weeks before the predicted onslaught of mass chaos and disease hits. We are watching the numbers and the news and can see the train chugging along in slow motion toward the edge of the cliff.

As a pediatric hospitalist, I feel equal parts relief and guilt. What we know so far is that kids seem to be relatively protected from the worst of COVID-19. The data that keep pouring in suggests that the likelihood of kids requiring hospitalization is very low. Which means I probably won’t be facing the same type of craziness that adult hospitalists and intensivists in Italy, Seattle, and New York have had thrust upon them. There will be collateral damage and ripple effects and unknown impacts on pediatrics to be sure. We are preparing for the worst as best we can and considering how and where we can help our adult medicine colleagues. The text conversations and Listserv postings and conference calls and daily briefings consume hours per day, even for pediatricians.

I’ve donned and doffed, I’ve read countless articles, and I’ve spent more time looking for toilet paper in the past week than I have in the combined entirety of my adult life. And now it’s time to wait. And to mourn.

Although it may seem self-indulgent and trivial compared to the staggering horrors and losses that have occurred in Italy, in China, and in pockets around the U.S., and although I know that the worst is yet to come, I need to mourn the loss of my normal everyday life in these quiet moments before the storm.

Professionally, I am mourning the cancellation of a conference that I planned to attend later this month in San Diego. Scholarly activity doesn’t come easy for me, but I was involved in two different presentations at this conference, and I had worked hard to prepare and meet deadlines for talks that will not be given now.

I am heartsick for our third-year pediatric residents. They are an amazing group of young adults who have worked their butts off for the past three years, who have come into their own as empathetic and competent pediatricians, who never cease to amaze me with their poise and insight. We were all looking forward to celebrating them at a weekend retreat and at their graduation ceremony in May, neither of which will happen now.

It was recently Match Day. Instead of ceremonies full of excited fourth-year medical students and their families bursting with anticipation as their residency fates were revealed one by one, the students received emails at 11:00 a.m. notifying them of where they had matched. The annual Match Day party was canceled. Our weekly hospitalist teaching sessions with the third-year students are no more, since the third-year students are no more. I mourn the opportunity to interact with these fresh young doctors in training and wonder how stressful this uncertainty must be for them.

Other opportunities for our residents to gather and support each other have also been severely curtailed. No longer do residents and faculty gather in the hospital auditorium for conferences – they are now either canceled or broadcast electronically. The group didactics are now occurring via Zoom while individual residents watch from their individual dwellings. I just discovered that the inpatient cardiology team had begun virtually rounding in order to limit how many people are gathered in one location. The attending and nurse practitioner and case manager sit in one conference room and discuss the patients by phone with the residents and fellow who are sitting in another room.

I mourn a great many things in my personal life, too. Travel, restaurants, my gym, my kids’ teachers, freedom from a constant and impending sense of doom, and being able to look forward to something/anything. I am enjoying my shifts at work, the camaraderie with my partners and residents, interacting with patients and families who are struggling with all sorts of things that are not COVID-19, and time away from homeschooling my children.

I know that the situation is ever-evolving and will get worse for us here. I know that I will do whatever is needed to fulfill my roles as pediatric hospitalist and associate program director of our residency program. Tonight, though, I mourn what has been lost while I steel myself for the losses to come.

Lisa Sieczkowski is a pediatrician.

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