Preface - This piece was written in fragments over the course of months through the pandemic. There are countless other families and physician households who struggled worse than me and my family, this is just a narrative of my experiences.
If you've ever read my previous posts on this blog you would have sensed that I'm an overly imaginative science enthusiast who day dreams about winning the Nobel prize or discovering a new species of bacteria, or even witnessing a cosmic miracle. But never in my wildest dreams had I thought I'd get to experience living in a pandemic the size of this one. It almost feels like living in the movie Contagion. I'll be lying if I say I haven't already imagined the numerous COVID19 screenplays for Hollywood movies that are going to grace our screen for the next two decades.
The other twist I hadn't imagined was being an Infectious disease
fellow (Physician in sub-speciality training) and now a consultant during all of this.
To be very honest when I first heard about the epidemic ( before it became a pandemic) in China I would imagine it arriving to the US and hoped I would have a chance to be involved somehow. Hoping to wear a hazmat suit and making history. Because I'm just a nerd like that with a poor sense of realism when it comes to fear.
Fast forward three to four months we had our first COVID patient in the hospital, an elderly lady, a traveler. We were in lockdown by then. Our department had allowed for us to work from home. I was on my research month and would still go to the hospital because 'work from home' was an alien concept that needed clarification. Fellows were not allowed to see COVID patients, so my husband, then a pulmonary and critical care fellow was spared from seeing her. Her outcome wasn't good and she passed away. I believe she was the first COVID death I came to know of. Our Infectious Disease Department decided we would not see COVID patients in person unless we needed to and even then trainees were exempted. Such was the dearth of personal protective equipment that hazmat suits remained a dream and we could only wear N95 masks and hold on to them till we secured the next one. I was kinda upset about not being directly involved with COVID patients. They were few in the beginning and every patient that I did not personally see seemed like a lost opportunity of being actively involved in a pandemic that would make history. But ofcourse I hadn't known then that this pandemic would extend for two years and I would come to a point of burnout with COVID.
I soon transitioned to my clinical month on ID consults. Hospital hallways were deathly silent by then. The very few people you'd come across would jump at the sight of other humans and slide away to the farthest corner they could find, making sure they don't touch the walls or a banister or a door knob on the way. For all we knew, back then, COVID could be airborne, or spread by contact. Some would even shy away from eye contact lest the other stops to say hi and breathes into a space within 6 ft. Hysteria, and hypochondria were rampant. A slight tickle in the throat would convince my husband that he was about to die and announce to everybody that he would rather not be intubated, not want so and so medication and that he would willfully allow me to marry a second time after his death. A classic case of hypochondriac manvid ( can we make that a word like manflu?) In all honesty though, he suffered through COVID the most. He was a Pulmonary and Critical Care fellow who needed to be in the ICU with the sickest of the sick patients not knowing if he could unknowingly be exposed to COVID.
In order to keep my parents and our 1.5 y.o old safe we had them move in to our house while my husband and I moved into my parents apartment which was closer to the hospital. And thus from a public health standpoint, a high risk cohort in terms of risk factors and a high risk cohort in terms of exposure were separated. What it really meant was being separated from my baby, and burdening my parents with childcare all on their own.
Soon our in-patient rounds were made virtual. Never in my pre-pandemic mind would I have thought it realistic, but thanks to our university and division leadership, trainee safety was never compromised and for the next few months we would see non-Covid patients on our own in the hospital and then convene to discuss patient care plans over virtual platforms like zoom or webex to limit larger gatherings and remain socially distant. This limited my exposure and I moved back in with my parents and baby after a week or so. But, my husband stayed at the apartment and would visit us in the evenings before his nightshift to get dinner in to-go boxes from our garage which I would leave on a chair by the entrance. He would wave to our baby and me from a distance, we couldn't hug or touch. Death rates from COVID were high back then and there was no approved treatment and of course no vaccines. When you are facing the enemy blinded, unknowing of what its true powers are, no amount of sacrifice seems enough to keep yourself and family safe.
Death tolls were rising. It was a domino effect. There were daily press conferences at national, state and even county level. We would await any information we could get pertaining to the virus. Is there a cure on the horizon, is there any prevention, do masks really work, are we all going to die, what can we expect, how does this end? It was as if you we were put in a space shuttle on auto-pilot without any information about the trip, landing etc.
I spent a loooot of time at home the next few months during lock down. I put up curtains that hadn't been hung in over a year, I organized my linen closet, re-hauled my laundry room, did mini reno projects and even gardened. I did things that brought me joy, things I didn't even know I could do. I had been in training mode for so long I had forgotten what life outside of the hospital is like if you have time.
Driveway art competition
Masala dosa by me and Biryani by the husband
Tocilizumab, convalescent plasma, Remdesevir, steroids, each made an entry into treatment options over the next few months. COVID started to become a routine. A crazy routine but still something you begin to get used to. Like that new rowdy neighbor who you know isn't going away so you make peace with it. My husband was now directly involved in taking care of COVID patients and even intubating them (high risk exposure) We were now exhausted of living apart and fear of COVID had abated some so he moved back in with the rest of us with precautions. If not taking care of COVID patients, he was off and at home. We had been married almost 3 years when the pandemic started. I can confidently say I hadn't spent as much time with him in those three years as I did during the pandemic. There were no distractions, it was just us at home with nothing to talk about besides COVID and life in general. We would take a daily evening walk with my daughter in the stroller and make plans about the future. That was our highlight of the day. Seems funny now that I think of it that we were planning a future in the middle of a pandemic, but as they say, hope is the only feeling stronger than fear.
Our daily walks
I graduated from fellowship and started my first job as an ID specialist and an Assistant professor at the same place I did my fellowship while my husband graduated to his last year of fellowship. Starting a career you dreamed off in less than ideal circumstances isn't easy. Our census reached 50-60 patients at one time. There was a weekend when I was covering two hospitals with a combined census of 70-80. It taught me efficiency and resilience. We would have presentations and town halls on COVID all the time and I learned as much speaking for them as the audience I was speaking to.
9 months later, there was a breakthrough, the first vaccine got an EUA (emergency use authorization) from FDA. Healthcare providers were among tier one to receive it. My husband and I were beyond elated. We jumped at the opportunity and got the vaccines. We posted pics on Facebook like it was the triumph of our lives and to encourage others to get it too. The wave of relief was accompanied by a wave of rumors and misconceptions. Talks after talks, social media campaigns and what not ensued and still run to counter the anti-vaxxers. There were surges and declines in COVID rates but the protection from vaccines gave my family and countless other families like mine some sense of protection that would allow us to move a step closer to normalcy.
A few months after our booster shot we moved to IN for my husbands job. Vastly different from IL in terms of public health mandates and public perception about masks it was still a good feeling, a fresh start.
We are two years into the pandemic. COVID is nowhere near gone but life around me seems like its back to normal. Countless people whom I've known and loved have died from it, but life goes on. That faceless, mysterious virus whose origins are still debatable has evolved over and over and now has a variant that is 4 times more resistant to the vaccine than the earlier strains. It's more contagious. But, it's also milder. The quality of a good pathogen is that it never kills its host, it co-exists and more importantly, it adapts, it evolves, it needs to do this to continue living.
But, its enemy, humans, are a resilient species. We are a great combination of odds and extremes. COVID just made it all so obvious. As the death tolls were rising there was still a segment of the population that thought that this was all a conspiracy by doctors and big pharma. They didn't believe in social distancing and didn't care if they caught or spread the virus. Then there was misconception about the vaccine and heated arguments followed. There were also people who introduced nuances like azithromycin and ivermectin and advocated that they worked when they really didn't. For every ounce of truth there was falsehood out there as well. Thanks to the tireless work of public health workers, scientists, healthcare workers and responsible citizens, truth prevailed. For all the death and misery we saw, there was also renewed sense of appreciation for life. Society recalibrated their lives and priorities. We bounced back, resilient and strong.
Husband hasn't had a COVID patient in the ICU for a few months now, neither have I dealt with it in the hospital in a while.
Uncertainty remains though, I'm not sure what the future holds for us in terms of COVID but it sure doesn't seem as bleak as it did two years ago. Instead of gazing in the dark, we are now looking at the light at the end of the tunnel. We don't know how long the tunnel is... but hey atleast there is light.
