When I wear a mask over my face, I am protecting both of us.
When I wear a mask over my feelings, I am protecting both of us, too.
When you ask me, “How are you doing?” this is why I have no answer.
Four days a week, I have a (currently, mostly virtual) primary care practice taking care of manageable problems, trying to teach folks how to take care of their chronic health conditions so they can continue to function and stave off catastrophic complications and premature death, and doing my best to address the anxieties of a traumatized, worried, frightened, mourning population through uncertain times, to say the least. Much of this work is (still) unpaid, and many people are avoiding everything medical these days, so revenues are way down (to be honest, independent primary care was struggling badly long before this pandemic came along) and the bills that I can’t pay are piling up.
Two days a week, I run an inpatient unit caring for a mix of patients, including people horrendously sick with COVID, and also with brutal traumas, advanced cancers, and every form of suffering imaginable.
Plus, as the doc, it’s an unwritten part of my job to set the example and help everyone else on the team do our jobs with calm and poise, and according to the best instructions we can come up with under inconceivably under-resourced conditions.
I have to support nurses working despite chronic health vulnerabilities and caring for fragile or abusive loved ones at home, when we’re all having to make one KN95 mask last us a whole week and just pray that’s good enough.
I have to gently correct and re-educate non-clinical colleagues when I notice them donning, doffing, or wearing their precious PPE incorrectly in a way that may increase our and their exposure, and try to swiftly get us both through that moment of helpless terror when they understand the implications of their innocent and well-meaning mistake.
And then I have to finish suiting up and review with my patient — a human being who is doing the best they know how to through a harsh and bitter and still-somehow-beautiful life, a human being with family and friends and people who love them — and while they’re still lucid, review with them the gruesome options of how much they do or don’t want done to their flesh in an effort to keep them on this side of the grave, and what does “futile” look like through their eyes?
Finally, a few precious hours each week are my own. I come home, strangely grateful to be living alone and try to cook, do laundry, listen to music, or create some art. I meditate, I call and video chat with the people I love, and I try to immerse myself in the beautiful and simple and ancient and futuristic and dizzyingly complex things that make this life worth living. I try to get enough exercise and sunlight, I eat pretty healthily, I drink too much coffee but stay away from booze and cigarettes and hard drugs, and sometimes on a good day, I even remember to give myself credit and recognize that what I manage to do is enough.
But it’s been almost nine weeks since I’ve felt a human touch against my skin without a glove between us.
Ten weeks since I’ve stood in the same room or house with my beloved.
Ten weeks since I’ve had another human being’s arms around me to help hold me together while I carry this all.
Ten years since I sat in my therapist’s gentle cocoon of an office and took in the explanation that this gnawing, driving suffering in the hollow of my chest and the mucus in my throat and the pounding in my skull is PTSD, and that I had earned it honestly and now it’s time to learn how to navigate these scars that hold me together.
Twenty-three years since I swore an oath in the names of my ancestors, Hippocrates and Maimonides, Ibn Sina and Paracelsus, Alan Berkman, and Barbara Starfield, to always serve and strive to learn, and to be the best physician I can be.
Thirty-six years since the first time I touched the cold, dead flesh of a fellow human being whose warm touch and laughter I had known in life.
Thirty-two hours since my alarm clock last rang. (Yes, thankfully, I’ve had a few hours shuteye since then.)
Twenty-seven hours since I submitted my last grant application.
Thirteen hours since I signed my last death certificate.
This morning I drank my coffee with simple gratitude to fill my bladder without worrying about the elaborate, death-defying ritual dance of gown and gloves and mask every time we dare take time to pee.
So, yeah. When you ask me how I’m doing, these are the answers I don’t say, for both our sakes.
Because, if there’s one thing I’ve learned, it is (as often, but questionably, attributed to Winston Churchill): “If you’re going through Hell, keep going.”
And it is my work, my art, to keep us both going.
Leto Quarles, MD, is a family physician.
This post appeared on KevinMD.
Last Updated May 21, 2020