It's been quite the year -- personally, professionally, and for the entire world.
December: snow in the canyon - For me, the changes of 2020 started on a snowy day in December 2019 when I stuffed a thrift store dress into a backpack and hiked with Wade and a few dedicated friends to the top of a butte in the Grand Canyon ...
....and got married.
It was a beautiful, special day, and I highly recommend the outdoor micro wedding approach -- even outside of a pandemic.
January: transition - Then came figuring out how to be able to live in the same place together. I struggled for months with the idea of leaving my job and my life at Hopi. I felt so connected to my patients, my colleagues, and the whole community. I knew I would be hard pressed to match that level of meaning in another job. Yet I also was ready to live in the same place as my partner, and we ultimately decided that meant living and working together in Flagstaff, about two hours away. I accepted a job at a hospital in Flagstaff, which serves as a receiving hospital for many of the clinics and hospitals on the Hopi and Navajo reservations.
February/March: a novel virus - As I was starting this whole transition process, we started hearing more about this novel coronavirus that emerged in China. Like so many of us, I went through the motions of preparing for its potential arrival to northern Arizona, but didn't truly worry too much about it, remembering all the preparedness for Ebola in 2014 which never really came to the United States. I focused on transitions for my patients, my projects, and a re-centering of my life in Flagstaff.
March/April: quarantine - And then it came. The first cases on Navajo Nation came just before my last day at Hopi in mid-March. Then I was off for four weeks between jobs. My travel plans canceled, I quarantined at home with the rest of the country as Wade began caring for coronavirus patients as a nurse. It was a surreal time -- I felt like a player sitting on the bench while my team was playing the hardest and most important game of the season. I had four weeks of anticipation as cases surged in New York and New Jersey, and surged even harder on Navajo Nation, with a higher per capita case count than either of those states during the first wave. I heard heartbreaking stories from Wade as our hospital repurposed other units to make more intensive care units to handle all the coronavirus patients, the vast majority transferred in from the hard-hit Navajo reservation.
I waited at home. I unpacked. I bought rainboots to wear to work in the closed coronavirus units. I watched the news, read the medical journals, and tried to prepare myself to take care of patients with this novel disease.
April/May: on the frontlines - I started my new job mid-April, and as I learned my way around the hospital, I realized that nothing was normal. All the new faces I was trying to match with new names were covered with the same blue medical masks. Many of the usual ways to get around the hospital were blocked off to make closed coronavirus units. With all the uncertainty of how the virus was spread -- if we were at risk in our jobs, if we could spread it to loved ones at home, it did feel like we were on the 'frontlines'.
I won't ever forget the first time I was called to admit a patient known to have the coronavirus. Gown, gloves, face shield, mask. My heart raced as I slid open the glass door, and then slid it closed behind me. I walked up to her, introduced myself, and started my interview. My heart calmed to its normal rate. I was a doctor, caring for a patient. I knew how to do this. She told me her story, I asked her questions, examined her, and told her our plan. I made eye contact, touched her hand with my gloved hand, and tried to be as human and reassuring as I could through all the layers of protective gear.
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| A partner of one of Wade's fellow nurses took these photographs during this time, which were later published in a beautiful Washington Post Magazine piece, and they certainly resonate with me in terms of the gravity and intensity of those months. |
I also won't ever forget the first death certificate I entered for a coronavirus patient. Completing death certificates is part of our job as physicians -- certifying the cause of death of patients who died while under our care. I have done it many times before and will many times again. As I submitted this one, though, I felt like I was watching a single drop fall into a large and ever growing bucket. I had added one more number to the rising death toll of this virus, which now as of September 2020 has surpassed one million in the world. One thousand thousands. I knew this one person--I knew what she had gone through in the last weeks of her life, I knew her husband and her children, and what they went through as she worsened and began to struggle to breathe, video chat the closest they could get to saying goodbye. I know this one story, but each of those 1,000,000 people has a story, a family grieving for a loved one who is no longer with them, many with other deaths or critical illness within the same family. It is hard to wrap our minds around the magnitude of the tragedy these deaths represent, let alone the tragedy of jobs lost, economic hardships, evictions, mental health consequences of this pandemic.
June/July/August: a new normal -- over the summer, we settled in to a 'new normal'. I stopped thinking twice about walking into a room with a patient with coronavirus, because I do it so frequently and trust the protective equipment to keep me safe. Still, the 'new normal' was not a comfortable one -- Arizona surged in cases over the summer, like Texas and Florida, with hospitals starting to near capacity in many parts of our state. The demonstrations for racial justice sparked by George Floyd's death stirred much needed conversations about police violence and the deep roots of racism in this country that persist to this day, but also disturbing counter-protests rooted in hate and fear. I do see some rays of hope in the conversations they have sparked within medicine. Like so many institutions, our medical system and our medical education system perpetuate bias and racism, and more mainstream voices within medicine are acknowledging this fact and starting conversations about what can be done about it.
September: gratitude - as summer turned to fall, Arizona managed to contain a large surge in coronavirus cases that caused much anxiety for all of us in July and August. For this I am tremendously grateful. Right now, I have to say that I don't feel that I am on the 'frontline' any more of dealing with this pandemic. I have it easy -- I leave my house regularly and get to interact with people in meaningful ways at work. Aside from extra protective equipment and headaches due to slow turn-around on coronavirus testing (wouldn't you think we would have adequate supply of rapid tests in this country by now?), I mostly get to do the same kind of job in a relatively similar way as before the pandemic. I got it easy.
Instead, I feel those bearing the brunt of this pandemic right now are many -- all the parents out there trying to work from home and provide childcare and keep their kids on their zoom classes. All the teachers trying to do the impossible task of virtual distance education for children of all ages. All the administrators in schools and universities trying to pick some kind of a path through a no-win situation. All the governors and mayors who have suddenly become public health officials. All of the people who have gotten sick or died from the virus and their friends and family that are grieving. All those who have lost jobs or whose businesses are suffering or closing. It brings me tremendous sadness to observe this economic recession that is amplifying pre-existing disparities between the wealthiest and the lowest wage earners, between men and women, between white people and minority groups in this country.
October: a few requests -- and now it is October. We are finally 3/4 of the way through this crazy year. With elections coming up and the prospect of a combined coronavirus/flu season this winter, it seems the last months of this year are unlikely to be any smoother a ride. Indeed, in a first curveball of this last quarter, President Trump has just tested positive for the coronavirus. I wish him a mild course and speedy recovery as I do for all those affected by this virus. I'll close with a few requests for all of us to get through this time together:
#1 - Get your Flu Vaccine -- its not a perfect vaccine, but it does reduce your chance of a severe flu illness. If we all get vaccinated, we'll have fewer cases serious flu illness, fewer hospitalizations and deaths from flu, and more room in hospitals for coronavirus patients this winter.
#2 - Be safe when visiting with friends and family. It may not be realistic to all quarantine at home at all times until a vaccine is here, but the risk of getting/giving coronavirus is real if you spend indoor un-masked time with other people. Spend your time together outside if at all possible, and if you do spend time inside together, wear masks! Here's one table that helps show levels of risk of different contact situations:
#3 - Vote. As a doctor in this pandemic, I have felt abandoned by our current president, who has systematically downplayed the risk of the virus, encouraged an attitude of recklessness that facilitates its spread, and has not ensured adequate testing and protective equipment in this country to this day. Electing Joe Biden and Kamala Harris would be an incredible breath of fresh air to have strong, logical, science-based leadership for pandemic management.
