2020 Fall Voices

the economy; every day I worry
if today is the day I get COVID
or pass it to a patient. I know
he’s scared, but I don’t have the
emotional bandwidth to support
him. I have to ration my emotional
energy like he’s rationing
toilet paper.
03/22/20: We just started televisits.
The billing is a mess, and
the rules are unclear about who
qualifies. Working through this
pandemic is like trying to walk
with vertigo - you can hardly
take a step forward without feeling
like you’re going to topple
over. The effort to stay upright all
day is so exhausting I get home
and just go straight to bed. I
keep hoping hedonic adaptation
will kick in and I’ll adjust to this
new norm, but nothing stays the
same long enough.
03/23/20: Laura whacked me
across the face with a news
update before I managed to sit
down at my desk. She called her
friend, a CT surgical resident in
NYC, who said their heads of
transplant and general surgery
had both been placed on vents
and an ED nurse had just been
escalated to ECMO. Apparently,
the hospital has developed an
ethics committee to weigh the
life contributions people have
made to determine their worthiness
for a vent because there
aren’t enough to meet the demand.
I deflated into my chair. I can’t
imagine what it’s like inside
those walls for my NYC brothers
and sisters, their families,
and the patients dying alone in
isolation. Those shoved into the
position to choose who lives
and dies will do the best they
can and then carry the burden of
that responsibility forever. Their
decisions are inevitably going
to be dictated to them from
“higher up” based on a set of
criteria they may not agree with
but are forced to execute. They
will have to look a patient in the
face and tell them that because
of their higher likelihood of dying
and estimated longer need for
resources than someone else,
they have been sentenced to
death. In a few short weeks I
could find myself deployed to
a COVID unit in the hospital,
involuntarily forced to play God.
I don’t want that burden. I didn’t
sign up for that. But it would be
my duty if I found myself there. I
keep praying that doesn’t happen,
but then I feel ashamed.
If it isn’t me, it’s someone else,
and as a medical community, we
carry this together.
I took a blank Advanced Directive
form from my office to fill
out at home.
03/24/20: I just need a hug!
I’m physically isolated from everyone
and emotionally isolated
from non-medical people. Thank
God for my work family. I started
a tradition at lunch a couple
weeks ago where everyone has
to share three things they’re
grateful for to help us cling to
positivity. Sometimes it takes a
while, but we all consistently say
our families, our job, and each
other.
Day after day, we face a firing
squad hoping to avoid impact,
and if we are hit, that it isn’t anything
vital.
It’s probably time to call Mom.
Before the conversation started,
I apologized to her and then
told her what I wanted if I died.
It’s grim, and as a 30- year-old, a
bit unsettling, but it’s enough of
a possibility that to not have the
conversation seemed irresponsible.
Mom took it like a champ. I
was proud of her.
I asked Hannah if she would
advise my mom on my medical
care if the time came, apologizing
for being morbid. She’s
apparently preparing too. We
don’t talk about these things at
the office, but it’s comforting to
know I’m not overreacting. We
all have to acknowledge that
we could die in the next few
months. I spent the rest of the
evening writing an email for my
mom to reference:
Cremate me and scatter me in
Maine.
No funeral or black clothing.
Make it a life celebration and let
my brother name it something
cheeky.
Play Amazing Grace.
Supply lots of alcohol.
Use my life insurance to go on
a trip somewhere you couldn’t
afford on your own.
03/25/20: I’m not sleeping.
My jaw is sore from grinding my
teeth through the nightmares
of trailers filled with black body
bags. I asked the other providers
if they were having trouble
sleeping. Apparently, we’re all
having nightmares.
03/26/20: During lunch, we
watched the Facebook video of
Atlanta residents on their balconies
applauding hospital workers
at shift change. We all cried.
03/27/20: I’m trying to sleep,
but there’s a group gathered at
the courtyard firepit, which is
supposed to be closed, loudly
socializing and not six feet apart.
I know it’s only 8:30pm, but I
need every ounce of sleep I can
get. And frankly, I resent them.
Every day, I get up and put myself
in danger. The only job they
9 · SITES.DUKE.EDU/VOICES FALL 2020 · VOL 10, ISSUE 1