40 days.

April 20. 

Monday. I think its Monday. Yes, I checked, definitely Monday.  Forty days since the NBA announced they were postponing the season. We have been in “social distancing” since March 19th.  Life has happened since then in some ways: I have gotten engaged, moved, started telemedicine.  Amidst it all we as a society still are trying to plan a future.  I see it for me as we are forging ahead planning our wedding (not for the faint of heart doing a pandemic I might add).  We dream of our perfect honeymoon and hope we can go somewhere amazing. But as it looks now, that may not be in the cards with the regulations on foreign travel in the short-term. 

But life has also stopped. Hard stop. In some ways life hasn’t happened at all.  No sports to cover.  No concerts to attend or dinners out to be had.  People’s most joyous life events usually celebrated on a grand scale like birthdays and baby showers have turned in to drive by affairs. Vacations have been postponed.  And let me be honest with you, it has not been easy.  It seems petty to complain about not having a Friday cocktail out on the town, but we’re missing out on celebrating life’s milestones in the way we’re used to. We are social creatures. And when you take away the social part, even the most introverted souls are rippled.  

So now, we are all suddenly given this block of time without socialization or events to attend.  A full block of protected time spent at home.  Yet, somehow, I am personally struggling to know exactly what to do with it. And you know what, I have decided that is okay.  

There is so much pressure around us to do something productive at all times, especially during this social quarantine.  Social media is full of daily workouts, everyone is baking banana bread or reading novels or cleaning their closets or doing 73 step skin care routines nightly.  And sure, I have upped my home cooking (mostly out of necessity), but honestly some mornings I am simply proud that I have gotten out of bed.  There have been no home projects completed.  My closet is still a mess, and my at home workout routine has not been as strong or structured as my workout routine was pre-COVID-19.  I have been reading about how part of your brain- whether you realize it or not – is focused on this whole pandemic. Part of your brain is literally in panic mode wondering about your safety and survival, even if you aren’t consciously thinking about it. When I read that, my internal feelings made sense for the first time.  Sure, I want to be running every day and planning this wedding and dreaming of my fall sports seasons, but the future is so nebulous right now and my brain is at least in part in fear of the world around me.  It makes it nearly impossible to plan ahead, to dream, to have any sort of existence outside of waiting. 

And the waiting is hard. We don’t know how long this will last. Luckily for us, California has done an excellent job at social distancing so far, and our number of cases has been what most would call fair.  Under the leadership of our governor we are appearing to use science and testing and planning all appropriately.  But, no one knows when we will return to “normal.” And what is the definition of normal going to be?  For someone like myself that tends towards the worrier type, I am in a constant state of heightened fear. And even in the moments of joy and comfort I am in the background playing the movie reel of “what if it’s not okay.”

I admit this because I want you, or anyone who might read this, to know that it its okay.  It is okay not to know. It is okay to be worried and fearful and not feel like learning French or refinishing your wood floors is high priority right now even if you’ve always wanted to.  Just because you have the time, doesn’t mean now is the time.  Sometimes we just need to let ourselves survive anyway we can. Give yourself grace today. We all need it.

I am scared.

March 30.

I sit here reflecting on what is happening around the globe, and frankly I am terrified. I struggle to wrap my mind around the pace of the last few weeks and how quickly this has progressed. My mind battles with itself to comprehend how quickly life has changed. And not only do I feel scared but unprepared for what is likely to come in the next few weeks.

I was sent this article…  John Hovanesian, Use Use your physician ‘superpowers’ during the coronavirus epidemic

The author (@DrHovanesian) had some poignant thoughts and encouraged people to journal during this experience. I agree this is really important because 1) we want our future generations to understand the feelings we all had during this, and 2) we will survive. This will be my first entry into this journal of sorts. A little illustration from my perspective (as I really wanted my online presence to be), and I will continue it for as long as it’s needed… until we are on the other side of this fear.

If you read nothing further please for the love of humanity, STAY HOME AND STAY SAFE. Find joy in the stillness, and support those you can. You are not alone in your fear, and sometimes just acknowledging that this is all so very not-okay is the first step.

Why am I so scared? I saw a NY times article this week about how doctors are writing their wills (NY times link). I live in a two-doctor household where one of us must continue to be in the line of care for emergent issues no matter how sick patients may be, and where the other (me) may not be far behind in needing to care for those that are the sickest. He and I met only a year ago, a romance I never imagined or expected. First it was friendship. There was an offering of kindness and some shared life experiences that brought us together. It was easy, and the old adages of timing and comfort, and something about it just working all are spot on. We have our whole lives ahead of us. I am scared for my safety. I am scared for him. I am scared for the future we are starting to plan together. I joke that our love story is on the brink of being an unfortunate made-for-TV movie, but the jokes are based in my fear of a very scary reality. The scale of this pandemic and how quickly life has changed for everyone is agonizing my every moment. I hear horror stories and read the harrowing tweets from providers in NYC who are currently hit way harder than us here in LA, and I am scared.

On a staff meeting call recently we talked about re-allocation of resources. Let me be clear, we are the resources. I am a resource for caring for the sick during this time, and although I haven’t practiced this sort of hospital medicine at least 8 years (instead focusing my career on Sports Medicine)… I am next up. This is a war against disease, and doctors are in a sense, getting drafted. Or at least the closest thing our generation understands of it. Yes, I signed up for this in some sort of way, but not in a way that would put my own life in imminent danger. There is an extreme pull between my safety and the oath I took years ago to do my part for humanity. When I see news reports of people on vacation or traveling or having overall less than ideal judgement about this whole ordeal, it makes me take pause to consider the risk involved, the risk I am putting myself in for the sake of others. Part of me wants to lock myself in the bathroom and wait it out. I know how to survive. I can follow the ‘safe at home’ rules and not infect myself or others. But, I took that oath. It is my job, and I have the training to save others even if it puts myself at risk. If and when I am called to help I will. When the time comes, doctors step up. That is what we do. You have seen the news stories of medical professionals flying to Italy and the other hard-hit areas. We even volunteer for it. It is not only my responsibility, but my hit is my honor to care for another human being during their most vulnerable times. It has not fully hit LA yet, but it is coming. We know it is. There is a looming threat on our doorstep that we know is able to do terrible things. People are dying. The world itself feels fragile.

January 28.

We have heard of Coronavirus by now. I had heard some news reports of the awful state of affairs in Wuhan China since December and saw they had their first death on January 11. Wuhan is so far away from LA, and sinister things happen around the world all the time unfortunately. It is not in my backyard, or even near it, and I am not really thinking about it on a day to day basis in life or when it comes to the care of my patients. Sadly, we read of a sick 30 year old in the US on January 21 who had traveled back from Wuhan (CDC release). Memos, as they often are, are sent by email — what to look out for if a patient has a respiratory issue, be aware of travel to/from Wuhan China… Well, okay?? Not exactly a hot spot destination for tourism that I am aware of. If this would have started in say Palm Springs well then, I like all other Angelenos would have taken more notice. Besides, we are dealing with the flu right now. Influenza B is running rampant in LA and where I work. I am diagnosing multiple cases per day. I am not scared. I know what to do. I do my swab and use some gloves or a mask when appropriate. I know the protocol for the flu. I know how it is spread. I know how people get sick, and I know the population at highest risk.

So, life and work goes on as usual. I do a Facebook live for post-race recovery (Click here to watch). I see patients in clinic and at student health. I am covering USC basketball games and NHL games. I go to my favorite salon to get my eyebrows done and adventure with a long LA hike after. Today I am at work and approached about taking temperatures on every person from China in the building. I might have audibly laughed, and if I didn’t my face sure did. That seemed so absurd. We cannot discriminate by race. Period. We cannot assume a fever means anything, especially when people are more likely to have the flu, and taking a temperature seems to open a can of worms that just simply does not make sense. Now if they are from, have traveled to, or have been in contact with someone from Wuhan, then sure that poses a different threat. (present day me still agrees with this btw). We do what we know. We hand wash. We advise sick people to stay home and teach people how to cough/sneeze. End of story… or so I thought. Spoiler alert, not even close.

Again, life goes on. We are building momentum with our new clinical practice and seeing more patients than ever. And after almost 1 year of working on this project it feels good to see the growth. We have faculty dinners. I fly to Las Vegas to meet my boyfriend after he spent a few days at a medical conference. We go to a Superbowl party and plan our housewarming party to celebrate my relocation to his little downtown condo. It was a joyful affair. There are more hockey games, basketball games, football practices to cover. There are lectures to give and more patients to see.

Meanwhile, things are progressing globally. The WHO had declared a global health emergency, and travel from China was banned. Cruise ships are quarantined, and death tolls are rising. Italy and Latin America are being affected.

March 2.

It is my birthday. I turned 37. My significant other makes it very special and takes me to a lovely dinner. We laugh and enjoy the night fully at Bestia in the arts district of downtown LA. I always wanted to try it. The Italian dishes served in small plates come until late in the evening. The wait staff is superb. The wine is perfect.

But something about this week is clearly different. Just 2 days before the US put in place a travel restriction after we had our first death. Something is changing. Because now it is in our backyard. It is closer. Fear is starting to rise. What if this gets worse? How do we control it? What if we cannot control it? At a concert this weekend I am noticeably uncomfortable. I try to keep my distance from people (which isn’t too far my usual MO; let’s be honest usually crowds make me very uncomfortable), but something is just different. The difference is I am now scared.

That is the thing with the 2019 novel coronavirus (now COVID-19). We are all new to it. We are learning as we go but not fast enough, as doctors or as society. When something is unknown and new and not fully understood, it is very scary. Some information (or worse, misinformation) makes the fear worse. We think we know how it is spread. We think we know how people catch it. We think we know how to properly mask/glove/protect ourselves. But it is so strong, and we are so new to it. Are we right?? We don’t know the reasons why some people get sicker than others, and we don’t know what else we don’t know.

March 11.

This is the night it all changes for me. I work my usual day. During it President Trump suggests banning travel from Europe. I take my scheduled phone call with my accountant to discuss tax season. It is now announced as officially a pandemic. I talk to a colleague about patients. I hear that Universities are starting to plan to halt classes, and rumors are starting that basketball tournaments are going to play without fans. By the end of the day, there is clearly an air of something transpiring, and it is starting to grow. But I have a job to do, and tonight there is a Kings game.

I walk to work that night at the Staples Center, and there is an eerie feeling in my heart. Fans are still lining up, but there are noticeable differences. As one walks in there are hand sanitizer booths everywhere. News channels including ESPN on the screens of the arena are talking about COVID 19. Per my usual I walk and wait in the back medical office pregame. Watching the TV, the news seems to be rolling out in slow motion. No fans at Pac12 games (USA Today link). Boom. NBA announces a game planned the following night without fans (ESPN link). Boom. Do you know how eerie it is to stand working a professional sporting event among thousands of fans knowing that in the same state, less than 400 miles away no fans are to be allowed? My baseline fear of crowds grows. There is now a heightened fear of the mass of people around me.

There are no fans allowed into the ritualistic pregame areas tonight. The Kings usually come out to fans watching the doors open, smoke billowing out to the ice. No fans allowed there either. Straight to the ice they go. I go to my usual seat in the stands. We watch them play. The stands are averagely full. But something feels off. The news breaks of the first NBA positive. At the first break I am told not to come to the back doctor’s room unless I am called. Usually we meet there at each period break. We are distancing. We are trying to keep safe. As I sit in the stands surrounded by thousands, I see the announcement on my phone that the NBA is immediately postponing all games including the one planning to start in a few hours, BOOM. (CBS Sports link). People are eating nachos and cheering for our team. Suddenly the nachos, the high fives after goals scored and the sweat on the players’ faces feel sinister. The players know what is happening and so does the staff. We all do. There are fights and goals, and I sit there wondering if this is the last time I will watch this season. I take a deep breath as I walk out into the night air and head towards home. Suddenly the hopes for the future and the joy of life experiences are suddenly equally foolish and paramount to continue. As I step into the darkness of the night, I know we must continue to show love and joy but wonder how to do so in a time of so much fear and death. I don’t know what the future holds. I don’t know how much and how fast it is going to get worse. But as I stand there watching the fans leave in the haze of a team’s victory, I am already unsure, fearful and can feel the worry bubbling up about everyone and everything around me.

be safe.

ADDITIONAL SOURCES:

www.nytimes.com/2020/03/26/opinion/doctors-coronavirus-safety.html

www.nytimes.com/article/coronavirus-timeline.html