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“How would I be able to help my sister?”

The inside of an empty airplane with blue seats.
By Julia Atkins, MD

Denver, CO
United States

I’d been planning to take a six-month hiatus from medicine for years. Although I’d resisted the “burnout” label, I knew I was falling victim. Approaching 2020, the timing seemed good; my sister was pregnant with her first child and needed help. After a decade working at a university in London, her visa wasn’t renewed. She was forced to leave her home and once-guaranteed paid maternity leave to return to the U.S. Her partner departed, as well, though he wound up in his native Cuba. It was unlikely they’d see each other in the coming months, and certainly not for the birth of their daughter.

At 32-weeks along and laden with 11 boxes and a house cat, my sister moved into the spare bedroom of a cousin’s home in south Florida — temporary accommodations as she navigated unemployment, Medicaid enrollment, and the anticipation of a baby on the way. It was mid-January, and I was busy making my own plans to join her for the early days of new motherhood. I would fly out on March 19.

I knew it would be a challenge for the family I was leaving behind in Colorado, but my children — a 12-year-old daughter and 15-year-old-son — are old enough to understand, and my husband had been encouraging of the respite. After all, it was he who saw the signs of burnout before I was ready to utter the word. A break would be good for all of us.

Meanwhile, a global virus outbreak was gaining attention: COVID-19. We weren’t particularly concerned at first, but were busy preparing nonetheless — getting fitted for N-95 masks and learning all the ins and outs of PPE. Leadership was being prepped, and contingency plans were taking shape.

The week before my scheduled departure, I attended a book club, as I always do, and packed for a weekend family getaway. Some events were cancelled, but normalcy was largely intact.

Wednesday night, I joined my fellow family medicine colleagues for an evening of dinner and conversation. We laughed together, shared our concerns, and left feeling emotionally and physically sated. 

And then everything changed.

I was scheduled to attend a date night concert with my husband and a hockey game with a friend. Cancelled. Schools closed. We kept our getaway, though the mountain on which we’d planned to ski, and hike, and spend our last few days together before my departure felt eerily quiet. We drove up in the morning to a bluebird sky and fresh powder. By evening, the announcement was made that ski resorts were shutting down for the season.

The fear set in.  

We drove home in silence Sunday afternoon and into a new reality. We were entering the pandemic, and no one knew what that meant.

I kept my routine on Monday morning, waking early to workout before heading to the clinic at 7:00 AM. I was feeling a little under the weather and hadn’t slept well, but nothing particularly concerning. Under the circumstances, however, and at the behest of administration, I phoned the office manager to let her know. I also moved out of my house and into our garage apartment to be safe, opting to work from home until this minor cold passed. Most of my visits were now remote, so the disruption was minimal.

It wasn’t long after my voluntary isolation that I learned a patient who had been in our office twice in the previous week was in the hospital with COVID-19. Another provider came down with similar symptoms as mine, but no fever or cause for concern.

Our organization had set up a FURI clinic to safely see patients with fevers and upper respiratory infections; providers had adequate protection and COVID-19 tests were available, so I decided to visit. Tuesday morning, my colleagues administered a nasopharyngeal swab. I would now have to wait in self-quarantine for six days for the results.

There was no other choice than to cancel my plans with my sister and reassess when I had more information. 

The following Monday, I received the call: “You’re positive for COVID-19.”

How could that be? I wasn’t sick, not really. But I was a risk. For a physician, knowing that you could infect those around you is a disquieting emotion. First, do no harm.

I continued working remotely to care for patients and support staff. There were daily meetings with leadership about how to manage our clinics safely and effectively, rolling out telehealth rapidly, and trying to keep ourselves, our teams, and our hospital providers healthy. Two of our doctors were now positive, and one was on oxygen. I wondered if that could happen to me. I thought about how I put my family at risk before even knowing I was sick. How would I be able to help my sister? Even wearing a mask and gloves, we know so little of the disease that I couldn’t tempt fate. And if I did go to Florida, would I put my elderly mother with chronic neutropenia at risk? She was planning to be with my sister, as well.

I felt the stress and pressure build. My husband and children implored me to stay. Other family members condemned me for even considering traveling. But I also knew how alone my sister was, with no support or resources.

She needed me. What else could I do? 

I rebooked my flight for the following Thursday, just passing the CDC-advised ten days of convalescence and void of symptoms. After all, if health care workers were allowed to return to clinical care at that point, isn’t that a sufficient bar to care for a newborn and mother? Truth is, I didn’t know. The experts didn’t know — and to be sure, I asked every expert I knew.

Hours before my flight, I was retested. I cried my goodbyes, with trepidation and uncertainty emanating out of every pore.

Denver International Airport was a scene from some dystopian novel — apocalyptic. I was the only person checking a bag. The only person in the security line. Sitting at the gate, tears streamed down my face. I called my mom, who let me know she’d be there when my plane touched down. She reassured me that she had her N-95 mask, and that my guest room was ready. We’d be careful.

There were barely a dozen passengers on my flight — so strange to have eight rows to yourself. When I finally arrived in Fort Lauderdale, the usual buzz of ride shares and taxis was absent. I wondered if I could have gotten a hotel even if I tried. Getting into my mother’s car, I felt a surge of gratitude.

I spent two days with mom — days filled with unconditional love and conversation and waiting and crying. I stocked up on groceries for her before borrowing her car to drive the 30 minutes to my sister. 

I was clad in a mask and gloves, with a pocket of sanitizing wipes, when I finally arrived at my sister’s home. It was clear she was doing little more than breastfeeding and trying to soothe her little one. She hadn’t been eating much, so I got to work. Funny how women — regardless of generation or circumstance — seem to fall so effortlessly into that sweet, silent rhythm of caretaking. I did laundry and reminded her to nap when the baby naps and shower when she can. I offered advice from time to time as both a mom and a physician. And a kind of normalcy settled in. I even resumed telehealth visits and the occasional meeting as I played mother’s helper.

She and baby thrived, with two pounds gained in just a month. We spent much of our days idly talking about the future — whatever that may be. With the pandemic fueling so much unemployment and uncertainty, we began to make plans for her to move to Colorado. It would be the best place for them to plant roots.

Our time together was precious. And even in knowing that she would soon join my family in Denver, we were both overwhelmed with a sense of sadness when the goodbyes finally came. And I was relieved, too; no one I’d been in contact with over that month had gotten sick.

On April 26, I returned home. My flight was delayed several times, so I was late, dashing to the garage apartment to quickly shower and change before the long-awaited, bittersweet reunion with my family. I’d spoken and video chatted with them multiple times a day (especially my daughter), but missed them — terribly. I hadn’t even stopped to consider just how much I’d ached for their company. Indeed, it was the first time I’d entered my home since the onset of my symptoms nearly six weeks prior, and I’d missed so much. I missed supporting them through their own challenges — learning remotely, away from friends, missing team sports, and getting weary of close quarters.

And in that moment of reunion, I realized I missed something else.

I have a hearing impairment. I wear glasses. I’ve had anosmia since my COVID-19 diagnosis in March. Entering the house, I suddenly felt the loss of all of my senses. Mostly, I missed touch. I hugged and wept with my family.

What a strange time we’re living through. The impact is still to be determined and a new normal still so far off. But as we work to rebuild our communities and health care systems, I hope we don’t permanently lose the human connections we’ve been asked to pause in the spirit of public health.

I long to find our way back to touch. But how? How do we ignite and normalize conversation around human connectedness? How do we strengthen relationships with family, communities, colleagues, and staff? How do we welcome vulnerability and reach out when we feel alone? How do we create communities where everyone feels included and valued?

I came into 2020 feeling a sense of burnout. I’m now seeing in COVID-19 the importance of the shared human condition of connectedness. For that, I’m grateful. In my personal statement for residency, I quoted Ralph Waldo Emerson [in a variation of a poem attributed to Bessie Stanley], who wrote, “To laugh often and much; to win the respect of intelligent people and affection of children; to earn the appreciation of honest critics and endure the betrayal of false friends; to appreciate beauty; to find the best in others; to leave the world a bit better, whether by a healthy child, a garden patch, or a redeemed social condition; to know even one life has breathed easier because you have lived. This is to have succeeded.”

Emerson’s words are more apt now than ever as we look to rebuild our world: to laugh with friends, leave our communities better, find beauty and connection. If we can do that when the dust settles, then truly, we will have succeeded.

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