I am an anesthesiologist and a physician specializing in anaesthesia. I chose this profession with its difficulties and rewards. I knew there would be sacrifices and I gladly made them. I wasn’t expecting this, but here I am, doing what needs to be done, if for any other reason it’s not what I’m doing.
I want to share with you something I wrote in the summer of 2020. I couldn’t share at the time. It was raw, personal, and pervasive at the same time. Reading this can evoke feelings of fear, anxiety and dread. The kinds of feelings that have slowly subsided over the past year due to tests, treatments, vaccines, and a decrease in the severity of the disease. Life looks better now. Work looks better now. I have come to a place where I am ready to share and remember. I hope we remember when we remember the motivation to prepare. What do we do now to be prepared for the next pandemic?
“How will you come back?” Ask friends and co-workers. Honestly, it’s hard, a lot harder than before.
2020 was going to be our year. It’s the year my husband and I changed our lives in an effort to support the difference in our ages and do what we’ve always wanted to do before it was too late. Retire early and switch to part-time work in the weirdest of ways, full-time only for part of the year. The rest of the time, we’re gone, we’re traveling.
The plan was to travel internationally from January to May, return to work in the warm months, and take off again before the first frost. We started strong, and then factors beyond our control, like a global pandemic, brought us home. Well, not home, because we don’t have a home anymore, but we went back to the States where I really found myself, in the trenches of anesthesia.
Not sure what I was expecting. Not sure how I thought it would be, but here’s how it goes.
I routinely report to the operating room around 7 a.m. to get this done, I now wake up forty-five minutes earlier than in my pre-COVID days. I ate breakfast at work as per the time allowed. I used to walk into the locker room five minutes before my scheduled time, and toss my scrub, ready.
Now, I’m eating at home and planning extra time to put my safety gear in the communal locker room.
I wear an N95 mask covered with a level 3 mask with a face shield at all times. The N95 is turned on first, over the hair cap. In my closet there are five types of N95 masks they are fitted for.
N95 masks are designed for single use, but we’ve been using them now for several days. The type for which it was installed cannot be sterilized. Instead, they are stored in a brown paper bag with the date written on the bag, and rotated on a five-day cycle until they become dirty or difficult to breathe through. I pat it on my face and then breathe in, feeling the leaks. The glasses are then put on, taking care not to get caught in the rubber bands of the mask to risk loosening the seal. Then the mask with the shield, and a second hat, taking care to cover the entire N95 to keep it clean for several days of use. I grab two plastic phone cases, one for my shared work mobile phone, and one for my personal cell phone. I sanitize my hands frequently, every time I touch anything.
Ready, I head to the OR.
I try to avoid unnecessary social contact with others. However, I talk to many people every day. Masks make it hard to hear and understand each other, so I’m often around other employees who wear thin non-medical sheet masks or others who wear vented masks and seem to need to remind them of the need to cover them in order to protect not only the wearer, but others. I walk into patients’ rooms and ask them to wear the mask they’re supposed to wear but don’t often wear, or to hold the mask under their chin or nose. In labor rooms where the condition of patients and their partners is unknown, I ask both the patient and their partner to put on their masks and wonder if there is any point in that. I basically walk to their house, the room they’ve been living together for hours. I walk to provide epidural for pain control as a woman in labor uses alternating breathing or screaming techniques, both of which increase the risk of spreading the virus, to combat the pain of her contractions.
I take off my mask once a day to eat and drink for 20 minutes. For a location to eat, I go outside or find a place where no one else is. I wash/sanitize my hands after touching all hospital buttons and doors needed to get to this place before touching my face to remove my mask. The outer mask I consider dirty, the inner, clean. I sanitize my hands after removing the masks before eating and again after eating, before putting the masks back on my face. If my work day extends beyond 9 hours, I sometimes allow myself a second drink, which requires that dance all over again.
From the time I put on my scrub to the time I take it off, I hear the blue top page icon, or “STAT anesthesia,” which may call me into the room of a patient with COVID-19 gasping for breath or losing a fight. In these cases, I quickly get dressed, and add layer by layer of clothing to protect myself and my loved ones from this dreaded disease.
Then I touch on what has always been a stressful situation with these extra burdens. As I perform one of the most risky procedures for virus spread, intubation, I hope the N95 mask will maintain a precarious closure. If I’m lucky, a colleague stands outside the door in case I need help and watches and guides me as I carefully remove my layers of clothing in an effort not to contaminate myself after the fact.
At the end of the day, I went back to the locker room. I tossed my mask and scrub off, put the N95 back in his paper bag and write today’s date on the bag. I remove scrubs trying not to let the shirt run my face while I take it off. I wash my badge, glasses and phone because these things should come with me to my car. I wash my hands and sanitize my hands, and put on the clothes I was wearing at work. The glasses and badge go into the UV sterilizer in my car. I drive home, I leave my shoes outside, I walk, I take off my clothes in the laundry room, I turn on the washing machine, I go straight to the bathroom. My mouth and nasal passages are dry from the mask, or from dryness, and I don’t know which one. My chin is bruised and my face is exploding. However, there under the warm water, I begin to relax. When I go out, my husband is there, and I know for sure that all the precautions are worthwhile. We spend the evening together, until the next morning, when I do it all over again.
Again and again, until the first frost, when we become nomads again. Where will the Bedouins roam? What will be possible at that time?
I don’t know. Only time will prove it.
Davida Grossman He is an anesthesiologist.
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