Juggling
Pamela Adelstein
It is Sunday evening of my first full weekend off since Covid-19 hit Massachusetts and I have a horrible pit in my stomach. On edge, I feel rather meh, like the cold stormy weather outside. Often my moods are influenced by the weather, but tonight the driving rain and wind is only a fraction of what nags me at my core.
Tomorrow I shall report at 8:30 am to the ILI unit, where all patients with influenza-like symptoms are shunted for their medical care. I will remain on that unit for 11 hours, 3-4 of those hours in full PPE. The other 7-8 of those hours I will spend on the phone with patients. I’ll be sporting freshly washed scrubs, my socks that say “badass” (got to match socks to situation), a face mask that has given me the worst acne since adolescence, and my new colorful head covering to keep back my messy, growing-out hair.
A weekend at home feels like a tease. Last week I worked so many hours I could not think, read, or even hold a meaningful conversation. During a busy workweek I move through the motions, faithfully showing up, doing my duty, returning home to shower and eat and sleep before the bedside alarm pierces the air the following morning. Somehow this routine reminds me of swimming laps, which I actually love to do. One breath of fresh air and then my head returns to the water, arms paddling, paddling to keep momentum and to remain afloat. At the swimming pool wall I turn around and do it all again. When I compare swimming laps to the pace of my current work, the gasp for breath is the piece of the stroke pattern that resonates most.
The health center feels like a giant box that is cut off from the rest of the ways of humankind. Inside the center walls, we go about our business: interacting in person with others, sometimes in small groups. We have structure to our days, mission, purpose. We get to leave our homes as essential workers. We even touch items that someone else has touched, rather than dropping goods off at someone’s door and scurrying away. As some have pointed out to me, “At least you get to go to work.” Though so much of our work is new, there are threads of the past routine that we can grasp to ground us.
The contrast between work and the surrounding environment reminds me of when I worked in an overnight camp infirmary. A camp where Jewish laws including those of Shabbat (the Sabbath) were observed; writing, electricity, cooking, and all other work was prohibited from Friday sundown until Saturday sundown. Saturday morning I would join my visiting husband and kids at religious services. We ate our breakfast outside on the grass, and after services I would stroll back to the infirmary. Walking through the door of the infirmary was like passing through a border to a foreign land. Inside the infirmary we used the phone if truly needed. I cared for kids, wrote, used the computer, and did what needed to be done. When my afternoon work was complete I returned to the world of Shabbat. No one at camp knew of my Shabbat journeys. The slower pace of prayer, relaxation, and shmoozing was counter to the same old routine at the infirmary. Each week I marveled at this. I found it almost comical for reasons hard to pinpoint.
In this era of Covid-19, I move between two worlds. It isn’t time travel – it feels more like space travel. In one world, I am sealed inside my home, as we all are. Zooming, trying to exercise, hoping to focus on reading for pleasure, worrying about what will happen to us all, wondering what to prepare for dinner, considering all of the accumulated clutter produced by four people living and working and recreating in one space, but not actually doing anything about the clutter. Noting the change of season, the birds chirping, trees and flowers blossoming. Anticipating packages on my doorstep. Parenting and partnering. Getting behind in my email. Home can be chaotic, but occasionally I savor some blessed moments when I actually forget we are living through a pandemic.
Work, my other world, is all-consuming. Nothing is routine – logistics are complex and ever-changing, and the to-do list has no end. Many questions have no answers. We improvise and watch intently and seek the sweet spot where new workflows run themselves. Glitches present daily, which beget meetings, which beget emails, which beget a need for more staff and more money, and more anticipation of what may go wrong, and more, more, more.
The pit in my stomach quakes as I navigate the space between these two disparate universes. These worlds blur when I check work email from home and discover that additional services have been rolled out at work and I have no clue about them. Or when I log onto the electronic health record from home and peruse messages that my patients have sent, asking for advice, medication, letters, or a simple phone call returned (which in practice, sadly, is never simple).
At work the disconnect hits me in those sparse moments where I have time to check my personal email or read my texts. My in box fills with offers of jokes, lectures, videos, information, news, etc. – anything to help those with copious time and without daily routine and structure create some. I know many people are lonely, bored, worried and scared. Others wish they could do more to help. Still others are overwhelmed by working and parenting at home while trying to maintain some semblance of normal. Everyone’s reality has shifted.
I do not know how to wrap my head around this “space travel.” Many others in our society have described similar phenomena – soldiers entering civilian life, prisoners released from jail, trauma survivors, and those who have literally traveled from one culture to another. Thinking too hard about it can be unsettling and disorienting. Movement helps shake loose the uncomfortable visceral sensations. A good book, movie or tv show (do they call them that anymore?) helps. So does connection with loved ones. Most crucially, I need to ground myself and try to integrate each day into my being to counter the forces that threaten to sweep me away.
Pamela Adelstein MD is a family physician at the Codman Square Health Center in Dorchester, MA and a preceptor of Boston Medical Center family medicine residents. She is a graduate of the UMass residency program (Family Health Center of Worcester). Writing helps her process complicated experiences and emotions. She enjoys spending time with her husband and two daughters and loves to practice yoga and kayak.
