I live in a beautiful place to isolate. We have ocean and sky and to my Northern eyes the Southern climate makes plants grow miraculously. My big Victorian offers ample space to ramble in bad weather. My neighbors boast darling baby lambs and goats and spotted piglets and happily sell us a leg of lamb for our quarantine Easter. We are raising a dozen layer hens who provide ample distraction from the covid universe.
This picturesque backdrop makes my work as a family doctor seem all the more bizarre and apocalyptic. Suddenly every decision carries a heavier risk. Rural medicine is always heavy with the burden of distance. Do you send the patient on an all day journey to see the specialist of specialists? Or do you try to manage with what we have close to home? Now proximity is such a burden I see more patients in the parking lot than in exam rooms.
Patients call with what sounds like heart failure and refuse to go to the emergency room because they fear covid. Newborns show up with febrile parents. Coworkers test positive. We stalk hospital charts wondering if our patients will be intubated today or will make it another day on high flow.
Grateful neighbors give us coffee and pizza and doughnuts. My nurses twirl in their isolation gowns. We become obsessed with hair covers and indulge in lattes and organize a group microbrew order and laugh hysterically at the everyday nonsense of humans. We are flooded with covid calls. We all want to quit. No one quits. We all want to cry. Most of us cry. We all want to scream at rude callers and disrespectful patients and we don’t. We do sometimes yell at our administrators’ teleconferenced advice while we are muted. We sweat inside our masks and gowns or sit alone in rooms with phones and screens.
Joyful seniors celebrate with me when they successfully log into their video visits and implore me to stay safe.
Patients show up for testing with oxygen saturations that usually render people unconscious. Patients video visit from inside crowded workplaces, from inside Walmart, from homes noisy with children, worried that they have covid. Patients die. Patients nearly crash their cars pulling up for swabs. Patients are transferred to hospitals hours away because our tiny hospital can’t take them all. A closet becomes an isolation room. A conference room becomes a covid unit. Patients ask us if they will die. Cancer patients worry about going to their surgeries. Cancer patients worry their surgeries will be cancelled. Children cry at my face shield. Children laugh at my face shield. Children haven’t seen their grandparents in months. I wonder if I will ever be able to see my grandparents again.
I grieve for small and large losses. I plan the most ambitious vegetable garden. I weed and shovel and rake. I watch spring magic, as the daffodils leave and the irises arrive. I frighten a heron when I go to visit the hens. Asparagus so tender and sweet it can be eaten raw snaps off in my hand. Strawberries ripen.
Written by Dr. Sandra Balmoria, MD