Tony Scott: Along Came COVID: Love and Loss in the 2020 Pandemic

“But you seem to have a brain, unlike some of our doctors and nurses,” she said from the reclined position on her bed.

“This is your third baby,” Faith said. “Your life is going to be really hectic, if it wasn’t before.”

“It was. I even worked part time. I don’t know if I can do that now. Childcare is expensive, and I don’t know if my husband is up to three kids for a whole weekend like before.”

“There are so many adjustments. Some of them will disturb you, but don’t worry about that. How is your family?”

“I have a good husband, a sister, and a sister-in-law who have been helping me a lot. My mom gives me good advice, but she works, so she’s been limited help. I’ll be able to manage.” Faith heard the coming challenge in her voice.

“Good,” Faith said. “Is there anything I can do for you?”

“No,” she smiled. “I didn’t plan this one, so I’ll just have to work it out.”

“You’ll do fine.” Faith reviewed the call center number in the same glossy folder she had shown Angie. “Well, good luck. Call us if you need us.”

At the charting station, Faith wondered if her advice was correct, if it was helpful, and if there were elements she missed. She had completed all the pieces Ann had listed on the cheat sheet, but she wondered if the sheet was the cake but not the icing.

“Ann,” Faith said when Ann whipped into the charting station, “I don’t know if I’m getting it all done. The patients ask me for advice, and sometimes I don’t know what to say to help them.”

“First, being upbeat and positive is as useful as what you tell them,” Ann said. “Only experience and follow-up will answer the rest. There are patients who need to be pushed, and some who need to be slowed down. It will take time for you to get a routine and into a comfort zone that works for you and your patients.”

“Thanks, Ann,” Faith said. “I hope I get there quickly.”

“I know you will,” Ann said, “because you want to.”

“Really?”

“Yes. Don’t worry about it.” Ann whipped away.

Faith dialed her phone. “Hi Dr Faith. How’s it going?” Faith’s sister Natalie was always a comfort.

“I think well. I saw some patients on my own, and I think I did what I’m supposed to. Our leader, named Ann, is really helpful. She gave us a cheat sheet of our duties, which is fabulous. I think it will be fun. I like the patients.”

“That all sounds good. Who is us?” Natalie was young but unusually perceptive.

“Me and Josh, the other first-year resident on this service. He is lucky because he is doing a cesarean now and has a delivery later today.”

“That’s exciting. How come you don’t sound like it is exciting?”

“It is exciting,” Faith said, “but it’s also scary. I’m now in the thick of things. As a medical student you’re more of an observer. This is a huge step.”

“That’s what you always said it would be.”

“Yeah. I don’t know if I realized how big a step.”

“Oh, Faith, sometimes you’re a weenie. I’ll bet in two weeks you’ll be scurrying around not thinking about it at all.”

“I hope.”

“Mom says you’re having trouble with Brian again?”

“Again?” Faith said. “Not really. Just the same. I don’t know where this is going.”

“He’s not a husband, Faith. What is he? Are you going to do anything about it?”

“Not right now. I have too much on my plate. I have to get into this residency and get my feet on the ground.”

“Don’t you have him as your supervising attending at work?”

“We will have,” Faith said. “We had our director today, Emily Beacham. She is a really good instructor. I can’t imagine Brian being like that — or even wanting to be.”

“What has to happen before you actually take some action, Faith? Don’t you agree things are not good as they should be?”

“Yes. But I can’t tackle that until work settles into a routine.”

“Whatever.” Natalie was pushy and honest but didn’t overkill an argument.

“I’ll talk to you later,” Faith said.

“Sure. I love you.”

“I love you too.”

Faith sat in silence for a few minutes trying to put the whole thing together. Brian was being a pain in the neck, and now he had accepted a position which made him her supervisor at times, never the case in Lubbock. Because she had maneuvered her senior year Ob-Gyn rotation while he was out on rotation in his fellowship, she had avoided any direct interaction. She was not looking forward to this new arrangement. How would she be able to interact and question him the way she did her other mentors?

Home wasn’t working, but it wasn’t at a flash point either. She would be able to tackle the Brian problem when work had settled down, after she had grasped her responsibilities, and after she meshed with her co-workers. She also had to settle into her new apartment, unpack boxes, and find the laundry room. Her Brian problem would have to wait.

Haley Denton, a third-year resident, opened morning rounds. “We have been reading about a new coronavirus which has been causing severe respiratory failure in China. There is now a report of a patient in the state of Washington who has this disease. I couldn’t find any more information. The first identification of it was late last year, so we are calling it COVID-19.”

At each of morning rounds, a faculty member, called an attending, was present, whose duty it was to be instructive, directive, and supportive. Brian Yankton, today’s mentor, asked, “There are dozens of human coronaviruses, most of which are innocuous respiratory illnesses that cause few if any hospitalizations or deaths. Do we think this virus is any different?”

“Yes,” Haley said. “According to the article I read, this one is on the order of SARS and MERS. MERS was well contained in the middle east, SARS has disappeared, but both were deadly.”

Faith said, “It’s already inside the United States?”

“In Washington state.”

“Was there was ever a case of SARS or MERS in the United States?” Faith asked.

“There were SARS cases in the United States, but there were no cases of MERS.”

“OK,” Brian said. “Let’s move on to the patients and get rounds finished.”

“Wait,” Haley said. “The whole point of rounds is to explore issues like this and expand our knowledge, is it not?”

“Yes, but we did that,” his inflection impolite. “It’s time to move on.”

Faith opened a folded sheet of paper. “We have two patients in labor, both of whom should deliver today. There is another who just arrived who we don’t think is in labor and can go home.” She made no eye contact with Brian.

“I need you to call and tell me about her before you discharge her,” Brian said. “I want to hear about each and every patient.”

“We have a patient with type one diabetes who has been here three days, recovered from diabetic ketoacidosis, and is ready to go home.” Ann stopped.

“Is she on a pump?” Brian asked.

“No. She does her own administration.”

“Can’t she get a pump?”

“No,” Ann said. “She can’t afford one. We do the best we can with those who have monetary constraints.”

“OK,” Brian said. “Thanks everybody.”

Ann approached Brian. “Do you have some idea about how to manage economically disadvantaged patients like this that you didn’t discuss?”

“No,” Brian said. “Insulin pumps and continuous glucose monitoring are what we should be doing. If the patient doesn’t comply, I am not sure why we even bother with her.”

“Sir, we have to take care of them the best we can. Otherwise, they show up in labor with dead babies, ketoacidosis, or worse.”