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

Faith Pernitelli, just weeks out of medical school, stood with the team of physician trainees at her first morning rounds. On the one hand intimidated by the upcoming expectations and responsibilities in a strange environment, and on the other hand proud to be a physician ready to step up to a new level of patient care. She looked around at her new colleagues, only known by brief introductions at orientation.

“I’m Faith Pernitelli,” she said, prompted by her superior for self-introduction. “I am from Lubbock, Texas, where I went to college and medical school — and to kindergarten through twelfth grade.”

“Thank you, Faith,” Ann said. “It wasn’t hard to hear the Texan part in your accent.” Ann McCauley was a second-year fellow, having completed the four-year residency in obstetrics and gynecology, the one Faith was now starting, and in her sixth year of training after medical school. “What brought you to Albuquerque?”

“I matched here,” Faith said. “I didn’t want to stay in Lubbock. It was time for a change.”

“Welcome. Here are the duties expected of a first-year resident,” she said, handing Faith a sheet. “It’s not a complete list. Everybody is expected to do whatever needs done, when it needs done. You can call anyone on the rest of your team if you need help, and, in return, you can expect to get called to help. On the back of the sheet are some important telephone numbers which we all have memorized, and you will too, in short order.”

Faith grinned, looking at the sheet which was well organized. An explicit assignment and a place on the team slowed her thundering heart. “I can handle that.”

Ann looked to some other faces. “What about you?”

“I’m Josh Menkowicz from Oklahoma. I like fetuses, births, and pregnancy. I went to college and medical school in Oklahoma and needed a change of scenery, like her.”

Ann gave Josh another copy of the informal job description sheet she had just handed Faith. “Welcome.” Without a breath, another tattered scrap appeared from her pocket. “Today, we have a cesarean section on a patient with a large baby and there is a patient in labor. We have an asthmatic spending her second day here getting her medications adjusted. There are some patients who delivered yesterday who need to be discharged, given appointments, and have prescriptions written.”

“Which of those do I participate in?” Faith asked.

“Faith, why don’t you help with discharges and post-partum rounds, and Josh, why don’t you go see the cesarean patient, make sure admission paperwork is done, and then help me with the cesarean.”

The group broke out in conversation as they scattered to their duties.

Josh and Faith stood scanning their duty sheets as Ann approached. “I’m Ann McCauley. The rest of the team and I will sort of herd you into your duties. Normally, one of you presents the patients, and then one of the more senior residents presents the complicated patients, like our asthmatic.”

“I think we can jump right in,” Faith said. “I didn’t have trouble assimilating on any of my senior medical school rotations, even the short ones. This little cheat sheet you gave us will really help.”

“Yeah, we’re on it,” Josh agreed. “We won’t disappoint you, Ann.”

Faith followed the cheat sheet and the advice from several others as they visited patients on the post-partum unit. “Hi, I’m Dr Faith,” she said to a woman standing at the bedside attempting to pull clothing on to a baby flailing hands and feet. She had learned in medical school that patients handled “Faith” well and “Pernitelli” poorly. “I understand you are planning to go home today.”

“Yes,” she answered. “I am excited about that.”

“Do we call you Angela?”

“Or Angie.”

“Did you already get your rubella vaccine?”

“Yes, just a few minutes ago.”

“What is your plan for contraception?”

“I always took the pill, and it worked out well for me.”

Faith went through several other issues, including vitamins, her follow-up appointment, about bathing and showering, and where to call for help with breast feeding. “Do you have any questions?”

Angie studied Faith’s face, then returned to her baby. “Why do I feel so down? This morning I cried because I dropped a clean diaper on the floor. Is that normal?”

“Yes, completely. Pregnancy makes huge body and brain changes, then the birth comes along and brings it all to a screeching halt. You might have some other things that happen, too, like having trouble sleeping, weird dreams, or forgetfulness. If there is anything bothersome that sticks around, you should call us.”

“Thank you. Where do I call?”

A glossy booklet lay on the foot of the bed. Faith opened it and circled the number inside the front cover. “Don’t hesitate. Even if it’s in the middle of the night or on a weekend, someone can talk to you.”

“Thanks.” She picked up her baby and handed him to Faith.

“Who is this good-looking one?”

Faith mirrored the wide grin on the patient’s face. “Joseph Oliver,” Angie said.

“He sure is good looking,” Faith said. “You get to go home today, Joe. I’ll bet you have lots of visitors in the next few days.”

Through the persistent grin, Angie said, “He has no idea. Both me and my husband are from big families. Among my cousins, two other babies were born already this year, and there will be one more.”

“Aww.” Faith looked back at the baby in her arms. “You’ll have to learn a lot of names, Joe. I hope you can handle it.” Joe slept on. “You’ll have plenty of cousins to play with. Here you go, Joe. Your mom will take you home.” After handing off the baby, Faith said, “Well, good luck. Call us if you need us. See you in six weeks.”

“Will I get to see you?” she asked.

“Yes, I made the appointment for me.”

“OK. See you then.”

Faith left the room, striding down the hall to the charting station where Josh was seated clicking away at a computer. “What are you doing here?”

“The cesarean was delayed, so I came to enter some more information on the patient.”

“I’m glad the computer prompts us,” Faith said, “otherwise, I’d be lost.”

“In a week, we’ll be sailing along, I bet.”

“I hope it doesn’t even take that long.”

He looked up from his work, “Do you want to get something to eat?”

“Yes, I skipped breakfast. I was too nervous to eat, but now I’m starving.”

In the cafeteria several floors below, the main hot meal line had closed until lunch. There was a bar with fruit, muffins, donuts, and coffee. “I need coffee,” Josh said.

They didn’t sit but headed back upstairs. She said, “I want to learn a lot and become an excellent obstetrician. I hope Ann and the others don’t mind machine-gun questions. Some of the residents and attendings were put off by that on some of my medical school rotations, but I didn’t care. If I wanted to know something, I just asked.”

“I was never that brave,” he said. “I asked questions, but I can’t interrupt a discussion for one.”

“I don’t have any trouble. I don’t need to be the best liked by my mentors or the best friend of my peers.”

“I get that,” he said, pulling his phone from his pocket to answer it. “The cesarean is ready to go. I’ll see you later.”

She went on to see more patients, one of whom talked to her about when to go back to work. “I think that is more up to you than to anything medical,” Faith said. “There really isn’t any way for you to injure yourself, so it has to do with childcare, your personal preference, and your energy level. Remember, you are getting this advice from someone who’s never had a baby.”