When my family and I left our New York City (NYC) apartment building in the fall of 2019, we said “goodbye” to our city life and set out to live in our first home in rural Massachusetts. We had built a life around the city and suburbs for years, made friends, visited family and enjoyed diverse experiences, but we longed for a quieter place where we could live amongst natural beauty. We were ready to leave, but it meant moving to an area where we did not know anyone. We also couldn’t have known that six months from our departure, there would be a global pandemic. Just as we were reaching out to meet new people, everything shut down. My husband, a teacher, began working remotely. My son’s school closed. Other parents transitioned to working from home.
But, I worked in a hospital.
Extra Strength Anxiety, Greatest Fear, Ultra Panic
Fear and anxiety resulting from hospital work were familiar to me. During my medical training in the NYC area, other students and I rotated through several hospitals in tough, underserved areas of the Bronx and Brooklyn. Duty hours are not regulated for medical students, and at times, we even exceeded 80 hours of work per week in poor conditions. We struggled with the lack of proper instruction in the inner-city culture of overworking. Points of pride were the number of consecutive hours one could stand, how little one could sleep, how much one could accomplish, and the trait of pleasing one’s senior physicians by not asking for help. As a result, I was often anxious when I had to google and guess how to practice medicine. There was also a culture of perpetual abuse – I had been screamed at and berated; during one long surgery, a surgeon flew into a rage and shoved me across the room, knocking over a cart of surgical instruments. That night, when I reached home, I curled up in bed and pulled the covers over my head. I was too scared to say anything.
At the beginning of the pandemic, those memories and the feelings associated with them came back to me. Fear, anxiety, and panic, like most feelings, trigger familiar circuits in our brain from times when we have felt them before. The frightened mind processes not only what is currently happening but also all the moments when we felt similarly. In March and April 2020, I got into bed at night and pulled the covers up once again, feeling the safety of that moment compared to the dangers of my workday. Only this time, in the minutes before I fell asleep, I worried about getting sick or getting my family sick. I was worried we might die.
At the start of the pandemic, when hospitals didn’t have enough personal protective equipment (PPE), our staff were given one surgical mask and one pair of goggles in a paper bag with our respective names written on it with a sharpie. We waited for supplies and continued each day. When we visited patients in the emergency room, in the locked psychiatric unit or on the medical wards, we were close to people and poorly protected. One day, a disturbed psychotic patient stood over me, screaming, and I could feel his breath and saliva on my face. On that day, those difficult times during my medical training surfaced. I believed I had put those negative experiences behind me, but they dropped into my mind like a stone, fear spreading like ripples and reaching me on the outer edge of those memories.
Moreover, I felt the deep pain and sadness of all those who were losing their loved ones. The colleagues whom I had left in NYC were devastated by the trauma of their daily work during the first waves of the pandemic. They didn’t have enough ventilators and witnessed many people dying alone. Those I cared for over many years were suffering far away from me, and I couldn’t be there for them.
Every morning when I arrived at the hospital parking garage, I walked with dread up the hill to the door. One day, I approached the entrance and saw a sign on it stating: “We appreciate all you do.” People from the community had placed signs, along with chalk writings on the sidewalk. Seeing this and working with my colleagues through those challenging times was a different experience for me than my years of training. This time, being afraid at work was a shared experience, understood, and acknowledged by others. It helped make this part of my professional narrative different from the past.
Reduced Patience, Freshly Baked Boredom, Precious Time
Strangely, I was fortunate to be able to get out of the house during the first phases of the pandemic. Although my colleagues and I talked through masks and shields and kept a distance, called video meetings with others in the very next room, we were near each other. We could talk about our fears and were figuring out how to do our work in new ways alongside others. My husband stayed at home with our five-year-old son, struggling to fill the hours while I was at the hospital. He was trying to complete his own work and care for our child. It was tough for them not to get bored and frustrated with endless throw-and-catch or Uno games. They brought up my husband’s old records from our basement and shared rock music to pass the hours, which they might not have done otherwise. They happened to find one tennis court in the area that wasn’t locked up and played there. I also struggled to fill the time with our son when I was at home, but work was draining, and there was no time to relax while doing both. As soon as I stepped into our house, I started my second shift – spending time with our child, making dinner, and ensuring smooth bedtime routines. I was glad not to be in a small apartment in NYC, but we still didn’t know many people in our new town. Hence, my family felt lonely without the support of familiar, reliable friends and family nearby. All of the usual ways we would connect with others, such as school drop-offs and sports activities, among others, were unavailable.
Vitamin Fortified Endurance, Calculated Risks, Self-Interests
As the weeks, months, then years of the pandemic passed by, it became an endurance practice. Everywhere, people lost the moments they dreamt of their whole lives, such as milestone birthdays and weddings, and couldn’t even have funerals to honor those who were dying. Many lost the careers that they had worked hard to achieve. We all lost something. There were moments when I reached my limit and disappointment spilled over, or when others did the same and expressed their frustration. Invariably, someone in the conversations would say, “It’s a pandemic. People are dying, which is more important than-” (fill in the blank –your job, loss of career, vacation, any time to yourself, sanity, or dreams for the future.) But having empathy for others’ struggles does not take away the severity of the illness and death. It is not a contest.
In December 2020, when the COVID-19 vaccine received its emergency use authorization (EUA) and arrived in hospitals, nothing was known about its long-term effects. The night before I would have been injected with the vaccine, I found out I was pregnant after five years of infertility. I decided to wait before taking the vaccine. Although my high-risk obstetrician (OB) agreed with my decision, some of my colleagues and friends were angry that I wouldn’t roll up my sleeve without question for the vaccine that next day. However, there was no existing data on the use of the vaccine during pregnancy. The brief trial didn’t include any pregnant patients, which was by design. Scientifically, testing experimental drugs on pregnant women is considered unethical because of the risks to the fetus, and therefore, it did not seem unreasonable to want to wait. My high-risk OB said that the vaccine could be either unsafe by causing miscarriage, birth defects or fetal death or it could be completely safe – we just didn’t know yet. Speaking generally, many friends and families were divided by who would get vaccinated and who would not or preferred to wait. As in much of our social lives, people do not always agree. The pandemic emphasized we all make our own choices (masking, gathering for holidays, or deciding on when to get vaccinated) and each person has his/her own unique life circumstances.
Healthy Attitude, “New Normal”
As soon as the rule of social distancing was applied, I noticed the opposite effect starting to occur. People began reaching out and checking up on friends and family in a way they had not been doing previously. Zoom gatherings began with friends that I hadn’t seen in a long time. My family, separated by some distance in recent years, had a Zoom call on Easter 2020 so we could all see each other for the holiday. True, it wasn’t exactly the same without the warm house, smells of cooking dinner, and magical light of the fire. However, a gathering would probably not have occurred at all since we had been living further apart. It was nice to see them and hear their voices. Ingenuity flourished – unlike a year or two of remote learning, our son’s school applied a new tactic. Outdoor classrooms were built, and school was resumed. Although my son’s sixth birthday had passed without much celebration, for his seventh birthday, we held a party in our yard with a magician in a face shield. It poured rain, and we were all quite wet, but the kids still had a lot of fun. Gradually, we got to know people.
At work, a senior physician started a meditation group to help us deal with the stress of the pandemic. I practiced meditation for the first time, something I might not have done otherwise, and it really helped me cope with the stress of those years. There has been a lot of suffering, but also so much grace in the moments when people helped others.
Our ability to suffer is in part what allows us to also feel happiness. In this age of social media, people have become afraid of talking about their struggles and believe that something is wrong with them when they feel sad. This is not a theory of mine; my patients tell me this often. Posts on Facebook and pictures on Instagram show how great people are doing, how good they look, how awesome their vacation was, and how far they succeed in life, but this is not a balanced view of people’s reality. It is not quantitatively bad to have difficult experiences or shameful to feel negative emotions but rather natural and human to have fear, pain, anger, or anxiety. Of course, we would all like to be happy and successful, but it is healthy to fail sometimes, experience and work through negative emotions and find healthy ways of coping. As a psychiatrist, I find some days hard when I witness others’ struggles in life. As a parent, I find it hard to watch my children struggle either physically or emotionally, but this is what helps them, like all people, to develop resiliency practices – the ability to withstand stress in a supportive environment. We all need the support of others, particularly when we are raising little humans. During the pandemic, I noticed several articles in mainstream news media written by parents about the challenges they were experiencing, and I deeply empathized with those struggles while feeling grateful that they had the courage to write about it with honest voices.
In my blog, I am hoping to share my perspective on parenting though the lens of a mom and psychiatrist because, in a lot of ways, these roles have been similar for me. I’m not offering medical or psychiatric advice, rather just thoughts on real life situations as they happen. Also, I hope the new reality we construct, or “the new normal,” can hold a bit more honesty about all of our experiences.