Month: December 2020

Vaccinated

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I received my COVID-19 vaccine today. The Pfizer one was offered to me and I took it. I feel a bit like I did after Election Day this year – ready for a big sigh of relief.

I still remember how we stumbled around COVID in the early days of the pandemic at my hospital. We weren’t quite sure what the precautions should be. When my first patient showed up, having just flown in from China, I went into the room alone, wearing an N95 mask and gown. But we still didn’t wear masks or eye protection in the workrooms and all other patient encounters were routine protocol. I remember the first time a COVID test was run on a patient I had seen on the inpatient service. My colleague called her daughter’s school and they asked her to pick her up. I was so worried that I had been exposed and would be exposing my whole family. Fortunately, that patient tested negative. I remember clinics shutting down completely and being converted to video. A few patients still wished to be seen in person and I would go in to see them. I brought my own Lysol wipes from home and wore scrubs every day. Hair up, N95 on, surgical mask over the N95, face shield in place. I would avoid my children when I arrived home and jump straight into the shower. I was so worried that I would contract COVID while pregnant – so worried that I stopped seeing patients at 34 weeks and took a full month of prepartum leave. At the time, all of these precautions seemed temporary and we thought we’d be up and running full throttle by the summer. And yet, here we are 9 months later.

One disclaimer here is that I am primarily an outpatient physician. I see oncology patients and do round regularly in the hospital on our consult patients, but I am not on the front line (emergency room, ICU, COVID units, etc.). I am in complete awe of the physicians, nurses and hospital staff who have been on the front line this entire time. I do not have it in me to do what they did. My patient population is primarily healthy, but there was still so much fear around pre-symptomatic patients coming to clinic, colleagues coming to work before diagnosis, etc.

All this to say that getting this vaccine was a big deal for me. It was a sign of hope – hopefully the beginning of the end. Although I plan to wear PPE the entire time I am at work, I feel reassured that I am less likely to contract COVID if I am exposed. Although we don’t have the data, I am also hoping that this means I am less likely to transmit COVID if exposed (again, this wasn’t studied, so we won’t know for some time). I am still nursing but decided that the risks to my infant of getting COVID were greater than any theoretical risks related to vaccine administration. I hope that by the time the general public has the opportunity to be vaccinated, we have more information to power the decision-making process. I am not the type of person who jumps on the bandwagon for new therapeutics, but as I always tell my patients who are interested in a new therapy or intervention – you have to weigh the risks against the alternative, not the ideal. Do I wish that we were not in the middle of a pandemic that has kept us away from our families for the past 9 months, kept my kids out of school for much of the year, led us all to wear masks and stay 6 feet apart and completely crippled our social interactions? Of course. But the fact of the matter is that we are in the middle of a pandemic and I will be working through it. It made sense to me to add a layer of protection by receiving the vaccine. And hopefully this truly is the beginning of the end and we can start moving towards relative normalcy sometime in 2021.

Merry

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Yesterday, I asked my husband what was on his agenda for work and he responded that it was a “thinking day”. A day to reflect on strategy, innovation, next steps. To be honest, it sounded glorious. A whole day to just think about something unrelated to the home.

Right now, I am enjoying a bit of quiet, thinking time. My oldest three children are with our nanny and my youngest is taking a nap with me, in the carrier. I have decided to return to work next month and am feeling incredibly conflicted about that. On one hand, I really miss working (I’m a physician). I miss my patients, I miss my colleagues, I miss teaching, I miss having adult conversations and I miss being able to THINK – about diagnoses, patient messages, treatment options, research, etc. On the other hand, the flexibility of my maternity leave has been a godsend – especially during this incredibly tumultuous year. In the morning, I don’t have to wake up before the children do to get ready for work. I can let them wake me up, sit with them while I drink my cup of coffee, stay in my pajamas and play. With school closed during this holiday break, we have even less obligations since I am not rushing to get the kids out the door in the morning. This flexibility allows me to be available at the drop of a hat when the school calls because someone is sick and needs to be picked up. If we didn’t get to errands on the weekends, I can run them any day of the week. I can take the kids to appointments whenever they need to go. Honestly, the flexibility is what I will miss the most. Even though my schedule is incredibly forgiving for full-time work, it is still a schedule. It is not easy for me to cancel a full day of patients because I hate letting my patients down (especially when they may have waited months for an appointment) and I hate creating more work for my colleagues and administrative staff.

I have really cherished the time I’ve been able to spend at home with my children this year. 2020 has been an incredibly unpredictable year and, at times, incredibly challenging. But I feel so fortunate to have had this time, and I will hold on to these memories as I transition back to work in the new year. One lesson I’ve learned is that quality is much better than quantity. When I have been home all day with the children, it is impossible to have fun activities planned all day long and to engage with them fully at every moment (especially when there is cleaning to be done, food to be cooked, etc). I feel confident that I can still incorporate a significant amount of quality time with each child when I return to work.

So I will spend these next few weeks cherishing each additional unburdened minute with them and reflecting on how to incorporate more of that time into a busier future. And I will also be looking forward to returning to a sense of normalcy – for myself – through my career.

Phase two

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My husband is back at work this week. It feels like the end of a chapter – 3 months in, past the harried days and nights of the newborn stage. For weeks, my husband and I took turns holding the baby days and (some) nights while the other tried to “get things done”. Usually things were a shower, cooking a meal, tidying something up. In the mornings, we tag teamed to get the older kids dressed and set up for virtual school or out-the-door for in-person school. He held the baby in the car when I had an appointment. I held the baby in the car while he went into the store to get groceries. We ate lunch together (and if we got take-out, this was also eaten in the car because of COVID). One of us would stay home while the other drove to pick up the older kids. When we were less sleep-deprived, we checked off some items from our to-do list. We also watched movies, TV shoes and read books. We took walks around the neighborhood. I feel very fortunate that he was able to take 3 months off this time. We talked during the day about our kids – adult conversations, something we can’t do when 4 kids are in the house. This hasn’t been the case after every baby’s birth, and I can tell you that the toughest postpartum period for our marriage was when our third was born. He kept working because the baby arrived 2 weeks early and he had some things to wrap up at work. Then, because we had family help, he decided to save his leave for when I returned to work. But it was hard. As the only person who could help me overnight, he would stay up and then be tired for work. I leaned on him to help around the house as well and this was an added responsibility for him. In sum, I am grateful for this time we had together, and also feel a bit sad that we are closing the chapter on our newborn days. But, as my husband would say, “we’ve done it 4 times. I think that’s plenty!” And he is certainly right about that.

So this week, I am adjusting to our new normal. He’s working from home and I’m in charge of getting the kids ready in the morning, driving them to school, tidying up, planning meals and spending time with our littlest one during the day. I, again, feel incredibly fortunate to have this extra time with my baby. I also have to admit that this is the hardest part of maternity leave for me, because I do think there is an imbalance in our marriage when my husband works and I do not. It is especially exacerbated during COVID since I have no alternative social outlet at the moment. I take great pride in my career. I love working with and helping my patients. I respect the trust they have in me and think about them when I’m not at work. I also have amazing colleagues and feel so indebted to them for keeping me safe during my pregnancy and covering my patients while I am out.

As I start planning for my own return, I am having a hard time deciding what to do. I am worried about going back to work during the winter COVID surge, but also feel that it is my duty to do so since I have “sat out” the past few months. I am concerned about committing to a schedule since the kids’ schedule is so up in the air. There are potential quarantines if any of the children or teachers in the classes test positive, and the kids have also had to stay home for a myriad of “symptoms”. Once, my 4 y/o had a temperature of 99 and “was not acting like himself”. Another time, my 6 y/o thought he might have felt a sore throat but it was gone by the time my husband went to pick him up. He still had to come home and get a COVID test (it was negative). Yet another time we quarantined at home for 14 days because our 2 year old was exposed outdoors to someone who later tested positive for COVID. I very much appreciate how cautious the school is – so far they have had no COVID cases – but it also throws quite a wrench in any plans to work as I so hate having to cancel patient appointments. So, basically, I am now having to deal with COVID reality for working parents. I have had a reprieve during leave and it was immensely helpful during the start of this crazy school year, but now I find myself incapable of being decisive on what 2021 should look like.

For now, I am trying my best to set up some sort of schedule for my remaining days at home while mulling over the return-to-work possibilities in my mind. I am enjoying these last few weeks of snuggles because this is our last baby. Maternity leave seems like a slow uncoupling, in preparation of returning to work. First, there is the full immersion in your newborn – he is held in arms all night, worn in slings or carriers all day, nose to sweet-smelling newborn head. I am there for every minute of his day – obsessing over details like wet diapers, hours of sleep, when he last nursed and on and on. Slowly, there is a move towards (relative) independence. Trying to get him to sleep on his own at night. Working on a morning schedule – now so that he can join me on the car ride to drop off his brothers and later so that I can feed him before heading into work. Soon I will have our nanny hold him for longer stretches so that he can get used to her and her to him. We’ll try a bottle while I pump (we have never followed the “introduce a bottle early” rule with our infants. I know it’s not recommended but so far we have not had issues and it honestly just seems like more work). Maybe I’ll run an errand without him, leaving him home with my husband. And that’s how we’ll transition from spending almost 24 hours joined together to my being away during the day. Again, I am fortunate: I work full-time, but my hours aren’t terribly long. I don’t have to be separated from him at night. I have the option of doing some of my work from home. Despite this, it is clear that this next phase is bringing me closer, day-by-day, to being away from him for longer stretches of time. And even though it is a choice, it is still hard.