Week 7. Journal Entry. To the Parents…I See You.

The last two weeks my practice has been taking upwards of ten referrals a day. We can’t take everyone. There aren’t enough of us and I’m the only person who is full time.

I try and get back to every one. I’m not sure I’m always successful. Between the e-mails and phone calls and seeing patient’s at least nine hours a day, often more, and dealing with insurance companies…yeah it’s a lot. Aetna screwed up my reimbursement and they only let you give them three claims at a time that need to be corrected when I call provider services.

It’s their error but I’m the one who had to call three times to have them re-process nine claims. I emailed my rep and blasted them. Then sent the remaining ten via email to her to process in bulk.

Anthem. I can’t even comment on Anthem. At the end of this I will be dropping them.

Meanwhile I still have two four year olds screaming in the background of all my sessions.

My clients are all anxious. They all can’t sleep. They are Mom’s feeling like failures because they’ve yelled at their kids more in the last six weeks than ever before. They are teenagers stuck inside missing out on their senior year- senior prom, graduations, it’s all passing them by. They are Queer or abandoned young adults who had found refuge on college campuses; now finding themselves homeless; couch surfing or taken in by a generous friend’s family. They are front lines worker’s fearing for their own safety and the safety of their families.

They are front lines worker’s who have already tested positive. They are family member’s of people who have died from COVID.

For the people protesting this lockdown and calling it all a hoax. Sit in my chair for one day. Then take yourself back home. People are dying.

It’s a heavy time for mental health professionals. We are carrying the loads of everyone impacted by COVID. Because I haven’t talked to one person who hasn’t been affected by it.

There is a general feeling of exhaustion among parents. We are tired. We want a break from our kids. At least I do. And many of my friends and clients agree. I don’t miss the daycare bill. But I miss the reprieve. My kids do too. Even my Jackson. He’s finally started asking to go back to school. Only took him seven weeks to miss it.

I keep trying to be grateful for having a job. For having an income (no thanks to Anthem). I’m grateful for my health. I’m grateful for…yeah then I fall flat. Because I desperately and acutely want life to go back to normal. I feel like I go through the stages of grief. All five of them- rapidly- daily. Denial. Anger. Bargaining. Depression. Acceptance. Except I think I mostly skip the acceptance part. Maybe that’s when I’m trying to be grateful. Definitely lasts a minute. Maybe less.

I deny that this will permanently change my life. I’m angry that our whole life was turned upside down. I try and think in my head the different ways I can fix this. Then I get sad because I know I can’t. I see some clients. That may or may not make me more sad. Then I accept. Then I start over again.

It’s twisted.

We try and make things seem normal. But they aren’t normal. The first two weeks were like adventure camp. The next two were like an outward bound likely abusive wilderness camp. The last three weeks were a blur. So busy with work and clients. Aching for warm weather. Making follow-ups into July and saying, “Maybe we will be face to face by then…”

I’m meeting people’s pets. They are meeting mine. Both cats make frequent appearances on camera.

During a rare hour of me working with my wife out…me doing an intake; I wiped one of my son’s butts while on facetime. The things I never thought I’d do. Wipe poop during an appointment. The struggle is real. The client actually had no clue and was relaying a rather distressing part of their history.

I tried to maintain a neutral expression as I slowly moved down the stairs and into the bathroom, (in response to him screaming “MAMA! I POOPED!! CLEAN MY BUTT”) then wiped with one hand while carefully keeping the phone held up and in the opposite direction. My whole body was contorted and it was one of those times I wish we were filmed. Because that would have been reality tv gold.

My friends in mental health agree. We are all beat. We all feel the brunt of this pandemic on our clients. We all also feel the brunt in terms of the broken healthcare system. Clients can’t pay their premiums or their deductibles. Then they get mad at us for billing them. I do payment plans, and reduced fees, but I need to get paid also. It’s a reflection of our broken healthcare system but it gets taken out on healthcare workers who are business owners.

Seven weeks. I crave normal more than I can possibly put into words. I crave time away from my kids. I crave normal volume of referrals. Not ten a day. Not desperate pleas for help. I crave work that is separate from my home. Because the blending of the two makes it harder to create boundaries for my personal life.

Our coffee maker broke this morning. I had an epic meltdown. We have a new one now. I’ve said this to my clients and feel that it resonates with me…I’m filled up. Too much stress. I can’t handle extra stress. Broken coffeemaker…that went into the extra stress category and I couldn’t deal. I made one of my sons eat his muffin on the deck. I was sick of vacuuming the crumbs. It’s not warm out- not freezing- but not warm. Within about thirty seconds I felt like maybe I should let him back in. But my wife didn’t say anything. So he finished his muffin on the deck. Then he cried. I cried. In the midst of the meltdowns and muffins his brother stated “He will get eaten by coyotes!” And my wife and I shrugged and said maybe.

That’s where we are at. His brother opened the door and announced he would save him from the coyotes because obviously both his Moms have lost it. But legit, the amount of crumbs is not just a little bit. It’s like half the muffin on the floor.

If I have to tell them to leave the cats alone one more time it might break me.

I’ve already warned my co-workers who work inpatient to just drug me up and let me sleep if I make it in there. Honestly it would be a relief. Bed. Drugs. No kids. You know it’s bad when you’re dreaming of a psychiatric admission.

This is the essence of COVID stay at home orders. Feeling filled up and still having to make room for more.

Seven weeks. Hang in there. Parents of kids…we are all heroes after this for making it through alive, sane, and with our kids intact.

P.S. #45 still sucks. No surprise there. North Korea’s leader may be dead. Weird. And New Zealand’s leader is killing it. But female leaders all are too emotional and irrational to lead…and the e-mails.

Mental Health Stigma Suicide

(Non-Pandemic Post) Racism in Mental HealthCare.

This has been digging at me for awhile. I collaborate with several therapists and prescribers of African American (also Jamaican and Haitian) descent.

There is one in particular who practices close to where I am located, and who is simply phenomenal. I refer practically everyone to her. She’s seasoned, she doesn’t get phased by high acuity, and she can take on complex families and cases, and she is always open to collaborate.

I’ve had more than one client come back to me after a couple sessions with her (often white parents of a white kid) who ask for another referral as they “don’t feel it’s the right fit.”

You can imagine my facial expression right now. It’s the one that smells and calls out bullshit.

I always pry to the Nth degree…exactly what is not the right fit? Yeah but exactly what didn’t go well for you/your child…I need to know precisely the issue because I don’t want the same issue to happen with the next person I refer you to. They usually smile because people tend to smile when they get uncomfortable. They squirm in their chairs, and make super vague statements about what went wrong.

I push until it is awkward to push any further.

I’ve then spoken to the therapist and we hash it out. We are comfortable enough with one another that she can say if she feels it is related to race or not and I agree or disagree. Most often I agree.

There was one case that the family just didn’t want to do therapy work. It was almost palpable relief to us both in that dialogue that there was one white family who wasn’t racist, just lazy. We laughed about it.

As I said, she is seasoned. I value her input and I value her clinical opinion. I don’t think I can put into words the enormous respect I have for her clinically. It’s hard to find good therapists. Especially forty years into a career when they can be burned out or a little crazy and not as invested in their clients. But she invests everything in her clients. I definitely have a top ten therapist list of who I would refer my own family members to. She’s on there. Probably at the very top.

To hear her question herself and her skills because of ignorant people who discontinue treatment abruptly because they are racist creates this anger and hurt that again is hard to put into words.

I’ve read “Me & White Supremacy” by Layla F Saad which helped me explore my own internalized racism and white privilege because I have Black clients who have made me do better and be better. Hearing experiences of African American women who have been abused and marginalized and ignored creates a space that cannot be ignored by any white person I would hope.

I’ve fired a client after they fired that therapist. One client admitted to me it was because of race. One client admitted to me it was because they didn’t feel they could benefit from treatment from a Black woman. I told them they likely then couldn’t benefit from treatment with a lesbian. So I’d provide them a referral and they could leave.

No one else has ever admitted to me that it was due to race. Though I have asked outright. I told her recently that I fired that person and she remembered them even though it was a few years ago. I didn’t tell her at the time. I didn’t know if it was right or wrong or what.

The older and more experience I gain the less tolerance I have for racism, hate, homophobia, bullshit.

It eats at me that a skilled clinician questions their skills because white people are ignorant.

I can’t apologize for other’s behaviors but I can ask white people to do better. Check your privilege at the door because there are plenty of brilliant Women of African American Descent who know so much more than you and who can support you and just do their jobs as clinicians. Skin color should not qualify a person to be or not be your therapist. That’s ridiculous.

I’ve lost clients because I’m out about being Queer. But I don’t wear it on my skin. I have it easier.

To all the clinicians of minority status whom I work with please know I’m challenging clients in my office. I’m not letting it go if they discontinue treatment abruptly and if they admit to discontinuing treatment due to the color of your skin I’m discharging them from care.

And Dear white people. Do Better.


Pandemic Journal Entry #1001….It’s cold.

Some things I never thought I’d do that I’ve done during COVID.

  • Apply for NY state licensure. I’ve had several clients who are transplants living here now, and want me to continue seeing them when they move back to NYC. I figure why not, it’s the right thing to do.
  • Had my sons do so many crafts they now literally cringe when I asked them if they want to do a craft, and run away.
  • Contemplate my mortality in a way I never have before now, even when my asthma was severe enough to warrant an ICU assessment in the ED a few years ago. Still didn’t seem as real as life and death does today.
  • Make masks for my kids and watch them wear them.
  • Mail masks to family and friends.
  • Become more bitter toward Anthem than I already was as a healthcare provider.
  • Buy a fancy mic and earphones for telehealth.
  • Buy pillow shams and make bed daily. Literally never in my life until COVID.
  • Miss people.

We finished week 5. It feels like week 15. While at the same time thinking we have at least another month of this seems insurmountable.

My boys finally were able to connect with a friend from daycare via FaceTime and that was fun. Though there seems to be this sadness with them after every video call- of why can’t we see them? Why are we stuck here and them there? Why? They know vaguely that there are germs we are waiting to go away. It’s really hard to explain a pandemic to a four year old without getting too graphic and without being too vague.

I’m tired. I find that my practice is busy, and my patient’s are sick. Sicker than normal. People I would normally refer to intensive outpatient programs (IOP) or interventional psychiatry (ECT, TMS, etc) or even inpatient; I’m trying to manage them outpatient at a private practice. It’s a lot.

I’m involving families (spouses, parents) more than I normally would because for people who would generally require a higher level of care- it’s a condition for me to try and manage them at home that supportive adults in their home know the situation and are actively involved in their care.

There are a lot of ethically deep situations that normally don’t exist. Pandemics change everything everywhere. I’ve refused to trial new stimulants on children who have had adverse reactions it the past because I don’t want them to need acute medical attention and not have access to it. It’s caused some heated discussions with parents. Spouses don’t always want their partners involved. Adult children don’t want their parents involved…etc. etc. But sometimes it’s not safe to do it any other way.

I try to live in the grey. I try not to be black and white. But there are certain standards of safety I will not compromise on and COVID-19 is making me learn a whole new level of compromise (and my clients).

There remains a blanket of fear and anxiety across everyone including myself. Who will get sick next? Will it hit clients, their families, my friends, their families, etc. There remains a level of fear regarding finances and income and paying next months bills.

My kids have been five weeks without daycare. They miss their friends. They still miss their teachers. They still crave a normalcy and routine that is not the same at home. Well, correction, one of my kids wants preschool back. The other could live this life forever. I have a homebody and an extrovert. My homebody says he only misses his cousin, my niece, and her mom’s (my sister and sister-in-law). My extrovert misses everyone and routinely runs through the names of his teachers and friends in case we’ve forgotten them.

They watch me as a I sew masks. They comment when I use a new fabric. They know that something isn’t right in the world because never has their Mama sewn masks before. They are acutely aware of the fear around them. We all do our best to move through each day as best we can though.

In the mean time people still get depressed. People still get manic.”Normal” mental health and physical health problems still happen. STD’s still happen. Pregnancy. Births. Deaths. Life goes on as we all try to adapt to life in a pandemic.

What keeps me going is my family. My kids. My wife. But also that moment when a client first connects with our video session. I have seen so many sincere smiles when they see me. And I have given so many sincere smiles back. I’m an anchor of normal in a wild sea for many of my clients. And whether they know it or not, they are an anchor for me as well. Doing my job, psychiatry, that grounds me. It’s normal. It feels right. I’m good at it. Even remotely via video I’m good at assessment, diagnosis, and clinical recommendations.

It feels good to be doing something I enjoy, that I learn from, that I feel confident doing and that I know still challenges me in every way. It also feels good to see people I’ve treated for years pop up on my screen and smile. To see a familiar face that suddenly relaxes when they see me; feels good. Even if five minutes later they are breaking down due to the stress and mental illness. It still feels right.

I can’t describe what it means to me to be able to continue to do what I know and love day to day during a time of such uncertainty. It provides me immense stress in some ways but also is incredibly grounding in other ways.

I didn’t go into owning my own practice three years ago with the intention of facing a pandemic in 2020. But I have rolled with it. Changed and updated where I needed to. And I continue to be open to change to help my practice survive and thrive. The first two weeks were absolute panic. But now, five weeks in, this seems somewhat manageable. Most of the time. If I really think about it I can spiral into a sea of…failure, broke, homeless…and every other bottom of the barrel thought I can imagine. I try not to spiral.

COVID-19 brings incredible stress and illness everywhere it hits. Even remotely. But it continues to allow me to grow as a practitioner and also to grow as a Mom. Not many parents can say they’ve parented through a pandemic. These are strange times. When we come out on the other side we will have done something incredible.

Some day our kids will look back and, hopefully be asked along the way about being alive during a pandemic, and be able to say they don’t really remember because it just seemed like normal times other than no preschool. That is my hope for my kids.

On the periphery COVID-19 has only affirmed my belief that our President is Hitler re-incarnated. #election2020 #votelikeyourlifedependsonit

Also on the periphery is the fact that many nurses I know are furloughed. Yes furloughed. Many hospitals have cut back on nursing because outpatient clinics and surgical centers are closed. So while it appears we have a major healthcare crisis in terms of shortage of PPE and shortage of warm bodies…healthcare professionals are being furloughed.

And there is massive shortages of PPE. Local hospitals are telling staff to use gowns for multiple patients (supposed to be single patient use), and wipe down after multi-patient exposure to use again later if needed. Masks are to be used for an entire shift, sometimes entire weeks at at time, and if JACHO or DPH ever comes in and bitches about food/drink at nurses station again I’m pretty sure they will be slapped. Hard.

Regulatory bodies love to show up when nurses are breaking their rules. But when hospitals are breaking the rules, to the detriment of nurse’s health, well those regulatory bodies are just nowhere to be found.

If you thought there was a nursing shortage before the pandemic. Just wait until after. I guarantee there will be many who will leave the workforce (I know some who have already quit due to no protection) and the horror stories are out there to prevent people from wanting to join. Polices have to change to protect nurses.

Cheers to week 5.

Stay well. Stay sane.

And it’s cold here in the Northeast. It snowed. Twice this week. I’m ready for some warmth. Still going hiking. Even though it’s freaking cold. Because there is literally nothing else to do. Work. Bake. Arts & Crafts. Hike. Obsess over pandemic. Sleep. Repeat.


Pandemic Journal Entry #58?…Exhaustion. Easter. 911.

It’s been an eventful week. One night a drunk driver crashed through the guardrail across the street at 2:14 AM. He then proceeded to wander around our driveway, our neighbor’s yard and driveway, and tried to open our cars. I called the police. I live in the sticks. It took about 10 minutes for the police to come. The drunk guy’s friends showed up and sped off with him. The police missed them.

If I was in my hometown the police would have been there in two seconds. And I likely would have gone to high school with the responding officer. It was weird. Calling a stranger police. My wife and I also had a discussion that if we were actually in danger that was a long ten minutes to wait. Not a fan. As a result we are looking at alarm systems today.

I was about to purchase one at 3 AM the other morning, but decided to wait until daylight and after some sleep so I could think rationally. In retrospect that was a good decision.

Another night my cat ate my flowers (my wife had them delivered on the anniversary of my Dad’s death) at 4 AM and then puked.

Another night one of my kids peed the bed. Another night we found him sleepwalking in our bathroom where he peed on the floor.

So no sleep this week. And it’s Easter on Sunday. Trying to make it “normal” but also acknowledging that it will just be the four of us and so not normal.

All day with the boys. Every day. It was a year since my Dad passed on 4/6. I took the boys for a hike up by a waterfall. It was a beautiful day and thanks to the pandemic I wasn’t focused on my grief at all. More generalized anxiety due to COVID.

I made the boys masks. It’s bizarre sending my kids out with my wife to the post office (to mail masks to our friends and family who have asked for them) and having them wear masks. We’ve told them there are a lot of germs right now, and they are definitely anxious- hence the peeing I think- but we try not to emphasize the germs and illness piece. Though the masks they have to wear. It’s all bizarre.

My days are full with patients who I see remotely for at least eight hours, often straight through, then at night I make masks and try and catch some snuggle time with the boys. It’s an odd regimen. I have finished four weeks now. Four weeks of telehealth for my practice. Four weeks of making masks. Four weeks of no daycare for the boys.

For my wife it’s been three weeks of being out of work and a full time stay at home mom.

Our lives have taken on this strange rhythm. I find I like looking out my home office window and seeing the big pines sway in the wind. I like the fire going and walking downstairs and being able to hug my kids in the minute or two between patients. Then I feel angry at myself for liking any of this.

Because there is a deeper part of me that longs for our lives back. Normalcy. Going to daycare drop off. Going to my office. Running to the grocery store for a few staples. Running to the bank. Seeing friends. Playdates. Seeing my mom regularly. Going hiking with my sister and sister-in-law and niece. All of these normal, seemingly simple things, that we all took for granted.

I miss hot yoga. I don’t necessarily miss people. Naturally an introvert, I’m okay with minimal interactions. But I miss my people. I miss my friends. My family.

I have a very low no-show rate. That’s a bonus. Everyone is sitting at home. I am often their one and only “thing” to do that day. They greet me smiling and with some relief. I am still the same. I’m still somewhat snarky, I’m still very caring, I still cause their teenage kids to roll their eyes at me and I now am taking care of several parents of my teenage clients who need acute treatment for anxiety. It’s been multiple sessions when parents ask their kid to leave for a minute and they have a minute of breaking down with me, and relay their fears about COVID.

So many of my clients are afraid. Afraid of catching COVID, afraid of dying. Afraid of family members contracting COVID and dying. Afraid of not having a paycheck. Afraid of not being able to pay bills.

My Queer clients are afraid of the stories of doctors choosing who lives. They have asked, “If there is a trans person and a cis person who do you think will get the vent? If they know that I’m Queer I’ve got no chance.”

The fear and anxiety is palpable and after four weeks on quarantine it’s taking it’s toll on everyone.

I remain humbled and honored that family members of my clients feel safe with me and have asked to see me or another practitioner at my practice in these strange times. I’m lenient with the co-pays. I’m telling people I’m keeping track of who owes but if they need to wait and pay me in September they can.

I’m working late and starting early to see trans intakes and healthcare provider intakes. I’ve had far too many healthcare providers call. It’s heart wrenching. I am providing space for front line providers to talk. I hear about the conditions. I hear about the deaths. I hear about their fears for themselves and their families. They grapple with the loneliness and isolation that comes with working front lines. They can’t see their families. They haven’t been touched with affection in weeks. During the toughest months of these people’s lives they can’t hug or be hugged. 

I treasure every snuggle with my sons. I treasure every time I round a corner in our house and one of them bangs into me and wraps their arms around me. Because I see the strain in my client’s eyes, I see the bruises on their faces from the masks, and I hear their sobs as they recount their utter isolation.

The days are draining. The weeks are long. And now we are through a month.

To all the front line workers…I see you. You are incredibly brave, selfless, and it would be wrong if you didn’t have a few breakdowns during this. Please reach out for help. There are many mental health provider’s who are here for you. It hurts me in my gut to know you all are not getting hugs and affection right now. What a cruel punishment for the people who need it most. This is temporary. You will be hugged again!

To all the mental health providers seeing front line workers…keep on keeping on. This work is important. I’ve yet to meet a new client who is a healthcare provider who is anything but grateful for giving them space to grieve/feel/cry etc.

Meanwhile I will keep spending each day trying not to be come too accustomed to this life even as I find myself staring out at the pines not admitting to myself that I love the view.


#COVID-19 · politics

Dear Mayor DeBlasio, a response to your op-ed about drafting medical professionals…Truly yours, a nurse.

Having worked in the emergency department, which is essentially the red-headed stepchild of a hospital, I already know that people treat ED’s like crap until they need one. No one make massive donations to emergency departments like they do cancer centers.

We are unseen heroes.

Until COVID. Now all of the sudden people have taken an interest in our critical care skills. They are hard skills to learn. I felt like it took me a year to become a real nurse in the emergency department. Longer to master IV’s on a coding child with parents screaming in my ear. Longer to recognize the signs of a child who can wait five hours versus some one who can barely wait five minutes to be seen. I left the emergency department proficient.

I saved some kid’s lives along the way. I started a lot of IV’s. I pounded on chests with no heartbeat and I breathed air into lungs that could not breathe for themselves.

In six and a half years I was exposed to H1N1, Influenza B, Tuberculosis, Pertussis, Hepatitis C, and meningitis. More than once. I was kicked in the ribs the week of my wedding. I spent the week of my wedding dealing with bruised ribs and worker’s comp.

I carried with me the grief of parents and the sights of dying children.

I saw my co-worker’s brutally assaulted by patients.

Throughout those six and a half years I never had the support of management. I had to fight to get a Pertussis vaccine covered by the hospital after my third exposure. I had to send about ten e-mails and make multiple phone calls to get worker’s compensation to cover the emergency department bill that occupational health made me go to when I was kicked in the ribs. During H1N1 we had a shortage of masks and gowns and gloves. We were told to put up and shut up or be fired.

We never received raises consistently and we never got paid more during the H1N1 pandemic for risking our own health. Our hospital did not cover any costs incurred when one of our employees got sick with influenza or H1N1.

The day I left the ED I left my family, my co-workers, but I stepped into a new life as an advanced practice nurse where I could leave behind the crap that came with knowing some of the best people I’ve met in my life.

I’ve been reading the articles and watching the stories and hearing from my own friends of nurses shamed and scorned for speaking out when we don’t have protection or PPE and I know I made the right decision back in 2013 when I walked away from the emergency department. Hospital management did not have our back then and it does not have our backs now.

I’ve been approached by the hospital I work at per diem to put my critical care experience to use. My brain and my skills are valuable right now. But they don’t want to pay me adequately. My skills are desperately needed and I am deserving of pay equivalent to risking my life.

I unapologetically value my life at more than just 45$-65$ an hour with no hazard pay or differential. As should all nurses.

Mayor DeBlasio, you implore healthcare provider’s to come forward and just put their lives on the line. Yet we know that on a good day hospitals and management don’t have our backs. They have their own. You have offered no incentive for any nurse or MD to step forward and risk their life. Risk time away from their families. Risk infecting our families.

Pay us. Adequately. Forgive all loans for all medical professionals who respond. Partner with state colleges in NY, CT, NJ, MA and offer free master’s degrees or bachelor’s degrees once this is all over for nurses to advance their education.

Guarantee PPE. I’m sure you’re sick of hearing about PPE. But I said recently to a hospital employee if you could guarantee me a new N95, face shield, and full body PPE I’d sign up today. But they couldn’t. I have kids. I have a family. I am the sole financial provider right now. I’m not risking my life for hospital systems that haven’t risked anything for us.

I can tell you nurses and MD’s are not soldiers. We didn’t go into healthcare to risk our lives. But the longer you work in critical care the more you realize our lives are risked daily. Without a pandemic. And you see how little front line employees mean to the hospital system.

We are not flooding into the frontlines because you have not guaranteed us free healthcare should we contract COVID-19 while “volunteering” for you.

Most of us have deductible plans. Who is going to pay our six thousand dollar family deductible if I’m in the ICU unable to work because I heroically answered your call, worked the front lines without appropriate PPE, and contracted COVID-19? Are you Mayor DeBlasio going to guarantee free healthcare for acute COVID-19 cases in all your healthcare workers and also free mental healthcare long term for the PTSD that will inevitably ensue in all your front line workers watching people die? Because on your website and upon pressing by the media the response was “Well most of our volunteers have health insurance,” That is NOT good enough Mayor DeBlasio.

You say to draft healthcare providers. Soldiers receive college tuition, healthcare at top hospitals in the country, free housing, adequate pay, and many other benefits that should come with being a soldier. You are asking us to soldier up without offering us any reason to do so other than we just should because you are desperate.

Until hospitals and cities and governments start incentivizing healthcare providers by paying us adequately for risking our lives, providing long term financial ease by canceling all student debt for first responders, and guaranteeing free healthcare for any COVID related exposure illnesses that occur during employment and emergency response to a pandemic…then you can write all the op-ed’s you want trying to appeal to healthcare providers (especially those of us with critical care experience)…but no one is going to answer that call.

Many of us have been there. We’ve worked front lines before. We know the risks and we know hospitals and management don’t have our backs and in this case we also know there aren’t enough masks to have our front.

Prove me otherwise and then maybe you’ll get the people you need.

I’ll summarize for you- Pay me. Pay my loans. Offer free education afterward. Free housing and food during. Free healthcare during and after for anything related to COVID-19. Offer life insurance policies. And for God’s sake. Provide me with adequate PPE- not sterilized, not re-used- I’m talking full body suits. Look at some pictures from China.

Those are my conditions for re-entering the front lines. I hope every nurse demands the same.




Pandemic Journal#4…Waiting for the Hurricane.

I live in the Northeast and when we are hit with a hurricane we usually have plenty of warning. It’s both a blessing and a curse because there’s only just so much preparing one can do before a storm blows onto our shores.

That’s how this has felt. We’ve been seeing it everywhere, and in the past week it’s been slowly creeping into our state. Now it’s here. For sure. Some of my clients have it and some of their family members. I’m grateful I went to telehealth when I did. I’m grateful I have that option.

I read stories and hear from other nurses who are having to stay away from their families right now and as one of my son’s screams upstairs while I write this I think of that for an instant with some longing, then I snap back and repeat ‘I am grateful’ in my head.

After two weeks of almost no referrals this week my phone blew up. Thank God. But there’s an alarming trend in my new patients I’m booking. They are all healthcare providers. They all have no psychiatric history. They are all begging for emergent appointments.

While I am still doing telehealth and not on the front lines, I feel like I’m there because I’m hearing the stories all day long. They are bad. Nurses I’ve treated for years who work administration are being mandated to the bedside. No one has enough PPE. They fear refusal or questioning as they will be fired.

At least one hospital system in the state has now implemented new DNR policies. Two MD’s can make a patient (Even a patient without COVID) a DNR at any time based on their clinical judgment. To me it sounded like a way to prevent “Unnecessary” ICU admissions. Save the resources for the patient’s with the highest likelihood of survival.

That was hard to hear and hold. Most of my patient’s tend to like me. They at least know what to expect. I’m direct. I had a client call me hysterically sobbing recently to run a situation by me that they felt they needed feedback on and they knew I would be honest with them. They weren’t sure they were right. So they called me.

That felt like such a privilege to be that person’s lifeline. To hear such horrible crises on the front lines from the people working there- it calls for honest and raw reactions but not enough that I can truly show how horrified I am. Because I have to be the rock in the moment. It’s a lot as a psychiatric provider to hold right now.

I’m making masks in my spare time. I sew. I’ve mailed some to some of my healthcare provider clients. It feels like the least I can do.

I’m generally good at compartmentalizing. But COVID is truly challenging that ability. Not only is my work not separated from my home and family…enter telehealth in my home office…and my four year olds running in and out of the background of my sessions. I try and lock the door but I don’t always remember. Suddenly my many worlds are colliding every second of every minute of every day. I can’t compartmentalize out thinking about my cat recently diagnosed with lymphoma and CHF because she’s literally on my lap half of the day for most of my sessions.

One of my son’s is having some sort of sleep regression so he screams uncontrollably about whatever he decides he’s going to be upset about that night for an HOUR before bed. I never get an escape from them. I am never truly relaxed. I can’t go to hot yoga. I can’t go anywhere and if we do we are constantly worried about exposure.

It’s a story that is being replayed every day with all of my patient’s who do or do not work in healthcare. My patient’s all seem to understand the severity of COVID and they are singing the same song in every appointment I have. Tired. Anxious. Irritable. Sick of their kids. Sick of each other. Sick of worrying about getting sick. Sick of worrying about elderly relatives who won’t listen to stay at home orders. Sick of worrying about newborn babies. Sick of worrying about themselves or their partners working the front lines in healthcare.

The day to day is passing. This is the end of week three of COVID-19 stay at home orders. People are dying still. People are scared still. People are out of work. Worried about paying bills. Worried about homeschooling their kids. Healthcare providers are scared of speaking out for fear of being fired. They are scared to go to work but even more scared to be the whistleblower who gets blackballed from healthcare in the state.

I don’t have any uplifting message to leave you with today. As a true journal entry I will leave you with the true uneasiness and terror that we are living with. The outer edges of the storm have hit and we are now just expecting to be pummeled.

It’s like Book 5 of Harry Potter. Shit’s getting dark. People are already dying. More people will die. And we can only sit back and wait.

****TO any healthcare providers working front lines. Reach out for help. We are here. I see you and I know you are facing life or death every day. I know you didn’t expect this or ask for this. That you didn’t choose to face a pandemic with no PPE and an incompetent federal government. You have allies. Stay strong. You are my heroes. And if anything comes out of this I hope it will be organizing of healthcare providers and demanding improved compensation and improved access to resources.****


Jan. 22

“We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.” CNBC interview

Feb. 24

“The Coronavirus is very much under control in the USA. … Stock Market starting to look very good to me!” Twitter

March 9

“The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power … to inflame the CoronaVirus situation.” twitter

March 10

“We’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” Meeting with R. senators.

March 15

“This is a very contagious virus. It’s incredible. But it’s something that we have tremendous control over.” News Conference

March 18

“I always treated the Chinese Virus very seriously, and have done a very good job from the beginning, including my very early decision to close the ‘borders’ from China – against the wishes of almost all.” twitter

March 24

“I’d love to have the country opened up and just raring to go by Easter.” Fox News

March 26

“I don’t believe you need 40,000 or 30,000 ventilators. You know, you go into major hospitals sometimes they’ll have two ventilators, and now all of a sudden they’re saying, ‘Can we order 30,000 ventilators?” Fox News