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.