The Candid Truth Behind the Personal and Professional Struggles of a PGY3
Let me say this first; never did I ever think that I would experience a global pandemic during my medical career, nonetheless be on the frontlines of it when I decided to become an emergency medicine physician. I also had had a hard go with romantic relationships, which wasn't shocking as I had been moving around the country with zero control over my future in regards to location. Little did I know that becoming a resident at St. Vincent's would be such a blessing in disguise from both a professional and personal standpoint. I had seen Konnor in passing while in the emergency department--I had no idea that we had our
own police department, and I was pleasantly surprised that we had a K9. Honestly, I didn't even know Konnor's name the first few times we spoke, which was mostly me asking to pet the dog. Yes, pets make the best wingmen. While we will forever argue who is actually responsible for getting us to our first date, it was easy to develop the fuzzy feels quickly. He was a good listener and supportive when I would vent about my days at work, would bring me food or do my laundry when I was working call or forgot to bring my lunch, and was understanding of my ever-changing unroutine schedule. From past experience, anyone who didn't work in the medical field had a hard time understanding and wanting to maintain a relationship when my daily life was so different. Days of the week didn't matter, holidays were just another day, no I can't just call off or not show up because I wanted to do something else--I had dedicated my life to this and you had to either get on board or move on. Konnor also comes from a family where his brother is a tech in the cardiac cath lab, his sister and mother are nurses, and his dad is a respiratory therapist; maybe it was easier to get because of this? Either way, he was a saint. We were only dating for about 6 months before we moved in. The biggest initial issue was him tolerating all of my decorations and wanting to hang things over walls, so I considered myself pretty lucky. Obviously things came up, we learned about each other's pet peeves, and got into arguments. There was never a time I stayed mad or felt like he didn't care; the fights were small and usually over silly things like the laundry being in the dryer for a week or the collection of water bottles near the couch. Coming from a single parent home where my mom is my best friend, Konnor made sure to clue my mom in on his proposal which was a few short months later on the beach during family vacation. I had also learned a few days prior that I had passed my COMLEX Level 3. Life was good. Between being excited and being a planner I took no time to start with the wedding details; venue, cake, flowers, invitations, dress, etc. This poor soul went and saw 15 venues in 2 weeks with me. Through it all his largest objection was that we didn't go to enough cake tastings; again, if this was the worst of it, I was overjoyed.
Life went on, residency continued, I started flying as a flight physician for Mercy LifeFlight. I saw some chatter on the news about this virus in China, and didn't pay much attention. The save the dates went out, and I was having the bridesmaids pick dresses. The news picked up; masses of people getting sick and dying in Italy and Spain. Could it come to the US? If it did could we contain it? It was portrayed as an "old person" disease, and the people that were dying were 70 plus or had pre-existing conditions. It didn't seem real, until it was, because it was in my face. Cities and states started shutting down. Hot spots popped up with one being only about an hour drive away, where I had friends from medical school in residency. We didn't know much about it or how to treat it. With being a routine-based person that loves planning, the unknown and lack of control freaked me out. PPE shortages happened. Ventilators were sparse. Physicians and residents were contracting the virus and dying--was I next? I had to admit patients knowing they would likely end up on the ventilator and not be allowed visitors. I was following my COVID positive patients, and I would say 50% of them died alone, in the ICU. Funerals weren't allowed. This bothered me, a lot. I was in a city where my friends were my co-residents who I wasn't allowed to see outside of work. My best friends from college and medical school were all in different states, and my mom was home in Chicago. Konnor and I were still going to work as if things were normal, but they weren't. I would get home, shoes off in the garage with lysol to spray. Got inside the mud room, scrubs off and in the laundry bag, then straight to the shower. Hospital issued scrubs became the norm instead of my bright colored ones, with hair coverings worn daily. One surgical mask per shift, eye wear for all patient encounters. We reused our N95s 5 times before we got a new one. But get this: one of our attendings developed "The Covinator," a UV light incubator and you could put anything in there from your PPE to cell phones to ID badges. Our attendings and faculty advocated for our safety. We pulled all of our residents from off service rotations to have full support in the ED. We came together as a group to support and ensure we were all doing okay and being safe at work. I still felt alone somehow, and like I was on autopilot. Konnor knew I wasn't myself, and I hadn't been like this since we had been together. Was it going to scare him off, was he going to cancel the wedding? He would tell me of course not and when he proposed that came with a never ending promise, yet the wheels in my head kept turning.
Time passed. Some people said that the worst was yet to come, others said it would die down. I never verbalized it because I felt it was selfish but I hoped it died down so we could still have our wedding. One of my friends from medical school had to move her wedding from June to September, with most of us assuming it would be under control or gone by the fall, referring to SARS, MERS, and H1N1. Hospital policies changed daily. People who should have come to the ED were waiting at home out of fear, and when they did come in, they were extremely sick--and ended up in the ICU. We had tents outside our ED and were extremely short on COVID tests. We were transporting these patients by ground ambulance, and soon after we went live with transporting these patients by helicopter. We had the PPE, but I was nervous. I didn't want to, I was scared. Was I selfish, not meant to be a physician? If I got it would it be mild or severe? What if I died? Luckily I had POA and living will paperwork. Which also became standard of care for our COVID positive or rule out patients when they were admitted from the ED. Social media became my main source of anxiety, frustration, and anger. Yes, everyone is entitled to their own opinion, don't get me wrong. But seeing what I did and being in the thick of it while taking it home with me, it gave me different perspectives.
With quarantines and masks, numbers improved. Our COVID unit decreased in size. But our "city," compared to the volume and concentration other places, did not improve. Our county had the highest death rate in the state for a while and no one could figure out why. But then we started to take a turn as we obtained the rapid tests. Some of our frequent flyers and normal complaints started to return to the ED. Was this good, bad, or what? Things started to open up and wham, round 2. Although we had more cases, not as many people were being admitted or dying. Sports were still cancelled, people couldn't decide about school, large gatherings were prohibited, and traveling was frowned upon. Things weren't looking so peachy from a social perspective. The rescheduled September wedding was cancelled, with a to-be-announced save the date. While they had to cancel, they had a private beach ceremony. She still made the best of the situation (not surprisingly, she's a fellow EM resident in NC). This is when I started to really question my wedding, our wedding. Restrictions continued to lift, we were allowed to have full capacity (with socially distanced tables and masks inside). More people continued to cancel due to concerns. I was worried. My mom is in her 60's and a smoker. We have young nieces and nephews. My sister-in-law was pregnant. And my grandpa has COPD. I was also a physician who was supposed to lead by example. I hated myself for being conflicted and not having an obvious answer. But ya know what? Konnor, his family, and my family did--whatever made us happy. We pulled the trigger: rescheduled the reception for next year with plans to still legally get married in a private ceremony. The small amount of planning I needed to do for our new little ceremony brought back some excitement and happiness, even though it wasn't the day I had originally planned or thought of. We spent the weekend in Hocking Hills, OH, and had a 26-person outdoor ceremony. Guess what? It was perfect. The day flew by and I literally remember nothing besides saying "I do" to my best friend. Don't worry folks, the doggo was a groomsmen complete with tuxedo and all.
Our company policy also required a 14-day quarantine for an international travel so the all-inclusive private resort we had booked in Jamaica was no longer a go. We get 28 days of vacation as a PGY3 and can't take more then 7 days vacation in a single block; needless to say it wasn't physically possible. Let me tell you getting the trip refunded was a nightmare, and I was bitter. If I would require a negative COVID swab and pass a travel screening questionnaire just to get into the country, why would I have to quarantine when I got back (especially if we were going to a private all inclusive resort)? Again, I felt selfish and confused. Was I supposed to feel this way, am I being selfish? I had no idea and it bothered me. After some research online we decided to go to a tiny island in Florida. My chiefs and attendings were supportive during the entire process, making sure Konnor and I still got the time we needed for our special day and honeymoon. Complete with a video they sent us on our wedding day of current and past residents, attendings, nurses, staff, and friends sending their well wishes. Let me tell you I had no more tears to give.
Coming back to reality after a week in paradise full of salty delicious food and adult beverages, I felt refreshed and hopeful. Yes, COVID is still a prominent thing. It's not going away, it will continue to be a threat. But we have some ideas about it now, and are continuing to work on it. Social distancing and masks are still a thing, and also not going anywhere anytime soon. But these days leaving the house it almost seems normal: keys, phone, purse, mask. Surprisingly, being married doesn't feel much different than not being married. I feel like I have known Konnor forever and we just get each other. We lived together before and will continue to stay in our home since I signed a contract with the same health system. Now I ask myself, what's next? Well I already have a contract which I truly feel blessed with since hiring and salaries are currently on the fritz. Moonlighting at outlying facilities, which I am both excited and petrified about. I would like to take my ABEM board during my first year as an attending, but nothing is on time or normal with that either currently and lots of physicians are attempting to play catch up and waiting. Then Konnor and I want to have kids; do I wait until I have a year under my belt as an attending, will he be able to fully experience pregnancy with me with the current restrictions, is it responsible to bring a baby into this world right now, is it possible to study for boards and/or take them while pregnant or with an infant? Apparently growing up never ends and being an adult is hard. Also graduation is creeping up where I will have to say goodbye to 13 of my classmates that are basically family. What support system will I have locally once they are gone? Yes I will know second and third year residents and my former attendings, but I feel like I should also develop my own friends outside of work. I guess only time will tell.
Through this entire process I learned a few things about myself and life:
Time continues to pass and you're the only one that determines how it is spent.
There will be things you have zero control over and understanding and embracing it is the biggest favor you can give yourself.
Life is made up of situations and reactions to those situations, you determine the latter.
It is okay to not be okay, and you will continue to develop and have internal struggles throughout life because you are human.
You, yes you, deserve to be happy and don't settle for anyone or anything less.
You are never truly alone, you may feel that way but someone somewhere is in your shoes and knows where you're coming from.
Dogs make everything better.
Finally, Frozen wedding cake 2 weeks later is just as good as fresh room temperature wedding cake.