The Gift of Space

So much can change in one week.  Last week I was seeing patients in clinic in Kaiser Permanente (KP) Seattle, doing cases in the surgery center, getting ready to head to Shiprock New Mexico for my week at the Indian Health Service.  I had been asked to help out with KP clinics in Bellevue.  Sunday I flew to Albuquerque.  The airport and flight were empty, people keeping respectful distances from one another. When I landed I received the text from the Shiprock Chief of Surgery.  He explained he was getting push-back about my coming, that they would prefer I stay in Seattle, a high risk “hot spot.”  This despite my confirming with the Chief two days earlier that I should come.   So I turned around and flew right back to Seattle.  I wasn't entirely surprised; everyone is anxious and afraid.  They think closing borders and building walls will keep out the virus.  Little do they know it is already here.  As of this morning, the Navajo nation has fourteen documented cases of Covid-19.

On Monday I went to KP clinic with the new mandate that non-urgent visits be converted to phone visits.  The CDC guidelines had come out a week earlier and included recommendations to cancel non-urgent surgeries.  Virginia Mason, Swedish, and UW/Harborview had already instituted these changes; now KP was following suite.  So I reviewed my current clinic patients and verified that most visits could be done virtually.  Later that night I received a call from the KP Service Line Chief thanking me for my help, but my services were no longer needed.  As a locum tenens (temporary, part time) surgeon, all my patients are non-urgent.  With the belt tightening and redistribution of resources, I am too expensive for the organization.  I could not even have final phone visits with my post-op patients.  I abruptly went from three jobs to none.  So here I am, taking an unplanned, unpaid sabbatical.  But don't worry about me.  I got this.  I have been training for this my whole life.

Social distancing is my default setting.  Social interaction is an intentional override of my basic programming.   Four years ago when I quit my full time practice, I had planned on taking six weeks off to breath, to think.  Instead, I immediately embarked on a three week road trip.  I start doing independent medical exams.  I spent six weeks in Africa; six weeks in Asia.  When I came back to the US, I start working in Delaware.  Over the last year, I've been doing clinic work in Seattle and in New Mexico, and continuing with IMEs.   I never took the time to reflect, to just be.  Until now.

How will I use this newfound space and time?  First of all, by connecting with other people in this unfamiliar situation.  This blog will be one way of reaching out to people out there, people who feel alone and anxious.  Even though I am a physician, I will not bombard you with medical information.  There are reputable sources out there (CDC, WHO, Johns Hopkins Public Health).  While there are well intentioned posts on Facebook, many are from untrustworthy sites.  Yes, this is a serious public health emergency, but please don't get overwhelmed.  Take a social media break.

If you do need some simple rules to follow, here they are.  Remember, I am a  (over-educated, under-employed) medical professional.

Wash your hands.  

Cover your mouth with a tissue when you sneeze or cough.
Stay at home.
Don't eat pangolins.
Don't stand so close to me (okay, so this last one is about hot teacher Sting having impure thoughts about a student, but still.)


"Tell me, what is it you plan to do with your one wild and precious life?"
                                                                             Mary Oliver

Here are some thoughts for how to spend a day.

1) Practice gratitude.  Be thankful if you have shelter, food/water, meaning, friendships, family.
2) Reach out (virtually) to those who may be struggling.  The elderly, sick, those shut-in with restless children and surly partners.  Use technology to connect, rather than alienate.  Call someone every day.
3)  If you can, donate to organizations that provide services for those who are hurting.
4)  Read that novel that's been sitting in your nightstand forever.  Start writing that novel that you've always talked about.
5)  Listen to your favorite music (aka desert island discs).  Check out the new shows, music, movies people have been talking about.  Netflix and chill literally.
5)  Practice your instrument, your art.
6)  Do an online exercise or yoga class.   Take a walk (six feet apart).
7)  Take an online class.  Visit a virtual museum.
8)  De-clutter your house (aka clear your space.)
9)  Do your taxes.  Write your will.  Not to be morbid, but we are all going to die.
10) Work in your garden.  Spring is here.

Over the next few weeks, I will try to blog more regularly and share some thoughts on how we get through this crisis.  These are my thoughts, take from them what you will.  We all need to care for one another and ourselves.  I'd like to say every post will be unceasingly cheerful and upbeat, but that will not be the case.   But today I will be positive.

Part of my routine involves a daily walk through my neighborhood (Portage Bay).  Yesterday I strolled to the Arboretum.  Is it me or is the air sweeter since everyone stopped flying and driving?  I breathed in the scent of the creeping clematis.  I noted how the clear blue sky contrasted with the exuberant cherry blossoms.  The elementary school was eerily quiet; just a couple of kids shooting hoops in the playground.  I waved to the elderly couple sitting on their porch.  I recorded the vibrant colors of tulips and lilacs and daffodils.  I gave thanks for the beauty surrounding me.