This is a pandemic of uncertainty. In the meantime, I think our patients need us more than ever.
“How do you deal with uncertainty?” That question was posed to me during my rheumatology fellowship interview.
I lied and said, “It drives me to try to figure out solutions to questions.” Had I been honest, I would have said, “Terribly.”
Uncertainty is uncomfortable. Uncertainty keeps me up at night. I like control and planning and knowing what is coming next. Had someone clued me in that I was choosing a subspecialty defined by uncertainty, I might have chosen otherwise.
I’m 15 years into my career, and I’ve become more comfortable with this disquieting feeling. I talk about it with my patients. We work through uncertainty surrounding diagnosis, treatment and prognosis. We share the discomfort together and figure out solutions. But I found out recently that when uncertainty becomes personal during a pandemic, it is unbearable to embrace.
Anticipatory anxiety about COVID-19 mounted, and there was little to do to take control. The first cases in Pennsylvania were in my county, and the numbers were just starting to climb in the second week of March when I took my turn covering hospital consults. Barely any testing was available.
As I moved through the hospital halls, I pushed elevator buttons with my elbows and debated the utility of a physical exam. I donned a mask, but really only to cover my residual post-viral cough from an upper respiratory infection in early February. I would lower the mask from my face as I paused to read emails, checking hourly to see what events were being canceled next.
My medical group tried to pre-screen patients for symptoms, but patients came in coughing and told me in the office of their recent travels. When the governor put the county on lockdown and closed the schools, we canceled visits for the following two weeks, but came in for one last Friday of seeing patients. For those who showed up, I would sit with a mask on, six feet away, without laying hands on any of them.
COVID-19 Comes Home
On Sunday, I played basketball in the park on a beautiful spring day. But by the evening, my post-viral cough insidiously transitioned to something deeper. I was achy. I stared at the thermometer in disbelief as it registered a temperature of 101.