” How’s it going ? To tell the truth, it is much more difficult than before.

I am an anesthetist, a doctor specializing in anesthesia. I chose this profession, with its difficulties and its advantages. I knew there would be sacrifices and I gladly made them. I didn’t expect it, yet here I am, doing what needs to be done, if for no other reason I’m doing it.

I want to share with you something that I wrote in the summer of 2020. I couldn’t share it at that time. It was raw, personal and ubiquitous all at once. Reading this may evoke feelings of fear, anxiety, and dread. The kind of feelings that have slowly faded away over the past year due to testing, treatments, vaccines and the decreasing severity of disease. Life feels better now. Work feels better now. I have reached a place where I am ready to share, to remember. My hope is that by remembering, we become motivated to prepare. What are we doing now to be ready for the next pandemic?

” How’s it going ? friends and colleagues ask. Frankly, it’s hard, much harder than before.

2020 was going to be our year. This is the year my husband and I changed our lives in an attempt to consolidate the age difference and do what we always wanted to do before it was too late. He took early retirement and I went part-time in the weirdest way, full-time for part of the year only. The rest of the time, we are nomads, we are travellers.

The plan was to travel overseas from January to May, return to work during the warmer months, and leave again before the first frost. We started strong, then factors beyond our control, like a global pandemic, brought us home. Finally, not at home, because we no longer have a home, but back to the USA where I found myself really back, in the trenches of anesthesia.

I’m not sure what I expected. I don’t know how I thought it would be, but here’s how it is.

I regularly go to the operating room around 7 am. To do this, I now get up forty-five minutes earlier than in pre-COVID days. I used to have breakfast at work according to the allowed time. I used to walk into the locker room five minutes before my assigned time, put on my blouse, ready.

Now I’m eating at home and planning extra time to put on my safety gear in the communal locker room.

I wear my N95 mask covered with a level 3 mask with face shield at all times. The N95 goes first, above a hat of hair. In my locker are five of the types of N95 masks I have been fitted for.

N95 masks are designed for single use, but we now use them for several days. The guy I was fitted for can’t be sterilized. Instead, it’s stored in a brown paper bag with the date written on the bag, cycled on a five-day rotation until dirty or difficult to breathe. I mold it to my face, then breathe, feeling the leaks. The glasses then go on, be careful not to get caught in the elastics of the mask at the risk of loosening the seal. Next, the mask with the shield and a second hat, taking care to fully cover the N95 to keep it clean for multiple days of use. I grab two plastic phone pouches, one for the shared work cell phone, one for my personal cell phone. I sanitize my hands repeatedly, every time I touch anything.

Ready, I head to the operating room.

I try to avoid socializing unnecessarily with others. That being said, I talk to a lot of people every day. Masks make it difficult to get along and understand each other, so I’m often close to other employees who wear non-medical grade thin paper masks or others wearing masks with vents who seem to need reminding that these must be covered with in order to protect not only the wearer, but others. I walk into patients’ rooms and ask them to put on the mask they are supposed to wear but often don’t, or pull the mask up under their chin or nose. In labor rooms where the COVID status of patients and their partners is unknown, I ask both the patient and their partner to put on their masks and wonder if that makes sense. I basically walk into their house, the room they’ve been living in together for hours. I come in to provide a labor epidural for pain control, as the woman in labor alternately uses breathing techniques or screaming, both of which increase the risk of viral spread, to combat the pain of her contractions.

I take off my mask once a day to eat and drink for 20 minutes. For a place to eat, I go out or find a place where there is no one else. I wash/sanitize my hands after touching all the hospital buttons and doors needed to get to this location before touching my face to remove my masks. The outer mask I consider dirty, the inner, clean. I sanitize my hands after removing the masks before eating and again after eating, before putting the masks back on my face. If my working day exceeds 9 hours, I sometimes allow myself a second drink, which requires starting this dance again.

From the time I put my scrubs on to the time I take them off, I listen for the blue page code or “STAT anesthesia”, which can call me into the room of a COVID-19 patient at my wit’s end. breath or having lost the battle. In these cases, I dress quickly, adding layer upon layer of clothing to protect myself and my loved ones from this dreaded disease.

Then I get into what has always been a stressful situation with these extra loads. As I perform one of the riskiest procedures for viral spread, intubation, I hope my N95 mask retains its precarious seal. If I’m lucky, a colleague is standing outside the door in case I need help and to watch and guide me as I carefully remove layers of clothing so as not to contaminate me afterwards .

At the end of the day, I return to the locker room. I threw away my masks and scrubs, dropping my N95 into its paper bag and writing today’s date on the bag. I take off my scrubs trying not to let the shirt slide down my face as I take it off. I wash my badge, my glasses and my phone because they have to go in my car with me. I wash and disinfect my hands and neck, and put on the clothes I wore to work. The glasses and badge go in a UV sterilizer in my car. I drive home, leave my shoes outside, walk in, undress in the laundry room, turn on the washing machine, go straight to the shower. My mouth and nasal passages are dry from the mask or from dehydration, and I don’t know which. My chin is bruised and my face is breaking out. However, there under the hot water, I begin to relax. When I emerge, my husband is there, and I know for sure that all the precautions are worth it. We spend the evening together, until the next morning, when I start again.

Again and again, until the first frosts, when we will become nomads again. Where will the nomads roam? What will be possible at that time?

I do not know. Only time will tell.

Davida Grossman is an anesthesiologist.

Image credit: Shutterstock.com

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