As An ER Physician, I'm Torn Between The Love Of My Career And The Safety Of My Family

by Sarah Iosifescu, M.D.
Originally Published: 
I'm An Emergency Medicine Doctor, And My Mom Guilt During COVID-19 Has Been Unbelievable
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My son was born between my second and third year of my three-year emergency medicine resident training program. After six weeks, confused about bonding with the adorable little alien-like creature who kept me up at all hours but then fell asleep in cute snuggling nursing positions, I went back to residency.

When my colleagues asked me about my child, I gave a big smile, talked about how cute he was, but it was hard for me to call him my son — he still felt like a stranger. I felt guilty for these feelings, but tried to just plug along, as we so often do in medicine. A few months later, I started to realize that part of having more than a few weeks of maternity leave is that carrying and growing a baby for nine months does not equate to immediate connection for everyone.

I had needed time to bond. However, ironically, the field of medicine is generally unforgiving when it comes to individual needs.

I proceeded to pump through night shifts, day shifts, 14-hour ICU shifts, cardiac arrests and dying patients and tried to bond with my child when I saw him, proud of myself for only having meltdowns every few weeks. I really felt like if I could make it through all of this, I could make it through anything. Life had to get easier.

Then COVID-19 happened.

The baby I had struggled to connect with had slowly become my son, Asher. He was about seven months old when our world became COVID. He had just gotten to the point where he would look at me when I got home and light up, absolutely warming my heart. I spent a few days agonizing over sending him away. We didn’t have a great option, but how could I expose him to this horrific disease that none of us understood?

People started calling front line providers heroes, and I felt anything but. I was terrified. I was afraid for myself, for my son, for my husband. I was afraid of the patients. I tried to be brave when I saw patients look on as we gowned up to talk to them “at a distance.”

I tried to smile underneath whatever mask I was wearing, hoping that they could see the upturned creases in my eyes knowing that I was trying to convey that I care and I always will care, even though I’m afraid. The humanity in medicine, being able to put a hand on your patient’s shoulder, providing gentle reassurance, body language, felt all but gone.

We couldn’t tell our patients much because we really didn’t know much. Patients came in looking like they never had in the past. Their oxygen levels were terrifyingly low, a level that in the past would have been associated with impending death, but they were talking to us. The worst was that we knew once we admitted these patients, many would continue to decompensate over the next few days.

Personally, I wasn’t sleeping. My mind raced at night. Will I get sick? I felt selfish and guilty. What kind of mother exposes her child to this? I’m young and overall healthy, I would most likely be fine if I got sick, but now I had a son to think about. I entertained the idea of quitting, to be completely honest. But that was also heartbreaking to me. My career is a huge part of my identity. I love what I do.

After many sleepless nights in early March, my husband and I decided that — given we had no idea how long this would go on –we would stay together, and we would keep Asher with us. We would take all the precautions we could, but stay together.

As an emergency medicine doctor, I always wear a mask during flu season. Patients cough on us, they sneeze on us, they come in when they’re sick. It’s the nature of the job that we are in, and we accept that. When we had the first case of an NYC documented COVID-19 patient, the administrators started telling us we couldn’t wear masks; we were scaring the patients.

Individuals who choose to become doctors are generally bright and ambitious. In the current state of medicine run by profit-focused, often non-clinical administrators, we are shushed, told to fall into line, and discouraged from thinking out of the box or challenging authority. As we saw patient after patient coming in with this new and not understood disease, often unstable and dying, we fought for access to N-95 masks that are the standard of care in these kinds of diseases.

Sometimes I got to work and was told we wouldn’t get an N-95 that day, or the size I was approved to use wasn’t available. Then we were told we may get one N-95 mask per week. Finally they decided we would get one N-95 mask per day.

The CDC started saying that cloth masks were acceptable, despite scientific evidence to the contrary. It was hard to have faith in anything. It’s now been about two months and we are on what we hope is recovery from the initial surge, but I still have dreams about not having access to masks.

The past two months has seen a complete transformation in how I manage being a mother. The fear of infecting myself, my son and my husband sits with me at every moment. I still pump at work but I have a slightly obsessive process for ensuring everything is as clean as possible. I get home and my son squeals for me as I take off my clothes at the door stuff them in a bag and run to the shower, making sure not to get near him, or anything else, on the way.

We had been having grandparents and a nanny help with childcare, but after everything started we got rid of all outside parties and kept our unit to my husband, myself and our son.

At some point, my fear of the disease has also somewhat lifted. I remembered why I became a doctor, to heal. I went back to sitting at the bedside of my patients, holding their hands while they were dying, trying to FaceTime and connect to people’s loved ones when I knew the patient most likely wouldn’t make it through this disease.

I struggle with how to end this, partially because there hasn’t been some happy ending. I still come home terrified of infecting my son and husband. I now wear even more layers and last night a patient (intoxicated) asked me if I was an alien from Mars. I couldn’t help but laugh, I do look like a Darth Vader kind of alien.

I do know that I don’t regret becoming a doctor, that I am grateful I’ve had the opportunity to be of service through this experience and that I’ve grown immensely from this. I’ve grown as a physician, as this has been a grounding reminder of why I chose to go into this field — and I’ve grown as a mother, as my every spare moment when I’m not in the ER, given we have no other childcare, is now spent mommying.

I’ve realized the looks of love I get from my son are not dissimilar to the looks I get from patients when I get to hold their hand, when I get to be present with them. My mommy and physician personality has certainly become more intertwined from this, a silver lining in this dark time — a lining I hold onto as I gown up in my alien suit for each shift prepared to help whoever may come in.

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