Running without a race.

During a weekend call in March 2020, I was paged 90 times. The whole weekend I sat at my desk in front of the computer screen with my cell phone in one hand, talking to people non-stop.

Suddenly I was being asked all the questions about survival during the pandemic when I didn’t know any better than anyone else. An elderly man who I tried to convince to go to the ER was short of breath on the phone but wanted to wait for his son who was bringing dinner for him. Eventually he went, but did not survive the hospital stay. Would he have been better off staying home with his son? Could his son have stayed with him at home? I don’t know.

I could not forget the voices of these patients. So many voices full of fear, worry and despair. When my call got over that Monday I was completely exhausted. I thought I was losing my mind. I couldn’t stop thinking of the patients I had spoken with that weekend. I couldn’t help logging into Epic again and again to check the status of the patients I had sent to the ER. Primary care physicians were supposed to be this wall between the patients and the ER to prevent the ERs from getting overwhelmed by patients who didn’t need to be there. That day I wondered if I even wanted to be that wall. It was so odd not knowing whether what you did, made any difference. I did all my medical training patiently hoping some day my knowledge would help me bring meaningful change in the world. But then here I was after so many years of training just being a wall during a global pandemic. Heartbreaking state mortality data showed up every evening at 4PM. For every human life lost I was thinking of the relationships that were getting destroyed.

So many daughters lost their dads, so many sons lost their moms, so many devastated friends, uncles, aunts, brothers and sisters. The sadness was so deep that it was crushing my soul. I could feel my heart pounding. I could hear the throbbing of my heart in my ears. Being an internist it alarmed me! I checked my pulse and was thankful to notice it was still regularly regular. Aah so no Atrial fibrillation but why was the heart rate 130/min!

That Monday afternoon I started running. I had to run to forget about my heart rate. I had to run to get out of my house and get away from my computer screen. To get away from the awareness of the fragility of my own life. Running also helped me forget that my husband was covering the ER. In addition to covering the ER my husband was also doing all the outdoor errands for the house to minimize my exposure to Coronavirus. We had somehow decided to decrease my risk so that I had a higher chance of surviving the pandemic and taking care of our 3 children. Who decides whose life is more worth saving?

Isn’t having a choice a privilege in itself ? What am I doing with the choices I have been given? I had no answers, so I ran everyday. I ran a quarter mile the first day and felt my lungs were ready to burst from the pressure of the air. I felt defeated with every panting breath. Not sure if the sense of failure was just from running or being part of that wall was also contributing to it. I wondered if I should work in the ER or as a hospitalist. Guilt from not doing enough made my heart heavy. I was not working as hard as my husband and other friends who were in the ER. My husband was always grateful for the lawn signs for healthcare workers and in my own self critical world I would just not feel that they pertained to me.

All of a sudden, primary care physicians were seeing patients virtually on zoom. It was so weird to see patients virtually. It restricted my ability to do anything I thought I was good at. I missed looking at the patient in the eye, walking with them to the exam room, holding their hands, listening to their heart and lungs. I was so resistant to this change. While running I saw my town’s haunted deserted look which made me unsure whether I was more alone outside or inside my house. I started covering longer stretches in the hope of seeing some more signs of life. I moved beyond a quarter mile after a week and then started counting the mail boxes I could go beyond. I tried to go beyond one more mailbox every day and that in itself brought me hope. My breathing started getting better one mailbox at a time. The quarter mile stretched to a mile, two, three and then four miles.

I started looking forward to Tuesday mornings during my runs when I would catch glimpses of a few neighbors taking the trash out for pick up. Days turned to weeks and months went by quickly. I learned the language of nature. Every day nature showed me a new leaf, a new flower, a new pine cone, a new acorn, a new dew drop, a new fragrance, a new stone lying on the side and a new puddle of water. Running on one of the trails one day I learned to recognize the intertwining roots of different independent trees that stood far apart but were still supporting each other. Those roots reminded me of all the different people who were supporting me while standing far away and still close to my heart. They give me the stability to find refuge within. They also give me the strength to remember that even though we are all running, there is no race. We are enough and will always be there for each other.