I am a frontline health care worker.  I am an emergency physician.  I am also a mother to two glorious, growing, miraculous children and wife to a handsome triathlete stay at home dad.  Additionally, I am one of three daughters to a pair of still practicing exceptional pediatricians in their late 70s, and sister to two strong, beautiful women.  I am also a severe asthmatic only well controlled by puffers and a medication that can compromise my immune system.

And now, I am one of the hundreds of thousands of physicians trying to stand between a monster of a virus, and the citizens of the worlds’ countries who are vulnerable to its fangs.

The people I work with are heroes; doctors, residents, nurses, orderlies, X-ray technicians, unit agents, registration clerks, security guards, respiratory therapists, and so many more.  They come to work each and every day with fear in their hearts but passion in their souls, and devote themselves to caring for patients.  In the background, the defenses are being laid by remarkable people who have been working day and night preparing protocols, simulations, and contingency plans for us all to fall back on when the enemy breaches the gates.

And that enemy is coming for us, quickly.

Going to work in my hospital used to be pleasant.  We worked hard, because we had the highest volume of patients in the surrounding regions yet flow was exceptional due to the intense devotion of our group.  The social banter was always there, smiles and jokes all around.  We were a family.  We still are.

Coming into work now is like entering a war zone.  Barriers come up randomly and block movement, so a COVID-19 patient can be transferred without risking contaminating others.  Signs on patient doors say “STOP” and “CODE C,” reminding that the patient within can pass the contagion to anyone that comes in unprotected.  Pandemic carts sit open, with N95 masks, impermeable gowns, gloves, hair covers, face shields, plastic stethoscopes, and material to resuscitate COVID-19 patients.  The mood is different; eery silence permeates the empty hallways and waiting rooms, and the lively conversations of before are muted.

Fear thickens the air, causing me to wade through curtains of anxiety each time I leave my car.  I steel myself for what’s coming by closing the door to my heart as I close the door to my vehicle.  By the time I reach the elevator, I am ready to face the shift, though deep inside, I am teetering.

When I don my armor and prepare to enter a room, I dance like a surgeon scrubbing in. Gown, tie at neck and waist.  N95 mask, two straps, make sure they don’t cross.  Mold to face, breathe out, and feel for air escaping.  Face shield, hair cover, tuck in a ponytail, ensure no whisps creep out.  Long gloves, pull up, and straighten over the wrists of the gown—plastic stethoscope in hand.  Walk to the door, sign the sheet to show you’re entering the room.  Breathe.  Enter.  Breathe.  Speak with the patient, examine.  Time to doff.  Buddy watching from outside that you don’t screw it up.  Wash gloves, peel off, wash hands.  Peel off the gown, discard.  Wash hands.  Exit room.  Hair cover off, wash hands.  Face shield off, wash hands.  Last and most dangerous: the mask.  Lean over, pull the bottom strap over the head, hold down straight, take other strap off.  Pull mask away from face slowly, drop in garbage.  Wash hands.  Wash again.  Breathe. Breathe. Walk away.

We repeat this dance many times each day.

In the beginning, our team ran a simulation one day to see how such a scenario would go.  We learned to don and doff.  We got the hang of it.

Slowly, our board showing patients in rooms began changing colors.  It used to be pink, orange, and purple, signaling new patients or patients leaving, etc.  Suddenly a new color began to creep in and has now taken over most of the board.  Poop brown, puke colored, fitting, signaling to anyone looking that the patient whom that square represents is being tested for COVID-19.  First, there was one square.  A couple of weeks ago.  Then a few more.  A few more.  Suddenly most of the board turned sh*t colored, and it’s stayed that way.

We are working in our ambulance garage, triaging rule out COVID-19 patients.

We are running simulations on how to intubate a COVID-19 patient while wearing our personal protective equipment, and how (if) to do CPR on these patients.  We are learning to stop CPR.

And here we are, officially in it.

The pandemic has made it’s way to us, and within a week or two, we will be overrun.

The enemy will breach the gates, of that I am certain.

It remains to be seen how our secondary defenses will hold. How our shields will protect us individually, how many of us will fall.

We know this is a war we may not entirely win.  We will take heavy losses.  But we are fighting it every day.  We are fighting not only for the survival of individual patients but for the survival of our way of life.  Our world has changed drastically in a matter of days and may change much more.

It is up to us to make sure that the world we knew is there waiting for us on the other side.

So the emergency physician superhero goes to work, but the Mother superhero comes home at the end of each shift.  Mommy and Daddy don capes and fly to rescue our children from despair.  We take them outside and bike, scooter, play frisbee.  We do arts and crafts,  play board games.  We home school them.  Most of all, we shower them with love and make sure they know that this world is going to be there when all is said and done.  School will resume, one day.  Friends will still be there, and can be chatted with over FaceTime until they can once again play side by side.  Pools will one day re-open, tennis lessons will resume, piano will be played, horses will be ridden.  Grandparents will be hugged, and kissed, and loved.

Life will continue.

Yet when I close my eyes at night, the darkness grabs me by the throat.  When I drive home from work, the empty streets yank sorrow from my soul, and it’s all I can do to see through walls of tears.  Remembering childhood innocence and wishing my kids could play at the park feels like a punch in the gut.

And I am left reeling, shaking, gasping for air in a world that wants to steal my breath.

So I go to work, each day, both at home and in the emergency department.  I risk my life.  I work for you, for our future, for the future of our children, and the future of our world.

#stayhome

Sara R. Ahronheim is an emergency physician.

Image credit: Shutterstock.com