Leanne, a nurse, sits next to me in the ICU. She says into the phone, “Now, Johnny, you be good for Nana.” We’re only halfway through another 12-hour shift, and she won’t be home until after her 5-year-old son is ready for bed.

Such calls to palliate separation have long been part of the fabric of health care families’ lives. But the pandemic has magnified the frequency and pain of these absences.

Much has been written about the arduous, high-risk labors of health care workers like Leanne and myself, a critical care physician, as we care for patients suffering from COVID-19. Not enough has been reported about the hidden hardships and heartaches of our families at home, whose teamwork enables our more celebrated efforts in the hospital.

Growing up, I learned early on that medical families did a lot of waiting. Every night, we would eagerly await my father’s return from the hospital because we missed him, and because we were missing our dinner. After sharing the meal and the news of the day, Dad would remind us that other families waited longer and more desperately, especially neighbors whose family career was fishing.

He would illustrate with a story like this one, about a patient of his named Paula. As he’d entered the exam room where she waited, eyes scanning out the window, she’d startled. “The wind is up,” she said. “Tom’s out there.” A storm was coming, and she hurried home to check the short-wave radio.

My father’s office was snug in downtown Gloucester, Mass. miles from the merciless swells of November, but the fishing life took a silent toll on those at home, waiting and worrying over the horizon and what it meant for their loved ones.

Nowadays, as we physicians, nurses, and other staffers go down to the COVID-19 seas in shifts, as we drive toward the coughing, our medical families wait and worry — and work — without the recognition they deserve.

In March 2020, the COVID-19 tsunami flooded our lives and those schedules. One year later, the surges of patients, the ceaseless shifts and the separation from family have yet to fully ebb.

At home, it’s not just the waiting, it’s the worry. And the worries in health care, like those of the waterfront, are rarely discussed on either end of the voyage.

To me, as a medical student leaving our New York apartment to care for patients with AIDS in the 1980s, or as a staff intensivist shipping out to take the first overnight shift in our Boston hospital’s Ebola biocontainment unit, my wife rarely voiced her fears for my safety and for the very real risk of my hauling home a highly contagious, barely treatable virus.

Ditto this past March. On learning that our hospital’s first COVID-19 patient had been admitted to my medical ICU team, she gave me a hug, and a shrug of silent stoicism.

I don’t often break the spell of silence either. Perhaps a fortifying dose of denial fends off an otherwise incapacitating fear of joining the thousands who have died in the line of duty. And we can spare precious little time on the wait and the worry.

But I want to acknowledge, resoundingly, that most days homefront heroes like my wife and Leanne’s Nana work longer and harder than we do in the hospital — only with far less acknowledgment. In the ICU, I have heard endless variations on “Now be good for Nana,” from a physician mother, a nurse father, or a staff couple on the same shift. For those of us who live solo, it might be a sister in a far-off city awaiting a reassuring, post-shift smile on FaceTime.

To the worry, the waiting and the work, add the weariness. We sometime-celebrity COVID-19 combatants slosh our way home, arriving exhausted, mentally and spiritually. Our long-suffering partners are entitled to a little recreation — a game of Scrabble, the trading of stories, a line dance — but we returnees often succumb to the overwhelming urge to simply slouch, sip, sup and sleep.

Dozing face down in the fettuccini, we offer little worthy companionship or diversion. Nor are we forthcoming about our viral odyssey, so relieved to have shucked off its every remnant — hopefully — and every reminder.

One more reason you hear little about the sacrifices and stresses of medical families: explaining the tribulations feels like complaining. Exulting about a triumph would feel like boasting. So, often we keep it to ourselves. Stories of sacrifice, even when tinged with pride, don’t always come easily.

On the waterfront in Gloucester, a solo Man at the Wheel, made of bronze and clad in oilskins, the PPE of a former era, has exemplified the rigors and risks of life at sea for nearly a century. More recently, the stalwart spouses of current-day fisherman erected a fitting testament to those doing double duty at home: a family, standing twelve feet tall, facing the sea with “faith, diligence, and fortitude,” and steadfastly defying the wind.

Meanwhile, the winds of COVID-19 are still up. Amid them, our families are the unrecognized health care heroes of this era.

Shoulder to shoulder with us in this struggle, never afforded a refreshing thank you from a patient, the cheers of a neighborhood or city block , or a Super Bowl trip, they deserve not just fleeting gratitude, but deep, abiding admiration.

Walter J. O’Donnell is a pulmonary and critical care physician. This article originally appeared in WBUR’s Cognoscenti.

Image credit: Walter J. O’Donnell