I am an anesthesiologist, a physician with a specialization in anesthesia. I chose this profession, with its difficulties and its rewards. I knew there would be sacrifices and I have gladly made them. I didn’t expect this, yet here I am, doing what has to be done, if for no other reason than it is what I do.

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

“How is it being back?” friends and coworkers ask. Truthfully, it’s hard, much harder than before.

2020 was going to be our year. It’s the year my husband and I changed our lives in an attempt to shore up the difference in our ages and to do what we’ve always wanted to do before it’s too late. He took an early retirement and I switched to part time in the strangest of ways, full time for only part of the year. The rest of the time, we are nomads, we are travelers.

The plan was to travel internationally from January to May, return to work for the warm months, and take off again before the first frost. We started out strong, and then factors beyond our control, like a worldwide pandemic, brought us home. Well, not home, because we no longer have a home, but back to the USA where I found myself truly back, in the anesthesia trenches.

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

I routinely report to the OR around 7 a.m. To accomplish this, I now get up forty five minutes earlier than in the pre COVID days. I used to eat breakfast at work as time allowed. I used to walk into the locker room five minutes before my assigned time, throw on my scrubs, ready.

Now, I eat at home and plan extra time to put on my safety equipment in the shared locker room.

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

The N95 masks are designed for one time use, however we now use them for multiple days. The type I have been fitted for can’t be sterilized. Instead it is stored in a brown paper bag with the date written on the bag, cycled in a five day rotation until soiled or hard to breath through. I mold it onto my face and then breathe, feeling for leaks. The glasses go on next, careful not to get caught up in the mask rubber bands for risk of loosening the seal. Then the mask with the shield, and a second hat, careful to fully cover the N95 to keep it clean for multi day use. I grab two plastic phone sleeves, one for the shared portable work phone, one for my personal cell phone. I sanitize my hands repeatedly, every time I touch anything.

Ready, I head into the OR area.

I try to avoid unnecessary socializing with others. That being said, I talk to many people every day. The masks make it hard to hear, and understand each other, so I am often close to other employees who are wearing thin paper non medical grade masks or others wearing masks with vents who seem to need to be reminded that these need to be covered 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 be wearing but often aren’t, or to pull up the mask below their chin or nose. In the labor rooms where patients and their partners’ COVID status is unknown, I ask both the patient and their partner to put on their masks and wonder if there is any point in this. I am essentially walking into their home, the room they have been living in together for hours. I walk in to provide a labor epidural for pain control as the laboring woman alternately uses breathing techniques or yelling, both which increase 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 an eating location, I go outside or find a place where no one else is. I wash/sanitize my hands after I touch all the hospital buttons and doors needed to get to this place 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 work day extends past 9 hours, I sometimes allow myself a second drink, which requires this dance all over again.

From the time I put on my scrubs to the time I take them off, I listen for the overhead page code blue or “anesthesia STAT,” which may call me to the room of a COVID-19 patient gasping for breath or having lost the battle. In these cases, I gown up quickly, adding layer upon layer of garments to protect myself and my loved ones from this dreaded disease.

Then I go into what has always been a stressful situation with these additional burdens. As I perform one of the riskiest procedures for viral spread, intubation, I hope that my N95 mask is maintaining its precarious seal. If I’m lucky, a colleague stands outside the door in case I need assistance and to watch me and guide me as I remove the layers of garments carefully in an attempt not to contaminate myself after the fact.

At the end of the day, I head back to the locker room. I shed my masks and scrubs, depositing my N95 back into its paper bag and writing today’s date on the bag. I remove my scrubs trying not to let the shirt swipe my face as I take it off. I wash my badge, my glasses, and my phone as these need to come into my car with me. I wash and hand sanitize my hands and my neck, and put back on the clothes I wore into work. The glasses and badge go into a UV sterilizer in my car. I drive home, leave my shoes outside, walk in, strip in the laundry room, turn on the washer, 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. Still, there under the warm water, I start to relax. When I emerge, my husband is there, and I know for sure that all the precautions are worthwhile. We spend the evening together, until the next morning, when I do it all over again.

Over and over, until the first frost, when we will become nomads once more. Where will the nomads wander to? What will be possible at that time?

I don’t know. Only time will tell.

Davida Grossman is an anesthesiologist.

Image credit: Shutterstock.com