It’s 3 a.m. and I am awake again, like so many other anxious health care workers around the world. Despite the global social isolation and distancing, I do not feel alone. In the last two months, I have suffered from insomnia, waking up every 1-2 hours. I glance at the clock and try to will myself to sleep again, if only for another 30 minutes. I listen to the rhythmic breathing of my husband and resent his ability to fall asleep as soon as his head hits the pillow; leaving me alone to wrestle with my thoughts.

I am a physician, an internist. My husband, a cardiologist. We met during our residency program in Boston. We have always enjoyed sharing our days, patients and experiences with each other. What an incredible well of empathy and understanding this has been for us in our lives together. Medicine is a tough profession. We are both committed and devoted to our professions and our patients. With that comes the daily encounters and stories of patients triumphing and others succumbing to bad disease and lifestyle decisions. Luck and fate no doubt play a role.

We here in Maine are ready to do battle with the pandemic that is surely heading our way. Our institution, Mid Coast Hospital, has had leadership and physician committees working tirelessly to be ready when the first wave hits and we anticipate it will be in this next week. For over a month, the updates and guidelines and workplace and workflow changes have come at a dizzying pace. Many of us in healthcare already suffer from a tolerable dose of OCD and like to have some modicum of control. This situation is in constant flux and is teaching me flexibility, a quality I do not possess.

The recent mounting anxiety is something my husband likens to knowing that a tsunami is coming…in a month. There has been too much anticipation and fear and it has been difficult operating with the knowledge of what that future entails as we see and hear stories from our colleagues around the world and in the current epicenter in New York.

We are ready. I think our community needs to hear that.

We have changed our ways of practicing medicine, embracing technology and seeing patients on Telehealth platforms on a computer screen. We and our dedicated staff of nurses, medical assistants, receptionists and hard-working practice managers answer endless phone calls about possible COVID-19 infections and instruct patients on best and safest practices and behaviors.

We are retraining so that we can be deployed where we are needed, most likely to be working as ER doctors and hospitalists. The response of my colleagues is inspiring.

Is it scary? You bet. Health care workers are being infected and dying at alarming rates. We have two daughters, ages 18 and 20. Do we worry? Absolutely. Do we have a choice? Not really. We will make smart choices and try to be careful. Circling back to what keeps me up at night is concern about COVID-19. Enough concern that I began writing an obituary for myself.

I am sure you have heard what you should be doing. Yes — stay at home. The only reasons to go out? Grocery, pharmacy, gas and work at hospitals and essential infrastructure. Indoor public spaces are NOT safe spaces right now. Try to stay out of them. The elderly and the infirm need to let us younger folks shop for you. This strategy of staying at home helps flatten the curve. We need you to stay at home and not be part of the first wave of patients that we will likely be seeing in the next few weeks. We have the logistics figured out but have finite resources. So for your safety and health we would prefer you to be part of the second/third or even fourth wave so that after that first wave hits us we have time to get up, wash the sand off and brace ourselves and the health care system for the waves that will continue to roll in.

Do get outside. We live in a beautiful part of the country. Maine has lots of outdoor and rural space. We can get outside every day and take a walk or hike or run or bike ride. Practice 6-foot distancing.

What else can you do? Wear a homemade mask, bandanna or scarf to cover your nose and mouth if you must be in public. This protects yourself and us. You do not want yourself or your healthcare workers getting sick from their once-weekly trip to the grocery. No one is going to mistake you for a robber and yes, people still will recognize you. My teenage daughters did our grocery run this week and wore homemade masks that one of my patients had kindly made. They came back from the experience realizing that for once, their mother was not crazy and overprotective and that many others in the store were also donning face masks. This was a week ago before the recommendation from the CDC was made. I was disappointed to see that yesterday on my trip into the local grocery that not a single grocery employee was wearing a mask or protective covering over their nose and mouth. That is not responsible modeling from a grocery chain that claims to value their employee’s health and safety. Masks should be mandatory, not optional.

Donate any surgical masks or PPE’s to local hospitals. Ours is accepting donations. Do educate your neighbors and even strangers if you see them engaging in unsafe or reckless behaviors. Practice random acts of kindness. Reach out to elderly neighbors and friends to see how you can help or make their life more tolerable or pleasant.

Be kind to your family. We are sheltering in place and are enjoying much forced family fun (FFF) time. Most of it has been great, amazingly great. We have been doing a lot of baking, cooking, exercising, reading, cleaning, dejunking, watching The Crown (la corona in Spanish) and realizing we must embrace the gifts this storm is bringing us. There have been surprisingly few meltdowns from them and few blowout fights. We have all been gracious about sharing our space and carving out private time for one another amidst all this togetherness.

As we gear up for some trying and scary times, please know that we in healthcare are ready to help but please help us to help you. Make good decisions and follow the guidelines and practice good modeling for your children as well as for your elderly parents! Hopefully, most of us will come out on the other side of this.

Dr. Kristin K Jhamb practices at Mid Coast Medical Group–Topsham Internal Medicine.

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