On Saturday morning, Mackenzi and I held a long conversation. Contingency planning for the next two to three months under the heavy weight of the coronavirus. If… then… scenario planning.
If either myself or Mackenzi contracts covid19 and develops symptoms severe enough to warrant hospitalization, then…
Then how will we care for Joonsu, our 16mo toddler?
Hospital visitation policies around the country have changed. Effectively, there is no more visitation policy. Due to the desperate and mortal need to preserve PPE (personal protective equipment), we limit who can enter a patient’s room. Otherwise, the highly contagious virus could find its way hopping around the hospital wards with even greater ease.
So, one of us is in the hospital as a patient, alone on an alien planet. The other is either an asymptomatic carrier or a pre-symptomatic patient. Either way, we’ll be pulled out of hospital rotations for testing and quarantine to prevent further spread.
This technically leaves one of us for baby care. However, 24hr Joonsu care is tough. He has not yet unlocked sleeping through the night. When he’s awake, he can outrun our chubby old dog. Our boy is a handful.
Add a strong emotional reaction to the hospitalization of our partner?
I don’t know if that’s a good idea.
I have read articles written by folks wearing two hats: physician and parent. I have read about others, in not-unsimilar positions: packing up their child’s things and sending them upstate or down the coast with family members for the foreseeable future.
Sometimes, it is framed as a desire to protect their child from the risk of infection: we believe covid19 to be usually mild in children, with only a handful of fatal cases amongst the thousands across the globe. But would you take that chance, with the guilt of bringing it home and causing death?
Sometimes, it is framed as a wartime measure: sending the children away from the frontlines so the soldiers may focus on the mission at hand. I imagine physician-parents around the world wishing their children were close but glad they’re distant.
Two weeks ago, Mackenzi and I did this. We sent Joonsu with my mother, up to NH and my childhood home. We made this decision for two reasons when the local schools and daycares in PA closed.
- We were concerned for my mother’s health, should she contract covid19 as a result of remaining in our PA home. As physicians rotating through the hospital, we are exceptional vectors for this disease. She has no major medical history or risk factors for complications with this infection, except her age. Both the optimist and the realist in me believe she would pass through unscathed. But could I live with the guilt of knowing I brought death home with me?
- We had no backup baby care options. With our newly established daycare in Allentown shuttered and with jobs that require physical presence, this left all of the daytime baby duties on my diminutive mother. She could endure, I’m sure, but for how long? Even while I write this, we are one to two weeks away from the surge in the Lehigh Valley. This boy is exhausting.
So Joonsu and my mother went up to NH. My father was pleased with this turn of events: he arrived in NH a few weeks earlier, preparing the property for spring. With his wife and his grandson around, he had wonderful company to replace the long quiet hours alone.
Without much fanfare, my family had been separated.
Just Mackenzi, myself, and our gross dog. No giggling baby to roam the halls and diffuse entropy throughout our shelves. Though he is three feet tall, he leaves a loud silence behind him.
We saw him through videochat and he would initially smile and laugh at our voices. After a few moments of joy, he would reach for our faces through the little screen. When he couldn’t touch us or bring us any closer, he cried and called for us with “mama” and “appa”.
At a certain point, do you stop calling because it hurts too much?
I imagine this plays out often for military families during deployments. In a past life as a single 20yo, I yearned for a tour of duty overseas. In this life as a married 30yo father, it is a terrible reality for which I did not ask nor request.
So, we scrabbled for alternative childcare options.
Some way to bring our boy back to us.
In short enough order, we connected with an option which suited all parties: a family with young children home from school and stir-crazy parents working remotely. The kids need something to keep themselves occupied, why not a high-energy toddler?
After one week apart, my family reunited in the parking lot of a McDonald’s.
He grew a lot in just one week. He is talking up a storm and knows all sorts of words. He’s a sponge for language and a daredevil with his body. One week away from him was too long.
Distance makes the heart grow fonder. But, what a bitter medicine.
And to bring it back to the top, we have discussed the reasons why Joonsu leave us again. And under what circumstances would we bring him back. Quarantines and family separations both have that in common: when you begin, you should know the criteria for the end.
For us, having experienced separation once, the reasons to endure this again are extreme. We want to keep our family together until we literally cannot. I do not fault other physician families who are making other decisions. These are individual circumstances and I cannot pass judgment on any other. I just hope to make it to the other side, unscathed. I have a lot to lose.
We all do.
The fear is palpable. The fear of bringing this unknown disease into the home. The fear of hurting those I love the most, by keeping them close to my heart. And I believe the fear is winning.
For instance, Mackenzi and I updated each other on advanced directives. Chest compressions, intubation, trach/PEG, blood products, and antibiotics, all in the specific context of what we are seeing with covid19.
Do I think we will succumb to this disease? No.
But does the fear propel me forward, into these types of conversations? Yes.
I have read about young resident physicians in NYC hospitals contracting covid19 and dying in the very wards they rounded on patients. Could Mackenzi be next? She is rotating through the hospital, on nights, interacting with covid rule-out patients.
I have imagined my son, my vibrant healthy son, on a ventilator in the PICU.
With the hospital visitation policies, could I even see him? Hold him? Kiss his cheeks and tousle his hair?
The fear is powerful. The fear is winning. But the fear will not win.
I stepped away from writing for these past four months. I wanted to live life, instead of writing about it. But now, a once-in-a-career pandemic and a week of scheduled PTO drove me back to the keyboard.
To consider the uncomfortable truth: I have allowed fear into my home, and that is a far worse guest than covid19.
And so, I will continue to write. I will resume these weekly writings. I will deny fear the foothold in my heart. I will say my fears aloud, and once shared, that fear loses its power over me.
Thank you for waiting on me.
Eugene H Kim 