The chart for the first patient of the morning states, “elevated blood pressure for two weeks.” As I enter the room, I see a frail, elderly woman perched gingerly in the chair. She has on large sunglasses and a fabric mask. She looks apprehensive, so I introduce myself quickly. Before COVID-19, I would shake her hand, but times have changed. Before I even sit down, she immediately shows me a detailed blood pressure log. She dutifully explains that she checks it when she monitors her husband’s, and she hurries to note that she has never had problems with it in the past. Upon further discussion, she denies headache or chest pain, but when I question her about anxiety, she breaks down in tears. She sobs that she has not slept in weeks and describes her recent panic attacks. Her distress stems from being the sole caregiver to her husband with terminal cancer. We discuss treatment options for anxiety, and I try to console her.
In the next room sits a fifty-year-old man who lacerated his leg on a branch in his yard. He mentions that he has been doing yard work since he recently lost his job. He is worried about the economy, but he has been trying to keep busy. He further explains that he is frustrated and angry that he feels that others are not taking the pandemic seriously, and he asks me if he should wear a mask. He interrupts me before I can even answer by stating that he thinks everyone should wear one, and he is tempted to often state this in public, but he “thinks he may get shot” if he does. I agree with him that I think that wearing a mask is responsible, and I sympathize with his fears regarding violence before I tend to his leg.
I step into my office and notice a call coming in from a friend. I pick it up, and she is frantic because her Mom was supposed to have a cardiac procedure today, but she has a fever. She wants directions on how to get COVID-19 testing immediately. I acknowledge how frustrating this is, and we discuss some nearby testing sites.
As I start to go into the next room, I receive a text from my twelve-year-old. He is home alone, struggling with virtual school. He is trying to grasp an algebra concept, and our internet connection just went out. He cannot get back into class, and he is panicked. I reassure him it will work out as I text his teacher.
I take a deep breath, and I realize that it is not even ten o’clock. I cannot help but reflect on how emotionally exhausted this pandemic has made all of us. While the staggering numbers of COVID-19 deaths display the mortality rate of the virus, there is also a profound mental toll that cannot be quantified.
Sarah C. Smith is a family physician.
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