A few weeks ago, while I was still seeing a full schedule of patients and the crisis was just beginning, I asked myself, “How can I reach this little person on the exam table in front of me?” It was our first meeting. He was deaf and partially blind, neither of those affecting his spirit or ability to draw me in. I’m hearing impaired, and so these littles always have a special place in my heart. I entered the room, mask over my face, and immediately began to speak in my high pitched, gentle, “pediatrician” voice. We all have one. Then I remembered that he couldn’t hear me. As I got to know the family, I asked, “does he respond positively to touch”? They assured me that he does. I touched his forearm and he glared at me from behind his blanket. He was small for his age, but clearly captured the hearts of his caregivers in a big way. He peeked at me with his better eye through his security blanket which he strategically held over his small face. The visit went well as I tried to keep communicating with him without speech and without facial expressions because I too had on a mask. After I left the room, I reflected on what a cherished encounter that was. Nonverbal communication is such a great part of our day to day interactions as humans. Body language changes when we have gowns and hats trying to act as a barrier between us. Maybe he was calmed because dad was calm. Maybe he was calm because he realized I was on his side. Just maybe he didn’t need to hear my voice or completely see my smile. Kids are adaptable. They intuitively sense the good. They respond to the calm.
A new mom brings in her newborn for a check-up. The anxiety she feels is palpable from the moment she enters our building. The staff notices with empathy, and I feel it upon entering the room. Without her husband by her side (we are minimizing exposure in our office), two weeks after delivering in a busy hospital, breastfeeding for the first time, I would expect her to be uneasy. All of us were when we had our firsts. It was such a beautiful but challenging time. But the world wasn’t being overwhelmed by a virus then. So I remind myself that this is different. I reassured her at every turn before, during and after my exam that the baby was healthy and thriving. I told her that she was doing a great job and her baby was growing and healthy. As a mother of four, I sensed that she wouldn’t hear that from herself in the coming weeks. She turned to me with a look of sincere relief and shared how grateful she was to hear my words. She also shared that she is mothering without her own mother present. A familiar challenge for me as I lost my mother a few years ago. Thank goodness I had my mom when my babies first arrived. But how similar the longing is for this mom as she parents her first now and for me as I parent my four years later. It’s the same struggle. But here we were, in the midst of a crisis, connecting as mothers. A silver lining was right there.
For us as physicians, these are the moments in this crisis that we call the silver linings. That term may just be too kind as we experience the trauma and loss that COVID has brought with it. They are scattered about our days at home and at work. It might be a patient encounter or a simple gesture by our kid, encouraging us to be more present. It’s the “silver happenings” among the constant anxiety about when it will end, if it ever will and when we can go back to having a choice. Are there valuable things surfacing as a result of this virus? Absolutely. Is it a challenge to focus on those things? Absolutely. Even for the optimistic ones, the fatigue of this new reality is setting in. We must be accepting of this new normal because it’s our reality, and in many ways, it’s out of our hands. We can socially distance, protect ourselves the best way we know-how and continue to practice our art. Discover what it means to move slower. Some of us might be more emotionally exhausted than physically, but wherever it lets up, welcome the time. Remember to notice these brighter moments. Create them if you can. Be patient because this time will eventually lie in the distance. We must emerge as better physicians, stronger humans with respect for the vulnerability we all possess.
Lauretta Stombaugh is a pediatrician.
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