I held back my tears as I headed home that day from work. A sense of impending doom and fear of the future was clutching my heart, something like I have never experienced before. For the first time in my medical career, my mind was preoccupied with thoughts about my own safety and how it could be at stake. What had started off as a regular day at work, had turned into one of the most unsettling ones to date. I had been exposed to a patient who later become a potential patient under inspection for COVID19 based on symptoms.
This day happened quite early in the trajectory of the COVID19 pandemic. Not much was known about the disease and its effect and positive prevalence in pediatric patients, which is my patient population. Not much was known about how it was spread. There was still an ongoing debate about it being airborne vs. not. And above all, for me, not much was known about its effect on pregnant women.
The fear and lack of pragmatism that I was feeling that day stemmed from the fact that I was 28 weeks pregnant and carrying life inside of me. This no longer was just a question of my own personal safety and health; it also affected the unborn child that I was carrying. I no longer could feel the invincibility and carelessness about my health that I had practiced my whole life as a physician. I was scared. I felt a loss of control, and I had to wait 24-48 hours for the test results to gain it back.
If the uncertainty of being in a pandemic with an unknown deadly disease was not unsettling enough, being a pregnant physician overruled it as being worse. Being in a state where COVID19 was not rampant in the community was, although, on the one hand, reassuring, it also came with the challenges of unpredictability. With inadequate testing, there was no guarantee of how many asymptomatic infectious patients we were being exposed to. And hence even though my colleagues were kind enough to not let me take care of any COVID-positive patients, there was a looming dread of being exposed by just going to the hospital every day. I dealt with it the best way I knew possible, as a physician I devoured all the available data that was available on how COVID-19 could affect pregnant women, but unfortunately did not find enough to ascertain myself that things would be fine if I ever get infected. I had no sense of how immune suppressed my body was with an ongoing pregnancy. The CDC had labeled pregnant women as high risk for COVID-19, and some studies had shown that they had odds of getting sicker than non-pregnant women if they contracted the virus.
Along with those imminent concerns, I was also experiencing the disappointment and social isolation that many other expecting mothers were going through at the same time. The disappointment of a canceled baby shower, canceled babymoon, not having family and friends around was at the back of my mind. But I rejected these every day as being insignificant by telling myself that the only thing that will matter is if I make out of this pandemic with a healthy baby. I ignored my mental health and let it build up over time, just to realize later that I had to address these normal feelings, to continue moving as a physician, and for my own personal sanity. I let myself feel sadness as I erased the mental bucket list of the things I had wanted to accomplish before having a baby, but I had to keep reminding myself what a privilege it was each day to wake up safe and healthy.
At work, as I sometimes requested my colleagues to take over the care of suspected COVID patients, I felt a sense of guilt of not being useful enough. I also felt selfish at times for taking a step back in a time of need. I had always pictured not letting pregnancy take away anything from what I was doing at work, and here I was sitting in this unchartered territory, feeling helpless, but also making the only safe choice that I could for myself.
What has kept me comprised during this entire time has been the realization that this whole situation is not normal. It’s not normal for me; it’s not normal for millions of other people. This is not how pregnancy is supposed to go. This is a pandemic and an uncertain time for everyone. Many of us have caved under pressure, either it is financial, or the risk of exposure to a high-risk individual at home, or the fear of losing your friends and family. Each of us has reasons to be afraid. Being pregnant is just one of them and should be considered that way. It is important to acknowledge the unfamiliarity of this all and be thankful for what we have. I am thankful for supportive family, friends, and colleagues who have supported me (virtually) and practically in so many ways. I am thankful for the many work from home days, where I have felt so exhausted to get out of bed. I am thankful for health and food on my table, and my heart goes out to those who haven’t been fortunate enough. And with that, I am also hopeful for better days, and a healthy child.
Saba Fatima is a pediatric hospitalist.
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