Why do I laugh during a pandemic?

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I just started laughing. It was early on Monday morning during our COVID surge. I couldn’t help myself. Phones were not on yet, but I already had triage COVID calls.  “Put on your roller skates” was all I was thinking. I questioned my laughter.

The day and a life of a primary care physician during COVID. Not a fun one by any means. Certainly not one to laugh at. But, if we don’t laugh, we would cry. Everyone knows that cliche. Our days never end. We don’t leave. The EMR has made sure of that. The nurses and staff are expected to smile and be respectful. They have, in fact, been so amazing during this pandemic. They have shown up every day with smiles on their faces.

But why was I laughing? What are we supposed to feel and act like every day? What is the expectation? Functioning on fumes. No sleep. No energy. Endless work. Down doctors and nurses because they volunteered to work inpatient in the overflowing hospitals. Praying for their safety and holding our heads up. As if we are the epitome of strength. As if nothing touches us. Because we are doctors.

We are the pillars of strength during this pandemic. No matter what is thrown at us. No matter what is going on in our personal lives. No matter how many death and dying stories we hear from our patients, family, and friends. We are expected to be strong. We are expected to be superheroes. Endless energy. Emotional, mental, and physical. All expectations that have been unsaid but, now, there was no wavering.

Telemedicine has become a new norm.  With the shortage of doctors and nurses in our area, we have become responsible for chief complaints, medication reconciliation, and all patient complaints during that call. It is grueling. It was bad enough when patients used to say they had been having chest pain at the end of their visit with our hand on the door. Telemedicine has brought the proverbial chest pain to a whole new level.

Thank goodness we can order COVID testing now. We have daily huddles with the administration for policies and procedures. We were doing this in March. Now, it is even more crucial. We are running out of all our resources. Patients are not listening. They don’t understand anything about this virus or the reason why we do what we do. The policies and procedures are our saving grace. But the energy expenditure in explaining this in every call is exhausting. Businesses making patients be tested and be negative before going back to work. I could scream. Who is making their policies? Because it makes no sense, and I can’t repeat it anymore.

But March was different. It was just the beginning. It was overwhelming because we didn’t know anything yet. Thank goodness for our direction every day. It would make your head spin since it was something different every day. But it worked. At least here in New York State.  We flattened the curve. We were successful. Our community came together, listened, and fought the spread. We all credited that to our administrators and medical professionals, making the decisions that needed to be made. The hard decisions. The patients did what they were told, and it worked.

Why am I not laughing?

Because our careers as physicians are behind us. We have jobs now. Just like everyone else who has retained employment during COVID. Feeling blessed that we have jobs and paychecks, but our jobs are so hard. Our voices are no longer heard. We are not the voices of expertise anymore. That was stripped of us. Perhaps with the blink of an eye or the words of one,  we have become obsolete in this battle. We are here to take care of you when you get sick, but you have no respect for our opinion. You have no respect for the fact that we endure death and dying. We endure the emotional and mental health effects it has on our patients. We try to protect and support our own. Because no one else is going to do it. We will have to pick up the pieces on our own. For me, I have to decide where I go after this is over.

Our voices are not heard. I have heard and watched doctors on Tik Toc trying to change behavior. I am with them. We are grasping at every platform we can to plea to the public to stop the virus’s spread. Grasping at any way to be heard.

Impending doom is upon us. I don’t understand where that went awry. We knew that if we flattened the curve that the lack of excessive death and disease would be the outcome. Instead of that being the motivation to continue with our measures, our community and country decided that the virus was not that bad. That not enough people were not dying from it. Most would recover, and it was like the flu. What a horrible change in thought pattern. This is not influenza. And, life lost has been so fast. Influenza has been insidious for years. Who started that rumor. I am not laughing at that.

I don’t laugh at night. I don’t have to put that face on at home. I am alone a lot, but even with my son, I can cry now. With COVID, it is different. He knows the stress of this. He has taken it seriously.

I cry myself to sleep. I do so because I know that there is so much suffering in the world today. All of the complications of COVID. Job loss, businesses lost, livelihood lost, and loved ones lost. I know that the suffering around this pandemic is so much more than the death and dying we are dealing with in the hospitals. I know that people are losing homes and cannot feed their children.

I don’t laugh much. But, I laugh when I have to and know that I have to exude strength. As a medical profession, we have to. We don’t have a choice.

Kelly Lisciandro is an internal medicine physician.

Image credit: Shutterstock.com

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