How essential workers cope with COVID [PODCAST]

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“I really shouldn’t complain. I haven’t lost my housing or job. I have plenty of food and toilet paper, and so far, no close friend or family have died from COVID. That said, this pandemic is hard. In fact, it is exhausting.

During the spring and summer, I gave positive COVID results to a number of patients from my home’s safety, thanks to telehealth. But the reality of telling patients how to self-quarantine when six people live in two rooms with one bathroom, or giving resources about food and other basics because the household provider lost a job, or can’t work because s/he is COVID positive, is tough. Tough on the recipient of the advice and tough on me.”

Therese Zink is a family physician and can be reached at her self-titled site, ThereseZink.com. She is the author of COVID Chronicles: How Essential Workers Cope.

She shares her story and discusses her KevinMD article, “The long journey of COVID.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Therese Zink. She is a family physician, and she wrote the KevinMD article “The long journey of COVID.” It’s an excerpt from her book, COVID Chronicles: How Essential Workers Cope. Therese, welcome to the show.

Therese Zink: Thank you for having me, Kevin.

Kevin Pho: We’ll get into the article and book in a little bit, but first off, can you just share your story and your journey to where you are today?

Therese Zink: Sure. So I’m a family physician, and when I started my career, we were trying to figure out AIDS. Now that is a chronic disease, and now I’m ending my career with COVID. I was an English major way back when and started journaling when I was in high school in a creative writing class. About 20 years ago, I did a mission with Doctors Without Borders in which my boss was kidnapped, and after that experience, I really started writing more seriously as a way to make sense of what was happening around me.

And as a physician, as you know, you really have the privilege of sitting on the sidelines of people’s lives and seeing the best and the worst of times, and sometimes that can be a burden. And so writing has been my way to understand those journeys and kind of understand my own journey. And of course, COVID, we’re all kind of consumed with that now, and that lent itself to writing and has birthed a book, just watching how people cope.

And then my own 90-year-old mother and my 57-year-old special-needs sister contracted COVID. Then I had a personal dimension to that as well, because I had my feet in two worlds, trying to care for patients and then having this very personal journey with my own sister and mother, who survived, amazingly. I kind of wondered what all the hoo-ha was about, but I was trying to manage things from a thousand miles away. So writing has been my way to stay sane.

Kevin Pho: All right, so I’m interested in hearing not only that story but some of the other stories from the book as well. The excerpt is titled “The long journey of COVID,” and once again, it’s from your book, COVID Chronicles: How Essential Workers Cope. Now, for those who didn’t read your excerpt, can you just share that story and explain why you decided to write it?

Therese Zink: Yeah. So I started out with COVID working telehealth. My boss told me I was too old to put myself on the front lines, and I had some guilty feelings about that, but then I realized he had given me a gift. In doing telehealth, many of our patients are living in the inner city and are Black and brown, and as I tried to explain the rules of quarantine to them, “Can you isolate in a room?” I came to realize how impossible it was. You know, you’ve got six people in a two- or three-room apartment, and I just realized, “This is crazy.”

So as we learned more about COVID and began having enough PPE, and immunizations were around the corner. The person who started in the tent was actually a podiatrist who had military training, and he had the skills to really set that up for the clinic. And then after testing through the winter, through the spring, and through the summer, he was ready to quit, and so my boss had asked if I would help out.

He had a delightful sense of humor and really saw that the Q-tip in the nose, so to speak, was the great equalizer, and everybody reacted, some in more pleasant ways than others. And so he collected stories and shared those with me, and I put that together as “The long journey of COVID,” under the tent, and that was my second story.

Kevin Pho: Wonderful. And share a little bit of what you experienced. You were in telehealth, and now you transitioned into the front lines under the tent. So how did you feel during that transition?

Therese Zink: You know, I was not in the ICU or the emergency room. I didn’t have to do that, but I felt like I could do my part at this stage of my career. And it’s a scary thing when you’re on the phone telling someone that they’re COVID positive, or talking to someone who is feeling awful and they don’t have COVID, and trying to explain that it’s not a perfect test, and early on, when we didn’t have enough tests.

You know, I reached out to colleagues really around the country as I put this book together, trying to give a broader perspective of COVID. One of the things that I think, as a health care worker, is the most amazing and frustrating is when you see people not wearing masks or believing this disease is a hoax, when you’ve seen up close and personal how traumatic it is for some. And some of those who were in the ICU shared some of those stories with me, and just how you show up every day, and particularly early on, when there wasn’t enough PPE, how you kind of make sense and keep your sanity and keep your humor when you’re putting your life on the line day in and day out.

So I think it forces us to go somewhere deep inside ourselves and to think about why we are doing what we’re doing. What is that commitment about? What does that mean to us? And how do we keep healthy when we’re trying to keep others healthy, and learning as we go? We don’t know much about this disease. It’s new information every day.

Kevin Pho: We are speaking in mid-March, and it’s just over one year of the pandemic, and even on KevinMD and on my podcast, I’ve had hundreds of stories from behind the scenes about what health care professionals are going through. I suspect more stories are going to come out if, hopefully, the pandemic ends soon. Now, what are some particularly poignant stories that you want the public to know that may not have been publicized in mainstream media?

Therese Zink: Yeah. So I also sought to talk to people other than physicians, because we are essential workers. We may be somewhat of the privileged essential workers. And so I interviewed a caregiver who works in a group home in the Midwest, and her mother works in a nursing home and turned up COVID positive. Jasmine lived in her house with her mom and her two brothers, who were trying to home-school, not doing very well. And so when Jasmine’s mom was positive, she called her boss and said, “You know, I think I need to get tested and not come in.” And her boss said, “We need you. If you don’t have symptoms, come in.”

And so Jasmine paused and then had to figure out what to do. You know, I think her story is true of many essential workers who are working in situations where the rules the CDC puts out are not being followed, or they cannot afford to follow them because they have to work in order to have food on the table. So that was one very moving story for me.

Another was a medical assistant who works in Southern California, and because her husband has been deported, she and her kids live at home in Mexico, and she crosses the border every day to work in her clinic in Southern California. The one good part of COVID is that the border crossing lines are less busy, if there can be a silver lining in such things. One of the difficult things was when she came up COVID positive. She was able to isolate in her small house because there was a room with a bathroom, but she felt so bad, because her 13-year-old daughter was cooking and helping the five-year-old son get online for distance learning. And you know, just to realize the real worry that she went through during that time. Amazingly, her family did not turn positive, and she was back at work, unfortunately, to go back to work on her son’s fifth birthday. The main way she coped was kind of her love and her commitment to her family.

And so, understanding these very personal ways that people keep going forward: For some people, it was faith; they looked at their Bible on a regular basis. For other people, it was getting outside. Somebody I talked to watched all episodes of The Office, I think all 12 or 9 seasons, 12 times, needing a way to escape, and to keep doing what you’re doing, and do it with humor and grace.

Kevin Pho: Now, how did you find all these people to interview for their stories?

Therese Zink: So I worked through networks. At the place where I work, I put out that I was putting together these chronicles and asked if anybody was willing to be interviewed. I kind of used places where I had connections and put the word out, and had friends and family help me recruit different individuals. So it’s not comprehensive by any stretch of the imagination, but I tried to be representative. And I think because I’m a family physician, there’s a fair amount of primary care stories.

You know, a lot of what we see on television is the emergency room and the intensive care unit, but there’s another story that happens in the family medicine clinic, or I’m sure in your internal medicine clinic. One of the people I talked to told me, “You know, I’m seeing so many more death certificates than I’ve seen, and I look, and I remember Señora So-and-so, and I remember Mr. So-and-so, and I won’t see them again. I didn’t get a chance to tell them goodbye, and feel sad for their family that probably wasn’t there with them either.”

Kevin Pho: We’re talking to Therese Zink. She’s a family physician, and she’s the author of the book COVID Chronicles: How Essential Workers Cope, and she shared an excerpt from that book on KevinMD titled “The long journey of COVID.” Therese, after sharing these stories from people across the health care spectrum, what are some of the main things that you’ve learned from them?

Therese Zink: As a caregiver, one of the important things is take care of yourself. Self-care is imperative, and find something that gives you joy, find some way to take a break. You know, take care of yourself. You can’t be a healer when you are not well yourself, and part of the writing for me was how I took care of myself and made sense of this.

For the non-clinical folks, I think, you know, wear a mask. As one of the people I talked to said, “It’s such a simple ask.” And you know, pay attention to science. It has something to teach us. And you know, we aren’t done with this, unfortunately. Thank God for vaccines, but we have the mutations. So this is a once-in-a-century pandemic that has brought many countries to their knees. I think that’s the kind of thing that has the opportunity to bring people together, to problem-solve together, and care for each other. I think that is the really important piece.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Therese Zink: Yeah. So for the caregivers, definitely take care of yourselves. You know, find a reason to laugh, find something that gives you joy. And for the non-clinical, please wear a mask.

Kevin Pho: And how could people find your book?

Therese Zink: So it is available on Kindle and Amazon. You can also go to my website, and that will link you to where the book is available. And the website, I think you put up, but it’s www.ThereseZink.com, and that’s Therese with three E’s.

Kevin Pho: Well, thank you so much for sharing your time, insight, and stories, and thanks again for being on the show.

Therese Zink: Yeah, and thank you again, Kevin, for having me.

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