Life On Hold

How are you feeling?


No, really, how are you feeling?


Fully vulnerable here: I’m scared. Worried. Agonized. Overwhelmed. Angry. Fearful.

The list goes on.

And I imagine you feel the same, too.

How do we keep going in a time of unprecedented uncertainty?

As you know, my own situation is layered with the fact that I was recently diagnosed with breast cancer and am undergoing chemotherapy. As the side effects of cancer treatment take hold, I add to them the very real worries of Coronoavirus infection to my immunocompromised body. I do not wish this burden to anyone.

But I worry less about myself than others: patients, our dear employees, my loved ones – many people fall into more than one of these groups – and we are all living with heavy burdens.

My heart hurts.

My brain hurts.

My body hurts.

Fertility treatment is literally on hold. We have been directed by the American Society of Reproductive Medicine and the Minnesota governor through a direct order that we must stop treatment. I will get into it later on whether fertility treatment is elective (it is not in my opinion), but our hands are tied. We can’t even do procedures that involve gloves. This effectively rules out almost everything we can do to help our patients build their families.

Super vulnerable: This morning I was feeling particularly hopeless. This is very unlike me; I am generally an optimistic person. I made a list of things I could not control. It was bleak.

I cannot control that there is a global pandemic. I cannot control that I have cancer. I cannot control that my life’s work and purpose have been – temporarily – taken away with an uncertain timeline to resume. I cannot control that patients whose own fertility timeline is limited are being forced to put their lives on hold. I cannot make this virus go away and get our lives back to normal.

And then I made a list of what I can control.

I can write in my gratitude journal every day; today’s entry was that I was safe for one more day. I can be present. I can show love to my family and pet. I can be kind. I can maintain relationships. I can eat nutritious foods when I am able due to my cancer side effects. I can hydrate as I am able. I can walk outside – alone – when energy allows. I can think and reflect. I can follow isolation guidelines to minimize my risk of infection. I can not give up hope.

And I can plan. Normally I do not have the luxury of time to think; I just do. Now I can plan. How to do better and be better. How to be a better physician, colleague, partner, parent, friend and human. As myself how I can help patients NOW. We may not be doing embryo transfers this week, but we will be back. And I can plan and be ready. We are finding ways to stay on top of the changing landscape and be able to nimbly slide back into our mission and work, only better.

Sending love and strength to all.

Could the Timing Be Worse?

^^^Rhetorical question.

I write posts when I’ve got something to say and a (little) time to do it.

Some I schedule to post in advance, usually within a few days.

Looking through some of the most recently posted – but not necessarily written – it’s striking how much everything changed so quickly in our world due to the unprecedented global pandemic we are experiencing.

There’s never a good time to do chemotherapy, but starting today feels particularly scary.

After some deliberation, this is what I chose to wear.

The irony of the message on the t-shirt isn’t lost on me, and I am not wearing this to be snarky.

There is so little I can control now.

I can’t control cancer.

I can’t control Coronavirus.

I can’t control my immune system.

I can’t control the calendar, fast forwarding several months to a time that is better, more convenient or less risky.

I can control my attitude.

So I will choose to believe that this day is the start of the next phase, one that will hopefully get me closer to being whole again.

“Cancel Everything”

This article in The Atlantic is getting a lot of (well-deserved) attention.

The link is above and it’s well worth your time to read it.

As someone who is currently undergoing cancer treatment – a.k.a. a high-risk, immunocompromised individual – I feel strongly about taking pro-active measures to keep society – and myself – safe.

Our long-anticipated spring break cruise?

Canceled.

While it was not a hard decision for our family to make, I am still part of a social media group of fellow cruisers who are still planning to embark as scheduled.

It’s disappointing to see so many comments along the lines of “Whoo-hoo! Less people at the buffet!” or “Free upgrades for everyone!”

The most dangerous fallacy, I believe, is this: “But I’m healthy.”

Up until recently, so was I.

I practice a very niche area of medicine and for the most part, I don’t have a high patient volume nor are most of my patients extremely ill.

But think about other medical specialties like geriatricians, ER physicians, oncologists, critical care physicians, etc. There are many specialties where patient acuity and volume are both high. Some fellow OBGYNs I know routinely see up to 40 patients a day.

So, even if you are a healthy individual, an infected-but-asymptomatic (or incubating) health care provider could easily be a point of contact for dozens of really sick people every day.

Patients who are seeking care for one illness may be put at risk for acquiring another.

This could get bad very quickly, and likely will.

I agree with many of my colleagues that health care providers, and especially physicians, should lead the way as role models as we wade through the Coronavirus pandemic.

Hopefully some of the residual cruisers will also get the memo, although as we’ve seen recently, even if they don’t, their vacation may get an unwanted 14 day extension in quarantine.