Ep. 02: Suzanne

A primary-care physician nearing retirement deletes an email about volunteering in a COVID-19 clinic — then regret sets in. 

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Episode Transcript

Speaker 1 (00:07):
I'm Danny Shapiro and this is the way we live now.
Today is day number thirty six, since most of us
began to stay home, shelter in place, social distance, and
it's day number two of this podcast. I keep thinking
about all the new language we're using. The phrases, the words,

(00:28):
the terms social distancing, elbow, bumps, droplets flatten the curve.
In the way that we adapt to new language, we
also adapt to new circumstances. We human beings are nothing
if not resilient. This, too, is the way we live now.

(00:49):
It seems wholly appropriate today day number thirty six and
number two that my guest is writer and physician doctor
Susanne Covin. Earlier this week, the New England Journal of
Medicine published an essay of Suzanne's titled They Call Us
and We Go. Suzanne's forthcoming essay collection, Letter to a

(01:11):
Young Female Physician, will be published by W. W. Norton
in one Susanne, thanks so much for being on the show.
Thanks for having me, Danny. To begin with, tell us
where you are, like literally where you are right now?
Invite us into your world. Where are you sitting, what

(01:33):
do you see? Who's with you? During this time. I'm
actually sitting in what was years ago my grown children's
basement playroom, and which has hastily been turned into my
eighteen month old grandson's playroom, as he and his family
have moved in with us during this quarantine. So I

(01:58):
am fitting among baby toys and baby blankets and blocks
and all sorts of things which seemed both very remote
and very familiar and very delightful. It's been the upside
of this miserable circumstance. Did your family move in with

(02:20):
you and your husband right around what I would refer
to as the sort of the moment that all this
hit home. I date that as March eleventh, which is
the day that that the Trump travel ban and the
NBA being canceled and Tom Hanks Gang and I don't
mean to laugh, you know, getting diagnosed. But it was
like this crazy trifecta of things that happened. Yeah, there

(02:42):
were a few days there weren't there where things seemed
to be moving very quickly, not so much in terms
of the reality of things, but in terms of our
um consciousness of their urgency. So on the eleventh, we
were in New York of visiting one of our kids,

(03:03):
and we had planned each weekend we love the beach
in the winter. On the twelve, we were so this
was the real kind of pivotal point for me. We
met my son and a friend of his in a
crowded restaurant in Brooklyn, and we didn't shake hands or

(03:25):
hug his uh with or hug his friend, but we
also were not particularly uncomfortable being in this crowded restaurant.
By the next morning, we canceled our weekend away. We
came back home, and the day after that, the rest

(03:45):
of our family, UM and the baby moved in with us.
You know, when I think back about when all this
started for me, yes, it was March twelfth to March thirteenth,
isn't it amazing saying how quickly that turned? I think
for all of us, in one way or another, I
think forever more, we're all going to have these stories

(04:07):
of the moment that it just simply was not okay
to be in a crowded restaurant anymore, or um where
we just needed to close our doors. As a primary
care duc. For me, that kind of where did it
all begin is very familiar because this is the way
my patients describe the beginning of their symptoms, the beginning

(04:30):
of their illnesses. You know, that was the day the
world changed. This is, you know, sort of a worldwide
extension of what is for many of us, in fact,
for most of us at some point um a very
personal experience in moments in life where there's a divide

(04:51):
between before and after. Everyone is experiencing this divide because
of COVID nineteen between before and after. But you know,
you and I both know, as as people who craft
uh and and think a lot about literature, that in
order to understand the after, we need to understand that before.
So could you talk a little bit about your life,

(05:13):
just sort of your daily life before. Yeah, this is
such a great question. Apropos of what I just said.
A sudden illness or injury doesn't happen, you know, in
a blank canvas. It happens to a life in progress.
This crisis happened to me at a very particular and

(05:36):
in some ways ironic point in my career, which is
that I was essentially ramping down my clinical practice. I
was reorganizing my schedule to spend less time with patients,
more time teaching and writing, really transitioning my identity even

(05:59):
be on that tough perhaps retirement uh and further away
from being a practicing physician. Well that changed very very fast,
as you can imagine. Yeah, So, so talk talk to
us about the experiences that led you to write your essay.
They call us and we go. When people ask me

(06:22):
how I come up with essay ideas, or when people
ask me for advice about what they should write about,
I always say that it's best to look for an
uncomfortable moment, even if it's a very tiny moment where
you're just not sure why you felt what you felt.

(06:43):
So for me, that moment looked like this. Not more
than a handful of days into this crisis, I received
an email asking for volunteers to work in a COVID
screening clinic that had been quickly organized in my hospital,

(07:04):
and I deleted it. And the reason I deleted it
is because, as a very late career physician, I've kind
of gotten into the habit of deleting emails that have
to do with new ventures, new I T systems, training
programs to acquire new skills. You know, this is sort

(07:26):
of a perk of getting older, is that you know
that stuff doesn't apply to me anymore. So I deleted it,
and I thought, gee, you know, I'm of an age
where I'd be at risk of having complications if I
were to contract the virus, and UH, if I got
very sick, I wouldn't be as much help to anyone.

(07:47):
And so I figured I would practice tele medicine UH,
and I would be supportive of my younger colleagues, and
I would continue writing and conducting reading and writing virtually.
And so, as I said, I deleted the email. And
over the next couple of days, I just walked around

(08:08):
feeling terribly uncomfortable. Not exactly guilty, but sort of guilty,
but just uncomfortable. And then um, I walked into the
living room and I sat down on the couch and
I announced, my husband, I have to go to that clinic.
I just have to do it. This is a Massachusetts

(08:29):
General hospital, right, this is a Messages Channel hospital. Can
I ask you to, Susanne, like, when you were having
that feeling of discomfort walking around during those days, did
you know what it was? Did you know what it
was right away? Or did it start two more sort
of creep up on you? What what where it was
coming from? Well, as is so often the case, I

(08:51):
didn't really know what it was until I started writing
about it. What I misdiagnosed it as originally was just fear.
Fear for myself, fear for my colleagues, um, fear for
my family. You know. I often think that the the

(09:12):
first stage of course of of grief, but also just
of dealing with any kind of situation that that feels traumatic,
is denial. And what that looks like is this is
not acceptable to me. And that's kind of what it
felt like. Um. I think that was sort of the

(09:35):
first stage. Was I feel anxious. I'm worried about my colleagues,
I'm worried about myself, I'm worried about my family. I
don't want any of this to be happening. I hate this.
But of course, a person like me who's ramping down
their career and hasn't worn scrubs in thirty five years
doesn't belong in a clinic like that. And I thought, no,

(09:58):
that's not what it is. What it is is is
you just feel guilty that you're not helping enough. And
then I wrote the essay and I realized there was
actually a different answer. So at the center of your essay,
I just want to read a little snippet from it
if I may um, because because this is really what
what struck me as the beating heart of it. I

(10:20):
am not a brave person. As a child, I hated recess.
The school playground frightened me. The monkey bars were too high,
the slide to slippery, the swing to swingy. As an adult,
I'm no more physically courageous. If I were to respond
to the challenge currently circulating on social media, name five
things you don't like that other people like, I'd put

(10:42):
air travel, roller coasters, and skiing, all of which terrify
me as the top three, with blue cheese and science
fiction coming in at four and five. Still, the hours
after the message about the COVID nineteen screening clinic arrived,
I felt that however much I feared from my physical safety,
the psychological distress i'd feel if I didn't volunteer would

(11:05):
be far greater, you know. And I found myself like
reading that and thinking about because I relate to that
very much. I am not a physical risk taker. I
thought about like the idea of physical courage versus another
kind of courage, you know, a courage that sort of
rises up beyond thoughts of primal, primitive physical one's own

(11:29):
physical safety and become something bigger, which really feels to
me like what you're talking about. First of all, thanks
for reading that. It sounds awfully good in your voice.
I am an absolute chicken, I really am. I am
a very um sort of physically fearful person. I am

(11:51):
not a risk taker. I think what the feeling was
um was not actually so much finding a different, nonphysical
kind of courage. It was if I did not do
this thing, I wouldn't be who I am. It really

(12:11):
had to do with a sense of identity. So if
I caught the virus and risk my life, that would
be a certain kind of erasure. And by the way,
I don't mean to over dramatize the risk I'm taking.
I'm working in a very safe environment compared with so

(12:32):
many of my colleagues. But if I didn't go, that
would be a different kind of erasure. It would be
a denial of who I have been since I was
in my twenties. So interesting, I've been meeting virtually with

(12:53):
colleagues of all ages in these last few weeks, and
reading and writing groups of the I usually run in person.
This is actually a common sentiment and one that I'm
hearing from young doctors. Two that you know, the reason
we do this is because it's who we are. And

(13:17):
it's actually more uncomfortable to be at home. And not
only more uncomfortable, but this sort of funny surprise to
me was that when I finally went to the clinic,
I found it very calming to be there. I was
much less anxious being in the clinic with patients with

(13:40):
fevers and coughts than being in the safety of my home.
You know your your essay ends with these lines from
The Plague, the novel of the Plague by Albert Camu,
which is a novel that many people seem to be
gravitating toward right now and rereading and and and the
sentences are I have no idea what's a waiting for me,

(14:03):
or what will happen when all this ends. For the moment,
I know this, there are sick people and they need curing.
There is comfort in clarity. As I say in the essay,
the doctors and the nurses and the respiratory therapists and
other clinicians. Our version of the firemen rushing into the
burning building is there's sick people who need us, and

(14:27):
so that's where we have to be. And usually answering
that call doesn't involve any risk to us, but this
time it does. And one of the things that'd my
spirits so much during this dark time, other than having wait,

(14:47):
my grandson I here with me, is just seeing my
colleagues in some way act is this, this is just
another day at work, This is just what we you
that very first time I went to that clinic and
a nurse strolled in with a cup of takeout coffee

(15:08):
and started, you know, cracking jokes, and I just thought, well,
this this feels like home. This feels like where I
need to be right now. Right, That's that's very moving.
Um So let's let me end by just asking you, what,

(15:28):
if anything, is bringing you hope right now or solace.
I'm an optimist by nature, so there are a lot
of things through bringing me hope. I'm very hopeful that
what's happening now will um shine a greater spotlight on

(15:51):
health disparities and on the brokenness of our health care system.
I'm hopeful that the hour of science will be more
evident to people who have lost faith in it or
haven't had faith in it. I mean after all, it
has been said, this is what the world looks like

(16:14):
when you don't have a vaccine for an infectious disease,
and it's not good than many many kindnesses that people
have extended to each other, and that um the community
at large has extended to the health care profession have
been very heartening. But I think most of all, for me,

(16:39):
it's just been watching my colleagues rise to this occasion,
and not just the doctors and the nurses and the
respiratory therapists, but the medical secretaries and the engineers and
the cafeteria workers and all the people who make the

(17:00):
health care system ron. They've really just stepped in unquestioning Lee,
and they've answered the call. And even though I've been
doing this now for thirty five years, I don't think
I've ever seen anything more moving. And I'll never forget it. Suzanne,
thank you so much for coming on and talking about

(17:22):
the Way We Live Now. I'm really grateful to you.
Thanks so much, Danny, thanks for listening to today's episode
of the Way We Live Now. Have a question or
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(17:42):
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(18:02):
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