10/29/20

“We were a bunch of headless chickens trying to answer the most urgent of the questions.”

USA, Ohio, 21 March -23 June 2020

Daily temperature taking in quarantine, Photo by the author.

I am a fourth-year medical student living in Ohio with my partner. I was in China with my family from January to end of February, and witnessed the unfolding of the entire event. As I returned to the U.S., the disease began to wreak havoc in communities here. I will be starting medical residency in July and will be moving to California for that. I wonder what the world will be like then. By the end of this journal I have moved to California and started my residency. The second wave is just arriving. I still wonder what the world will be like at the end of 2020.

 

 

 

 

 

Saturday, 21 March

Constant snowflakes but no snow, gloomy as usual

Another day at the hospital COVID-19 hotline. This might be my last day in a while.

Since the med school cancelled all of our clinical rotations, the administration has been scrambling to come up with alternatives. To be honest, they really failed us. The email that we should end our rotations “immediately” came on a Monday at 9:30AM, when most of us were already at clinical sites. They then sent a follow-up email saying that they really meant we should leave the hospitals and clinics we were at, literally “immediately”. Most of us fourth years still needed more clinical weeks to fulfill graduation requirements. Therefore, the email created massive waves of anxiety among my classmates, especially those who needed 4-8 more weeks. The various deans and admins fell completely silent after the initial email, with no follow-up on what we should do and if we could still graduate. A lot of us speculated that they were fighting amongst themselves in terms of what should be done.

All the while angst about graduation grew, angst about COVID-19 grew as well. Various student-led initiatives began to pop up. One of them was to volunteer for the call-center at one of our home-institutions. The student leaders worked with the administration to make this count as a “clinical experience”.
 

The only way for me to feel less anxiety about COVID was to be in the know.

 

So here I am! Working a hotline for the first time ever in my life. Having just returned from China, I knew that the only way for me to feel less anxiety about COVID was to be in the know. In China, it meant volunteering for an online group that required direct contact with doctors and hospitals in Wuhan. Here at the hotline, I would have the most updated information about testing and screening, and get a sense of how providers and patients are working the system.

It’s my last day at the hotline because the med school admin finally made another announcement two days ago that many of us will be able to graduate with more lenient requirements. So I thought it would be better to leave the hours to others who still urgently need them. With all the talk of medical students being recruited into the work force before they formally graduate, I decided to sign up for another class called “transition to residency”. The good thing was that this course used to be capped at a tiny number, but with online teaching it can now lecture to as many students as possible. The downside is that there will be no more simulations, hands-on activities, or group work, the same reasons that it had to be kept a small class initially.

The strange thing that happened today was that as soon as I walked into the call room, I noticed that everybody had masks on. This was new since I started on Tuesday. I guess we are just following the best practices of trying to distance from each other. The other odd thing was that I couldn’t find any bleach wipes to wipe down my work-station, which I do everyday before I start. Oh well, can’t have everything. It was a really light day today. Half way through, a doctor called and asked if we had changed our testing criteria because apparently, the governor just announced it during a press-conference. We all tried to look online but there was no official documentation anywhere to be found. I even checked twitter, because of how official it is, but no. It’s a Saturday afternoon, our manager just left and said no one was going to replace him for the day. We were a bunch of headless chickens trying to answer the most urgent of the questions.

 

Tuesday, 24 March

Cold turned slightly sunny

Today in the morning I facilitated Foundations in Clinical Medicine (FCM) for my M2s. All the sessions have been moved to Zoom now. To complete my own graduation requirements, I started the Transition to Residency course yesterday, also on Zoom. It is a nice refresher for what’s about to come. Both FCM and this course are in the morning. I emailed the course leader that I would miss the first hour of lecture on Tuesdays. This has never been an issue with any of my previous electives. Everyone that I’ve worked with in the hospitals has been super supportive of me teaching at the medical school, and that was when I had to miss an entire half-day each week. Given that the people who teach this Transition to Residency course are residents themselves, I thought they would appreciate med students who also have interests in teaching.

But no, even though I emailed yesterday in the morning, I only get a reply this morning at 8:40, 20 minutes before I have to start my session with the M2s. The reply states that if I don’t have 100% participation then I cannot pass the course, and that I should drop the course.

Reading that email was the first time I felt truly angry and riled up during this entire coronavirus pandemic since January. It was a feeling of being backed into a corner and a disbelief that during times like these people still want to fault/create unnecessary obstacles for each other.

The thing is, according to our medical school guidelines, students are allowed to miss 1 whole day during each 2-week elective so my request is completely within reason. Also, I’m not missing an hour to sleep, or for any personal reason. This is already a difficult enough time for all students as faculty physicians are being worked to the extreme in the hospital. I felt we should have more understanding of each other instead of sticking to bullshit attendance rules.

I wasn’t going to drop the ball on my M2s, so I emailed back and said it was too late for me to find a replacement for today and cited the med school’s policy. The result is a compromise, I get to keep taking the course, but I have to find a replacement for next week, which will be fine.

It is really nice to chat with the M2s, it totally reminds me of what I was like two years ago. Most of all, it reminds me how much knowledge I’ve gained since then. More knowledge than I’ve ever learned in my entire life combined. The brain is definitely an incredible piece of flesh, it can create as many synapses as it needs to, but it has to be pushed and pushed and pushed.

 

As I’m ready to face the pandemic again, I realize I’m able to write again, and to acknowledge the importance of my own experiences.

 
 

Friday, 27 March

Rain stopped overnight

Today I read an article in The New Yorker of the author’s experience in Chengdu. I don’t even know what to call it anymore, quarantine? Shelter-in-place? Lock-down? Isolation? Basically, staying home.

It made me think to my hesitation writing about my own experience back home. I’ve gone back-and-forth about whether to write something and post it publicly. Partly is I don’t know if my experiences matter. Some days I want to scream to the world about what I went through, not because it was bad, but because it was so much better than what we are experiencing now in the U.S. But that would just be unproductive and make other people feel bad. So maybe I should just keep it to myself.

Other times I want people to understand China better. But then I think, what can they understand from my personal experience?

For scientists/epidemiologists/public health experts, their interest lies on a national level, and even though I believe the individual interpretation and experience of a national event matters, my stories probably can’t contribute to their final publications.

There also was a coronavirus fatigue in me. I didn’t realize how much of an emotional toll it took on me by the time I came back to the U.S. on Feb 28. At that time, I didn’t want to read about the coronavirus, I didn’t want to follow any numbers or hear about it.

I only recognized my emotional distress by comparing it to how I feel now.

Since yesterday, I began helping to compile a daily COVID-19 newsletter. Even just a few days before that, hearing the word COVID-19 made me wanted to puke (the hotline was nice because it didn’t require me to actively follow any news, I just passively received information and put it through an algorithm). But now I’m ready to jump back in. I think I’ve properly healed and rested, and this second time around I know how to regulate my attention span, my information sources, and my restlessness.

As I’m ready to face the pandemic again, I realize I’m able to write again, and to acknowledge the importance of my own experiences. This diary is also helping. But now that I am able to write again, there are so many projects awaiting me.

It also has made me realize the importance of timely documentation of things and how hard that is. This gives me more appreciation for professional writers and reporters, for they have to overcome the pain of examining tragedy as it happens to record it, in real-time.

Another note regarding the hotline, per my friend who manages the roster, a lot of my classmates have quit either because they are sick with COVID, or because they’ve come in contact with someone COVID+. It’s getting real.

 

Tuesday, 31 March

Gloomy

Even though I dislike not being able to go anywhere, I enjoy isolation. I don’t mind not being able to hang out with my friends. There are so many things that I like to do on my own. In the normal world, there is never enough time to do all of them. I’ve never so consistently practiced an instrument and my Chinese handwriting in my entire life. I like to think that I’m building the little skills that I’ve always wished for.

I have been staring at my computer and my phone way too much, and I notice my eyes get tired so often now. My phone is also out of battery by mid-day, which never happens.

There is simultaneously a force in me that wants to scream and a force that wants to shut up. I oscillate between the two every minute. Sometimes it’s paralyzing, and I end up just staring into my black computer screen. I think as of now maybe I should not be so preoccupied at telling how others should act, no matter how “correct” I feel. I’ve been wanting to write an article about why wearing a mask is mainly for psychological protection, and can be dangerous if not done correctly. But all of the recent rhetoric for wearing masks is making me feel really fatigued. There is a fear that I will be quickly shut down. Even more is a fear that I won’t feel like it was a good use of my time. I guess what is my goal here? I think deep down I really want people to know the right ways to wear a mask. But deep down I also know there is no way they will be able to do that. As I was writing my essay, it almost felt like I was trying to convince people why they really shouldn’t wear a mask, no matter what. Maybe it’s going to be really unproductive because people are going to do it anyways. All of those feelings are a huge barrier to writing anything good.

Looking back at my diary, I forgot to mention in the first entry that I matched! This is perhaps the biggest event in my entire life, as it finally lets me embark on the career that I’ve dreamed about for the past ten years. I can finally say with 100% confidence that I am going to be a physician. This made me realize that maybe I am not treating this diary as a true place to record all my feelings. To kick it up a notch, I also had a fight with X from March 20-March 26. It was really bad, and it turned a celebration into hell. Maybe that’s why my diary entries have been really gloomy. I am noting it down here to track our progress. Something good did come out of that fight, he specifically agreed to not drink in front of me anymore. Even though I know he is trying to sneak in drinks during the day when we are doing our own work, I’m happy that it is under more control now (?) I hope I’m not just being naïve.

Now that we will be moving to California for sure, I’m starting to figure out housing, and it’s really hard when you can’t be there to visit. I really hope that through.

 

Wednesday, 8 April

Thunder to gloomy

The days pass by so quickly and easily forgotten. I want to document my life more but it always feels like I’m running out of time throughout the days. Curiously, I have so much time in life right now but I realize that I now spend a lot of time chatting with people on line. I haven’t decided whether this is positive or negative. In a way, it helps me connect and socialize, but it also distracts me and takes time away from productive things that I should be doing right now. That I can only do right now. That is a sad thought, that soon I will lose control over my own time, when I start working in June. To be optimistic, it can be seen as I will be more disciplined, and accomplish more under more time constraints.

In times like these, I often think about my middle school and high school days. What did I do when I had so much free time? I wasn’t on my computer. I didn’t have a smart phone. But I also can’t come up with any consistent routine that I would default to when I was free. All I have are snippets of memories of events and fun hang-outs with friends. But did I really do that all the time?

This past week has been a really good one. I think my meditations writing this diary pushed me to write with the goal of addressing the world. I wrote a medium article about how to wear masks correctly, it took a lot of effort since I am so fatigued from this topic since January. But thankfully, I had really encouraging friends and partner, who helped me edit. Surprisingly, it had good reception. As of today, it has 1815 views and 1138 reads, way more than what I had anticipated.

Ironically, a couple of hours after I published my article, the CDC changed their recommendation regarding mask wearing and began recommending it for everyone, much to my dismay. Even though my article was about how to wear a cloth mask correctly, what I was low-key trying to do was to demonstrate how incredibly difficult it is to do it in the correct fashion, and that most people would not be able to do it (including myself), and that because most people cannot do it correctly and when done incorrectly, this measure can increase the risk of spreading the virus, we should not broadly recommend it for everyone. I guess most people are already set on the “need” to wear it, so they didn’t understand the undertones of my article. But that is also probably why it got so many views. If I had come out against the measure, I probably would have gotten a lot of criticism. Figuring out how to write the article and get people to read it was a good exercise in terms of thinking of phrasing in a way that doesn’t blatantly go against what people wish to believe. My friend texted me the next day and congratulated me that I even beat the NPR to the discussion.

The disease has really shown me that fear is a powerful emotion. I feel fortunate because of my privilege in having a medical degree. Because of that, I know the limits of this virus and what all the fancy words mean. With it comes an urge to explain my knowledge to everyone, but also realizing that not everyone wants to know, largely because they are driven by fear, and me telling them or writing an educational article is not the same as a true education. Take the mask issue for example, I felt guilty for a long time because I felt the obligation to let people know that it is not something we should place our hope in. The guilt came because I know I’m privy to information that others do not have access to. So writing that article really made me feel relived, like I did my best, and if people still don’t care, then there is nothing more I can do.

Last night I had an interesting interaction with X. The night started off really nicely, but as it always inevitably evolves into a dull lull, I felt something was off between us. Then we had a very unpleasant exchange with him storming off. At the time, I thought I’ve had enough of his inability to face any tension/conflict. Now that I think about it, I’m infinitely proud that I was able to channel my energy into practicing piano, something I haven’t been able to do because of my injured index finger. To my surprise, even though I hadn’t practiced for 6 weeks, I was still able to play the piece for the most part. It was a Scriabin etude op 8 no 2 in F-sharp minor, one of my favorite pieces of all times. After maybe 40 minutes of practice I felt really good about myself. Maybe it was the confidence that I regained that helped me reach out and talk to X again. I think by then he had also calmed down. I invited him to listen to me play. Sadly, my performance was terrible, so much worse than when I was just practicing by myself. X was so excited though. He was able to see through the mistakes and enjoy my playing.

Interestingly, he’s never heard of this piece before, but he gave me some notes and they were all spot on. His musical instincts are so beyond me. It became a really fun session where he coached me through my own piece with his enthusiasm, helping me bring more contrast and helping me keep beat. He was surprisingly patient and never god mad when I kept making mistakes. He was even fine when I disagreed with some of his interpretations. We played together for about 2-hours, trying different variations of the same phrase. The whole session was smooth and purely lovely. When I played a section particularly well, he said that gave him goosebumps. It was a lot of fun. Safe to say, we haven’t had this level of intellectual fun in a while. We ended with him praising me as a “very talented piano player”, a truly hard earned title. I pointed it out to him that usually he’s so hard to get along with and that he makes me really nervous, but just now we were collaborating seamlessly. He thought about it and admitted maybe he’s been craving this kind of intellectual exchange for a long time, and that he doesn’t get any of it in Ohio. He ended the conversation with the exclamation of “I hate (place in Ohio)!”. Then we went to sleep in each other’s arms and it was a fantastic night.

 

Tuesday, 21 April

18:17

X was laid off just now. I had literally just come back after delivering a package that was supposed to be for someone on an entirely different street. I’m glad I made it back in time so he didn’t call out to an empty house.

I feel shaky, the type of shaky after doing something exhilarating. In this case, after finding out that our lives will be so different on top of the already known difference in a few weeks. This is X’s first time. We both know we will be okay. But I suspect it hasn’t hit him yet.

This was a shock as we often joked how awesome it was that he could work from anywhere, and had assumed that he wouldn’t be touched by this pandemic. He is the first person in my personal circle to be laid off. I feel lucky in this regard.

He is only getting 5 weeks’ severance pay. And I blurted out, “that’s so little!”. Of course, regretting it as soon as I said it.

So many decisions had to be made in an instant, and I am proud to have made them by now, so things will continue to run as smoothly as possible.

In a way, we have been ready for this, and I am proud that we have been preparing for an emergency like this not knowing when it would hit. I am thankful that we’ve tried to live a low-key life, and X has been saving up ever since he paid all of his student loans. I’m also thankful that my parents had just wired me a lot of money as a loan for me to pay off my student loans during the interest-freeze period. I’m so glad that during my loan pay-off frenzy this morning I decided to stop and keep a little for myself as emergency money. My mom is generous and lending me the money interest-free.

Even with all of these cushions, some made by ourselves and some made by sheer luck and subconscious-will, we will probably barely make it through unscathed.

I haven’t written for so long, partly because something really bad happened for the past two weeks. And I realized that when I feel so sad I don’t really want to write. X and I almost broke up, but I’m glad we decided in the end to preserve and keep fighting for our relationship. How pertinent a decision it was!

And when we are good together outside forces are never able to faze us.

 

 

Thursday, 30 April

Rain turns sunny

Things are bad again. Just when we’ve loaded up a pod that’s been picked up by the moving company. To me, things are looking good and exciting. Whatever may be in California, I’m really excited about the road trip, the change of scenes, seeing old friends, seeing X’s family. X, all of a sudden, is not excited at all anymore. I almost feel angry because the reason I focused so much on California was because he wanted to go back home. That’s why I did all my interviews there.

We are leaving Ohio on May 5. Yesterday I realized that it was cinco de mayo. Maybe I can secretly wish for transformation in X’s heart on that day?

X has been really distant. I know it’s finally hitting him now, the loss of his job. But he’s so often distant in the past that I’m not sure if this is because of his job. I’m sure it is a factor. But I just want to feel connected. Can a person mourn and still be connected? I know I can, and I have. But I feel this is just a convenient excuse for him to be closed off. Yes, it is hard, but being in a serious relationship means he is still a partner, which means he can’t just shut off completely and hide in his cave for any amount of time that he wants to.

This coronavirus is making us depressed, for sure. But amidst everything, I find things to be happy about. I am happy that we are together and feel positively about our future, that is, if he could act like a partner.

Part of me even feels scared because we were supposed to have a wedding this year, which of course is not happening. In fact, it was supposed to be this past Saturday, April 25. It was supposed to be in China in my mom’s garden. To be honest, I’m not that sad because I really despise weddings.

I think I despise them even more now because in this disaster I’m losing my confidence in X at how he can hold up his end as a partner. During hardships and uncertainties like this, the most important thing to me is not whether my partner can find food or shelter, because I’m perfectly able to do that on my own. And I know he can do that as well. We are not with each other because we need someone to help with the most basic life necessities. To me, the most important trait is to be able to uphold the human spirit, to maintain hope, and to cheer each other on, the best feeling is to be able to smile despite the horrible surroundings. Right now, I feel he is sulking, and he sulks more when I try to cheer on, and seeing that turns my cheer sour, and then bitter, and then apprehensive, and it makes him sulk more. And we are just hopelessly in this vicious cycle that cuts us deeper each time.

I’m writing all of this because I’m so sad right now. This morning I mentioned that every time we talk about his future plans, what he looks forward to, what he wants to achieve, his answer is always completely focused on himself and his friends. If you didn’t know I existed, you would think he’s just some bachelor trying to have a good time in life, getting into all sorts of activities, working out, getting a dog, etc, not someone who is in a 6.5-year-long relationship and trying to get married. His response was that he doesn’t get interested or excited when he thinks of doing things with me. The reason is that often I don’t like a certain way things are done and so it’s not fun. But really, I’m not someone who is so picky and hard to get along with. But I do want things to be done thoughtfully. And when I said that to him, his reply was that if had to think whether something would make me happy, then it’s not fun for him. That if he had to take other people’s feelings into planning an event or activity, then it would not be exciting. That just sounds ludicrous to me, as if the two things are mutually exclusive. It also made me feel that he only wants to plan a big party – our wedding- but he doesn’t care about the responsibilities of being a partner. I mean, what about the vows of how you will care for each other and love each other and all of that? I think I would vomit if I heard him say the vows because they would be so fake! If he said that, then it would mean that he has chosen to live the rest of his life unhappily because now he has promised to take my feelings into account? Why would someone choose to live life unhappily? I’m starting to feel so confused as to what he sees as a fulfilling life. My nightmare is becoming one of those “dutiful couples” who appear everywhere together but not in their hearts.

It almost feels as if he loses all interest in life if he has to consider my existence in it. But if that’s the case, why be with me????????????????? I guess I remember he did say he wanted to break up with me and I tried to convince him that we should try one more time. Maybe it’s good because it is finally starting to make me feel maybe we really shouldn’t be together after all.

 

 

Monday, 5 May

Perfectly sunny and cool

Today is our last day in (city in Ohio). It is 12:38 AM right now, and we are planning to leave in a few hours, hopefully by 3 AM. We are then going to drive to Nebraska, stay one night, then Colorado, then Utah. Moving during a pandemic seems weird, but also isolated. We are still social-distancing, but just in our cars.

Before we started packing we took a snuggle break in the bed (blankets on the carpeted floor) and listed things that our children have to do or we will disown them. We seemed very much on the same page about everything that each of us took turns listing.

X is doing most of the heavy lifting in the moves, packing the large and small things. I’m always getting distracted. I love moving but I hate packing, and I want to throw everything away. X is being very good. I may have to reevaluate about what I said over how he is not being a partner. In almost all other aspects of life, he is a very apt partner. Does it make the drinking insignificant? I don’t know. I still feel nervous when I know he’s had a drink or two. I don’t like the feeling, but I don’t know how to shake it off. Am I being manipulative? Or I guess am I making a big deal out of something that is only my problem?

 

 

Tuesday, 23 June

Perfectly gloomy and cool

So I started residency! The first day I was exposed to someone who was COVID positive. So the very next day we were all sent home to be quarantined. It seems like the algorithm has been improving because the new rule is that after exposure I can be tested on the 5th day. If test is negative and I have no symptoms, then I can return to work. This is better than waiting for 14 days in quarantine.

Back to quarantining with X, which is not too bad! Savoring the last few days when we can hang out during the day!