By Amy Woznick, MD, FACS

Today is Monday April 27, 2020. It has been over 6 weeks since the Governor of Michigan issued all schools to close, and within a week everything else was shut down. Our level one trauma center canceled all non-emergent surgeries. Office appointments were cleared. I assumed this was a temporary response to what we were sure was coming. Now five weeks into this we are trying to figure out how to resume life without risking the health of ourselves, our families, our staff and our patients.

At the beginning, the emails were fast and furious regarding policies of doffing and donning PPE. Who would get PPE? Where were we allowed to wear PPE? If you had your own masks why you were not allowed to use them. Honestly, it seems like an eternity ago. I could not stop obsessing about the current state and where we were headed. I ordered grocery delivery. I made schedules and lists for home and work. I became our housekeeper and a home schoolteacher all while being the managing physician in our four-person hospital employed hand surgery group in Kalamazoo.

Today things seem to have settled into a little bit of a rhythm. I have our summer nanny, sent home from college who is helping with my nine-year-old daughter while I am at work. My husband works from home, so his frustration is his work life has not changed at all. Meanwhile, they are getting a lot more face time with me. I drove into work this morning at 10 instead of my pre-COVID time of 7 am. That’s what we are calling it. Pre-COVID and the new normal are terms we use often.

I stopped at Charlie’s school to turn in last week’s work and pick up new assignments for this week. She goes to an amazing private school. They have been great with continuing the education process. However, my daughter is an only child. She is extremely social, and I can tell the social distancing is taking a toll on her. She was having panic attacks a few weeks ago. She said she felt like she couldn’t breathe. What nine-year-old has panic attacks because she is so worried her mom is going to catch an untreatable disease at work and die?  It was at this time we stopped watching the news. Since my husband and I stopped discussing our concerns and fears openly she has been less anxious.

When I pulled into the hospital parking lot today, I took a minute to look around my car and prepare myself to walk inside. Four weeks ago, I would have cried, feeling sorry for myself that I had to go in and possibly be exposed to the virus. Today I put on my handmade mask over my hair already in a surgical cap. I wear lipstick, because even though nobody will see it, I know it is there. I want to feel normal. I grab my new normal tote bag. The one made out of see through plastic. It was a freebie I got with make-up a few months ago. I so wish I were carrying the beautiful new leather bag I bought for spring. This however does not align with my new normal post-hospital decontamination routine.

After I pass my screening questions and get my sticker for the day, I go into my office. Today I finally get to operate on an adolescent with a scaphoid non-union. Her family has been very patient while we waited for the OR committee to grant me the time to do this case. I also have an acute comminuted distal radius fracture. I feel like I have won the jackpot. Two surgeries in one day! Pre-COVID it was common to do 14 in a day at our surgery center. Oh, do I miss that place. Our hospital system shut that down very early on in the process and has yet to reopen.

Everything takes so much longer in the new normal. After what seems like an eternity to do two cases, I took off my N95 outside the OR. This is the longest I have worn the N95, a mask over it, lead and loupes. I am sweaty and my head feels like it has been crushed in a vice. One of our CNAs points at my face and starts laughing. He tells me I am going to have marks for days. Three months ago, a friend was telling me I needed a silk pillowcase to decrease wrinkles. I am certain this new normal photo would make her cringe.

 Our hospital has furloughed several hundred employees. Over half of our staff is furloughed. I have not seen my RN since the second week in March. She took a transfer early to the COVID call center in an attempt to work more hours. The medial provider staff took pay reductions up to 15%. The administration did as well. Our 401ks will not be funded this year. It is yet to be determined how our future salaries will be calculated, since they usually take the previous six months of wRVUs. We are slowly going through canceled office and surgery appointments to try to decide who should be seen first. Do you take a healthy chubby 35-year-old or a thin smoking 52-year-old? It is so hard to know. These are questions I never thought I would have to answer, because pre-COVID I would schedule them all.

 I finally make it home for my decontamination routine. After I am clean, I can make dinner, clean the house, grade papers, try to order grocery delivery and do tomorrow’s lesson plan. While life does not seem as hectic in the new normal, I feel like I always have something I should be doing. I miss my girlfriends, my gym, a clean looking manicure, date nights, play dates and even Charlie’s crazy skating schedule. I used to often complain that I was working too hard, but I have realized I need to work. I truly love hand surgery.  I am trying to be grateful for this forced slow down and to look at it as an opportunity to evaluate what is truly important. An opportunity to spend more time with my family. But I know I am counting down the days until the new normal resembles pre-COVID and I can get back to my crazy busy over-scheduled life.