Of the many hours of orientation to medical school, there is one moment I will never forget. The dean, standing at the base of the steep auditorium, clicked his slideshow to a picture of a red disaster-preparedness backpack overflowing with emergency supplies: hand-warmers, canned goods, bottled water. “There will come a time,” he said ominously, “when you will be called upon.” He described Manhattan in the days following Hurricane Sandy, the crisis in most recent memory, when medical students volunteered aid in flooded hospitals downtown. “It’s just a matter of when.”
Those words stayed with me because I still have the hand-crank flashlight my mother sent me after the lecture. I have been prepared for disaster as long as I can remember. All of my grandparents survived the Holocaust, and their experiences informed my lifelong vigilance. More than that, their stories from “back then” created a framework with which to approach adversity: My paternal grandmother, a resistance fighter during the war, taught me audacity; my maternal grandfather, a Russian army soldier, imparted courage; and my paternal grandfather, a survivor of five concentration camps, resilience. Born from trauma, the traits I inherited formed a preparedness bag that I have always kept near.
In 2020, my dean’s prediction came true: As an internal medicine resident during the COVID-19 pandemic, I was called upon. While in medical school I might have leapt at the opportunity to serve in a time of crisis, in residency, I had responsibilities beyond work. In late 2019, just months before rumors of faraway contagion began to swirl, my daughter, Manya, was born. Though her first months were as a newborn’s should be — filled with festivity and time with family — as the pandemic emerged, her life changed. In January, my wife and I celebrated our daughter’s baby-naming at what would be the last party we attended that year. We handed down the qualities that her great-grandmother and namesake embodied: optimism, gregariousness, and tenacity. Sooner than my daughter would, I found myself calling upon those traits — and the others in the preparedness bag my grandparents packed — to ensure that although Manya would know a stranger’s face as only a set of eyes above a mask, she would still learn how to smile.
When, years from now, Manya asks about “back then” — about my experiences as a doctor and ours as a family — I will start the story just before the storm, when, in the beginning, time slowed. February felt like a year; we watched dark clouds on the horizon but pretended they would dissipate. Early on, I worked on the oncology service with an attending physician from Italy. Before our morning rounds, we traded speculation based on what was happening abroad, but the conversation always ended with some degree of dismissal. Their health-care system is flawed, we justified. It could never be like that here. But when no one was looking, I slipped an extra N95 mask into my bag.
In mitske drinnin — all of a sudden, in my grandmother’s Yiddish — those dark clouds turned to rain. I was working in the local VA hospital’s emergency room when I saw my first COVID-19 patient. On a Monday morning in mid-March, I greeted a middle-aged man with a handshake — both of us maskless — but retreated once I heard his barking cough. His wife had brought him in because his defibrillator fired, an event usually triggered by acute illness. I admitted him to the hospital for treatment of pneumonia but feared that there was more at play. By the time his positive result came back, he had died.
I was petrified. He was not only my first COVID-19 patient, he was also the first in the hospital. My chief residents imposed precautions for the next two weeks: to wear a mask to work and check my temperature twice a day. I heard stories of doctors and nurses who slept in hotels or offices, and I worried: What if I brought the virus home? The white stains on the collars of the pullover sweaters I wore over my scrubs are a testament to my incessant bleaching of my workstation and the stethoscope I kept slung around my neck.
All of my grandparents survived the Holocaust, and their experiences informed my lifelong vigilance. More than that, their stories from “back then” created a framework with which to approach adversity.
Through April and May, when I returned home each night, I’d peel off my scrubs before the door closed behind me. Manya had learned to roll over and crawl, and she often made her way toward me before I could toss the dirty clothes in the laundry. When she hung onto my leg and I scurried to the shower instead of picking her up, I felt like I was abandoning her. But we had to stay safe. And as my paternal grandfather would say, we were thankful for each day — so far.
If Manya one day looks at pictures from that summer, she may ask why things look so ordinary. I’ll have her look more closely: at the mask underneath my chin, the bottle of hand sanitizer poking out from her diaper bag, the boarded-up stores in the background. As my wife and I tried to preserve normalcy, for once, we were grateful that time dragged. We went for long walks and visited the zoo. When it was warm outside, we invited friends with children to join us on the lawn in front of our apartment building. Even if they couldn’t get too close, at least the kids would see another living child.
How long could this go on? friends asked. I shook my head. There was no way to know. I was reminded, over and over, of something my grandmother would say: “When you’re climbing up the tallest ladder, and you think you can no longer climb, look down to see how far you’ve come.” At times, the top of the ladder seemed to be in sight.
November brought another wave. A few weeks before Thanksgiving, I was called in to staff the COVID intensive-care unit. From a medical standpoint, taking care of the patients there had become almost like a protocol: steroids, an antiviral, supplemental oxygen. There was little medical reason for me to even go inside a patient’s room and risk exposure.
But the patients needed so much more than medications. And so, when an elderly woman with dementia called me through the glass doors to her room, I hesitated until I thought of her daughter, who feared not only for her mother’s physical comfort, but also for her mental well-being. I stepped inside her room wearing standard protective gear — an N95 mask, blue plastic gown, and face shield — and realized that the patient was confused. As we talked, she pulled off her ventilatory facemask, which delivered pressurized air, and unintentionally waved it around the room. I felt the cool air billow under my face shield.
A week later, I tested positive. When Manya asks what it felt like, I’ll tell her that thankfully, I felt physically fine. But I was as terrified as the patients I saw. In the days prior to testing, had I infected her and my wife? Would my parents, who often cared for Manya, end up like the patients I cared for in the ICU? I didn’t hug or kiss Manya for two weeks, waiting for my minor symptoms to intensify, and trying hard to distinguish between panic and prodrome. In December, as news of a vaccine broke, my symptoms — and my fear — faded.
When I held my daughter for the first time since testing positive, I finally understood what my grandmother meant when she told me that my visits were “like a shot.” The literal shot that would mean the beginning of the end of the pandemic was in the wings, but Manya, I’ll tell her, you were there the whole time. You were my shot.
I don’t think my medical school dean could have predicted the way the COVID-19 pandemic would ravage our country, let alone serve as a backdrop to the civil unrest and leadership failures that our nation has witnessed. But my grandparents taught me to always be ready. “This is not a story, it’s my life,” my grandmother would remind me. As my grandparents packed my preparedness bag for me, I will pass it to my daughter — hoping that she never has to open it up, but knowing that if she does, she will find in it all of the strength she will ever need.
A CALL FOR COVID STORIES
PAW is seeking to publish essays by alumni on how their lives have changed during the course of the COVID-19 pandemic. Stories about loss, hope, resilience, or any other topics that could help other alumni navigate this time of trial are welcome. Send your idea — not a completed essay, please — to paw@princeton.edu.