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Like Breathing

 In the midst of this pandemic, I’ve been thinking a lot about breathing. In the yoga that I practice, breath is important. It’s a way to focus attention and connect to the spirit. It brings calm to an anxious mind.
You don’t think about breathing, you just do it. My career as a family doctor has been like that to me for over thirty years. I work at a clinic in the Bronx, and I know most of my patients well. We work together to manage their diabetes and hypertension, the personal crises in their lives and acute problems like colds and back pain. It’s hard work, but it feels good to help people and to have them know me as “Dr. B.”

The intellectual challenges keep me sharp. Sometimes I’m not sure what the best course of action is, but since the patients always have another visit with me, we can try something and see how it goes. My breath is easy and sure most of the time.

Yesterday, I worked a shift in one of our local emergency rooms to help out the overwhelmed docs on the front lines. My breath did not feel easy and sure; I was out of my element in a new and stressful environment. Not only did I have to worry about how I could best help and how to get things done, I had to be careful to follow protocol with PPE as best I could. It felt very different from what I normally do.

Most of the patients in this part of the emergency room had COVID-19. Their breath was far from easy and sure. The tests were still pending, but the findings were quite similar. The patients came in with fever, shortness of breath, cough, and body aches. Their oxygen saturations were low, and they needed supplemental oxygen. The labs showed suppressed white counts, elevated liver tests, kidney dysfunction. The chest x-rays showed multilobar pneumonia. We admitted them and worried they would get worse. Some did get worse. Some needed to be put on ventilators.

I took a deep breath and started my rounds to check on the patients I would be covering, feeling a bit more comfortable. People were so appreciative to have someone listen to their concerns. One young man worried he might have passed it to his three-year-old son. I reassured him as best I could. An older woman was freezing, and I learned where the warm blankets were kept. A middle aged man was relieved to discuss his diabetes management so that we could give him some insulin to cover his elevated blood sugars. I had the time to use the translator phone for an Arabic-speaking woman and answered her many questions.

I called several families of elderly nursing home patients to discuss what we call “goals of care.” It was tough having these discussions with people I’ve never met. We talked about the futility of some of the things we do to keep people alive, what mom or grandpa would have wanted, and quality of life. I helped the wife of a ninety-year-old man speak to him by cell phone to say goodbye. There is no visiting in the time of corona. It is heartbreaking.

As I leave the hospital after my shift, the sun is setting over the north Bronx. Several fire trucks are gathered outside with the firemen standing on top. They clap and cheer and start the sirens. It’s beautiful, but I don’t feel like any sort of hero.

Home to a hot shower and dinner made by my wonderful husband, we eat six feet apart. He’s sleeping in the basement for now. And we’re both still breathing.

Sue Bonadonna
Larchmont, New York