2020年4月8日 星期三

When Your Spouse Is on the Front Lines


The hospital workers who are currently fighting COVID-19 all head into their shifts knowing the dangers they face: More than 100 doctors and nurses around the world have died since the start of the coronavirus outbreak. But they don’t take their chances alone. Doctors, nurses, and other health care workers could potentially bring the virus back home, placing their families on the front lines of the pandemic too.

Slate gathered the spouses of three ER workers—two doctors and one nurse—to discuss how they’re trying to keep themselves and their children safe, how they talk to their partners about their high-stress jobs, and how they feel about the risks they’re all confronting. They are:

Michael Kass, who lives in Brooklyn with his wife, Dara, an ER doctor at Columbia Presbyterian who has already contracted and recovered from COVID-19 herself. Their three children—ages 12, 10, and 7—stayed with Dara’s parents while Dara was in quarantine in the house for two weeks but moved back in with Michael shortly after this conversation. Michael works in financial services.

Jim Hayes, who lives in South Orange, New Jersey, with his wife, an ER nurse who typically works a few shifts a month at a local hospital. (She asked not to be named because “hospitals are getting pretty strict about staff talking about shortages.”) Jim works for a large life-sciences company. They have three children, ages 6, 3, and 1.

Hanna Kim, who lives in Pittsburgh with her husband, Steve Perry, an emergency medicine doctor at the University of Pittsburgh Medical Center. Hanna works as a philosophy professor at a small liberal arts college, a job she is now juggling with caring for their 6-year-old son while he is out of school.

Below is an edited and condensed transcript of their conversation.

Slate: How have your lives changed in the past few weeks?

Michael: Our life has changed a lot, and it’ll change a lot again. My wife got COVID immediately after going into the ER two weeks ago, so she’s been in quarantine. I was quarantined from her in the house. We literally divvied up the house to different floors. Our youngest is an immunocompromised kid; he had a liver transplant a few years ago. And so we don’t want them to be in the same house together if she’s working. We thankfully got our kids out of the house and to my in-laws’.

My wife is now basically recovered. I literally hadn’t been in the same room with her for two weeks. I’ve been by myself, except for teleconferencing. It’s just really isolating. If I knew what I know now, I would have moved out of the house from her before it happened.

Now we’re figuring out how to reposition the family for what we think is going to be a long haul. I’ll be taking care of [our three kids] and working at the same time. And then my wife will be living in a hotel and going to work. We’re thinking she’s going to be more or less 24/7 devoted to work or recuperating from work for the next two or three months—she’ll just live this binary existence in the ER and then sleeping.

Hanna: I wanted to ask you about your wife’s intensity of symptoms, because if she were extremely ill—I think about this with Steve. I don’t know how I would begin to think about caring for him in the midst of all this, with all the other things I’ve got to do.

Michael: It was really mild. Our next-door neighbor, unfortunately, passed away from COVID a couple of days ago. He was already in the hospital for another condition and got COVID in the hospital. My wife has some colleagues who had been hospitalized over this, though, who are young.

How has life changed for the rest of you?

Hanna: Steve and I are living completely separate lives. He’s in his own bedroom. He has a refrigerator and a treadmill set up in his room. He’s entering the house using a different entrance, spending minimal time in the common space. He wears gloves whenever he’s in a common space. He’s having only virtual contact with us—it’s how we decided to try to protect the health of [our son] Jack and myself.

I think that, for me, the biggest struggle was that the workload doubled for me. I mean, literally doubled. On top of everything I had to do for work, I had to take care of home schooling. And in addition to what I typically do on a day-to-day basis when I teach, I had to learn all these new things, convert all the lectures to be recorded as Zoom lectures, and then just sort of retool the whole syllabus of the courses. I am having to do this all by myself, times two. And so what I’m accomplishing with Jack, my son, is not great. And I would say the same for my online classes right now.

Michael: I know there’s no off hours, but I’m just curious—do you try to segregate the hours?

Hanna: I expected that you’d be curious about that, since I think I’m living what you’re about to live in a week or two.

Michael: I’m terrified, in case you hadn’t noticed.

Hanna: I’ll try to make it sound less terrifying. So from 8 a.m. to 8 p.m., I’m with Jack. I’m not trying to do anything else. I can’t do things in slivers of time, so I just don’t bother. When I do the work is after Jack goes to sleep. And typically it goes till 3 a.m. Lately it’s more like 2 a.m.

Every parent is probably dealing with some of this, but you guys are dealing with a more extreme version of it: How are you talking to your kids about what’s going on, especially since they have a parent who goes into the hospital regularly?

Jim: We’ve wondered about that because from a 6-year-old’s perspective, nothing looks different. My kids aren’t seeing my wife sneak through the basement doors and shower in the basement and change her clothes.

“When my wife comes back, what is she going to be? Is she going to be whole at the end of this?” — Michael Kass

Michael: My kids are pretty in the know. We’re pretty open with them. Probably about 5 percent of the darkest stuff we keep from them. My youngest asked the other night why he can’t live with his mom now that she’s already had COVID and is going back to work. And he’s like, “Well, isn’t she immune to it?” He’s a 7-year-old, can you believe that?

We had to sit him down, and we said it was about the fact that when she comes home at night, she’s going to have to bring her stuff in, and there could be pathogens on her stuff. The reality is we don’t know a lot about this virus, and we don’t know if you can get reinfected, and he’s on immunosuppressive medication, and she’s, you know, a walking petri dish. There’s no point in making him worry about his mother’s health. But we found in other situations that when we try to keep stuff from them, they just find out anyway.

Hanna: I’ve also tried to normalize it a little bit. We don’t sugarcoat it or avoid talking about it. Once in a while, when I’m watching something, he’ll overhear something about a death, and I’ll try to change the screen.

What kind of conversations have you had with your spouses about all of this? Are you talking about the future? Are you talking about the news? Are you having regular “how was your day” conversations?

Michael: The idea of having conversations about “Hey, this is what we’re going to do a year from now or two years from now”—I can’t even remember having a conversation like that. It’s just much more tactical. It’s who’s going where on Tuesday? Who’s doing what on Wednesday?

Look, I’ll be honest with you—I have very mixed feelings about my wife going back to work [after her illness]. This notion that health care workers are supposed to be the sacrificial people who come in and save us in our hour of need—she might have thought she signed up for that, but I never thought she did. Selfishly, I’m not rushing for her to pick up shifts. You see what’s going on in the hospitals, and it looks horrendous.

And I worry about her safety, but I also just worry about her state of mind. I don’t want to sound totally alarmist, but she’s going to have to make ventilator calls. She’s going to have to say, “You get it, you don’t.” That would weigh on my psyche for the rest of my life. And she’s going to have to do that again and again and again. And I just worry about—when my wife comes back, what is she going to be? Is she going to be whole at the end of this?

Jim: We’ve definitely talked about and had those same conflicted feelings. I see how this affects my wife. The first time she went for a shift, once this all really started, maybe two weeks ago, it was already affecting her. She normally does really well at compartmentalizing. But the conversations over the next week and a half, she’s like, “Well, what do I do?” And I have a really hard time giving her an answer, as I’m sure you guys do too. So is she going to go into her shift next week? To be honest, I don’t know.

Hanna: Our conversations are mostly about catching up with each other’s lives because we’ve had such separated lives now. I think we’re at the calm before the storm here. But this is only making me more anxious about what’s to come.

Michael: I have this really weird internal conflict on this stuff. Dara tends to be the mission-based person. I’m the selfish person. And lately, I find myself self-censoring a lot because I don’t want the last conversation we have before she goes off to work to be me saying, “Why are you being a martyr here?” I want her to feel supported. At the same time, every fiber of my being is just like, “Nobody deserves this.”

“I think we’re at the calm before the storm here. But this is only making me more anxious about what’s to come.” — Hanna Kim

Michael, what has Dara been telling you about what she’s been hearing and seeing at work?

Michael: She’s been doing [telemedicine] every day that she was in quarantine. Just the number of patients, the number of them that are presumptive COVID-positive, it’s insane. The number she has to admit or tell to go to the ER—every day we’ve been seeing it go up and up and up and up and up. As she’s gotten better, it’s like, OK, you’re actually going to be in the ER soon. And so there’s a tremendous sense of waiting, and looking at what looks like a tidal wave coming towards you. And being like, “Yeah, the tidal wave’s almost here. Time to go to the beach.” Is it the same where you guys are in Pittsburgh and in New Jersey?

Jim: It’s going to get worse, and it’s already bad. Back when we were in New York City [four years ago], my wife would probably see somebody put on a ventilator once over the course of two weeks. When she went on that Saturday shift recently, they had put five people on ventilators in that shift alone. And that was two weeks ago.

How are your conversations with other family and friends these days?

Michael: I find myself, like, not dispensing medical advice, but sort of. There’s no way my wife could see or talk to everybody that wants to talk to her because obviously, all your friends and all your friends of friends feel completely entitled to you. Like it’s tax season and you’re the accountant to the stars. So I find, every once in a while, some people call me up and they’ll be like, “Hey, can I talk to your wife?” And I’ll be like, “No.” The number of conversations I’ve had that are “Should I go to the hospital?” “No.” “Why not?” I’m like, “Because you’re not out of breath.” “How do you know?” “Because you’re talking to me.” People are worried, and their sense of discretion just goes out the window. It’s been a funny thing, seeing how people’s sense of reality morphs very quickly.

Jim: My wife will get random text messages. It shows how much our friends trust our spouses.

Can I ask you guys to share some high and low moments from this experience?

Hanna: I would say that the low and the high for me are two sides of the same coin. They’re just a constant sense of inadequacy and never getting enough sleep and being horribly groggy and grumpy to your child the next day. The flip side of that is that I get to spend this much time with my son. And when I spend as much time with him and do all these activities together, I am sort of the unique person who’s able to tell my husband updates about our day. I think that energizes him and encourages him in isolation and the work that he does.

Jim: The lows, I would say, were seeing how she is after a shift. It’s been a pretty stark before and after. Both me and my wife, we are Christians, and this has been a time where it has caused us to really kind of dig deeper into our faith and wrestle with things and kick the tires on it, and that’s been really cool.

Michael: Yesterday was the first day I went to go see my kids, because it was two weeks from when Dara had gotten infected. I literally hadn’t touched another human being in two weeks. I’m not a touchy-feely kind of person. [But] I cried. Not having human contact for that long a period of time, it messes with your head. It really, really does. I don’t know if it made me aware of how much time I had squandered not paying attention to my kids when they were around me. I’m sure I’ll fall into that trap again, because everybody does. But helping my kids with their homework yesterday was probably the best time I’ve had in the last two weeks, no question about it.

Is there anything else you all want to say?

Jim: It’s so good to hear that it’s not just me and my wife thinking about “Should you keep doing this?”

Michael: No, you’re not the worst person in the world. You feel like the worst person in the world thinking that stuff.

Jim: The last thing I’ll say: If you know of a nurse or a doctor who chooses family over this, don’t shame them. I don’t want my wife being another patient.

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