A professor and ER doctor balances saving lives and keeping her family safe.
While I was on maternity leave with my second child, a novel coronavirus was unfolding around the world. Months earlier, when I was pregnant, I remember thinking, “This is good. My son, who won’t be old enough to receive the influenza vaccine, will miss prime flu season, and I’ll return to work when things are winding down.” Little did I know what was around the corner. And yet, as we started to learn more about COVID-19, I was thankful that children weren’t as susceptible to the illness because that would have been very hard for me when thinking about my family and my job.
I returned to work in the emergency department at UC San Diego Health in February. Not only was I trying to regain my bearings after returning from leave (I have an older daughter so I’d done it once before), but COVID-19 was on the forefront of my mind. My husband Charley is also a physician at UC San Diego Health and the VA, specializing in head and neck cancer surgery. Because we’re both essential workers, both working in a hospital, we knew we would both be exposed to the virus. We had conversations about whether I should quarantine myself from the rest of the family like some other emergency medicine colleagues were doing. But we thought that would be much more scarring to our children. To not be there for them, and to not breastfeed my son, I just couldn’t do that. We would accept that risk and do the best we could to keep the virus out of our home.
Since becoming a mom, I’ve always come home from a shift and given a quick kiss to my kids before taking off my scrubs and washing my hands and arms. But now, my husband and I both strip down right when we get home, before we even go inside. We set up a decontamination zone in the garage. It’s a taped off area – we walk in the side door, take off shoes, take off clothes, wipe down phone/keys/bags, wipe off the door handles and then sprint to the shower, trying to avoid being chased down by our daughter wanting to hug us and ask “Who were your friends at work today, Mommy?” Everything from work stays in the garage, otherwise our toddler would touch it. I had to get creative with the breast pump to keep it clean. I wipe all the parts and the milk bottles down while pumping, after pumping, when taking it out of the bag once home. I’m a little OCD now, but I think we’re all a little OCD now. Everyone gets it.
At the start of this pandemic, I anticipated we would see many cases in the U.S. but I wasn’t sure to what degree. Reflecting back now, I believe we were more fortunate in San Diego than many other places. We had more time to prepare and knew how to better prepare because of the knowledge of what other people had suffered through. And I believe we had strong leadership in California to flatten the curve. It was hard to tell patients that they didn’t meet criteria for testing, that we would like to give them a definitive answer, but we just couldn’t. We told every single patient, whether they were tested or not, were positive or not, to act like they had coronavirus and self-quarantine at home. We were counseling patients in this way even before the various restrictions came into play, like social distancing and staying at home. Criteria for testing has evolved as testing becomes more available, and we’ve learned more about the various symptoms of the disease. We continue to discover more about this elusive coronavirus that manifests itself in sneaky ways. Each day there are new updates, endless emails, new concerns, small victories. Each day I’m proud to work beside amazing women and men who truly care for our patients and each other.
I’ve always tried to remind myself that a trip to the emergency department is often one of the worst days of a patient’s life. Now the stress involved in seeking care is even higher, whether it’s for the coronavirus or not. Our visit numbers are down, and perhaps that has to do with fewer patients coming in with non-emergent issues. But I also worry about patients with significant chronic diseases that are at home, suffering because they are worried about being exposed. It’s those really vulnerable populations that are waiting until their disease progression has gone too far to come in and be evaluated. By the time they do seek care, they likely need to be admitted, instead of having a quick “tune up” and safely returning home.
Some days in the hospital, there’s a degree of things being too quiet … as if we’re waiting for the virus to explode. I’m hopeful that doesn’t happen. It’s heartbreaking and overwhelming to hear the stories of what friends and prior classmates are going through in other parts of the country, like New York. I think we’re much better off than we anticipated. But I also think we need to be vigilant and not get too relaxed. We can’t have everyone rush to the beach or restaurants at once. The new motto is “It’s a marathon, not a sprint.”
Our lives have changed, healthcare has changed, education has changed. I now joke about our new online platform for the wilderness medicine course I teach as “the great indoors,” even as we talk about the great outdoors. In Richard Louv’s Last Child in the Woods, he interviews Robert F. Kennedy, Jr. while fishing together off the California coastline. As they drift along, Kennedy shares, “This is what connects us, this is what connects humanity, this is what we have in common. It’s not the Internet, it’s the oceans.” Despite what Zoom may have us all thinking, I remind myself of what truly connects mankind each day as I gaze out over the Pacific.
Even though we’re physically separated, people across the world are really working together to take care of each other. Out of all this stress and death and challenges we are facing as a human race, I think there’s good that will come out of this. In the end, my hope is that people realize that what seemed to be excessive and extreme measures have been effective in caring for our neighbors, protecting the vulnerable and helping save lives. So keep your eyes on the ocean and your hearts strong.
Dr. Christanne Coffey is a board certified emergency physician at UC San Diego Health and an assistant professor in the Department of Emergency Medicine at UC San Diego School of Medicine. A native of South Carolina, Coffey relocated to San Diego in 2009 to complete her residency in emergency medicine at UCSD. She was the inaugural fellow in wilderness medicine at UCSD and now directs the fellowship program and directs two medical student courses in wilderness medicine. She has worked for UC San Diego Health at both Hillcrest and Thornton hospitals since 2013.