August 25, 2021

My COVID-19 Memoir

Edward A. Lebowitz, MD

COVID-19 shook my complacency. Things I took for granted became unobtainable and shaking someone’s hand became an assault. In March 2020, I read John Barry’s The Great Influenza and shuddered. When San Francisco locked down, I cancelled my day-a-week Stanford gig at Lucile Packard Children’s Hospital and asked for a PACS workstation to readout from home.

By the time the workstation arrived, elective procedures were cancelled, and patients were afraid of hospitals. Volume tanked, and full-time doctors were offered a choice of either relinquishing vacation time or taking pay cuts. Stanford didn’t need me. I considered volunteering from home to stay engaged, but how would I have felt if I were a young doctor who thought my job or salary was in jeopardy and a retired doctor in the community offered to do it for free? Instead, I Zoomed innumerable COVID-19 webinars, read online articles out of Wuhan, Milan, and New York, and watched CNN Coronavirus Town Halls.

Epidemiological jargon became my lingua franca — PPE, PUI (person under investigation), RT-PCR (reverse transcriptase-polymerase chain reaction), aerosols, droplets, fomites, prevention, mitigation and harm reduction. Then, I became a PUI myself. I tested negative. Still, I felt like Dr. Tony Fauci was my captain, my team was making a goal-line stand and I was on the sidelines. I concluded that there are no essential workers, just essential jobs, and I lost mine.

What did I miss most about medical practice? I’d like to think it was the joy of helping patients, but it probably had more to do with feeling worthy of the job, hanging out with young people, reading room collegiality, exercising my mind and being valued even if not required.

Before the pandemic, I prepared a one-person theatrical show about going to medical school during the Vietnam War era that was accepted by the San Francisco Fringe Festival. As the pandemic ground on, the festival was cancelled too. So, I wandered the hills of San Francisco, Zoomed lectures on plagues, philosophy, ancient religious cults, astronomy, the worldwide crisis in democracy, epic poetry, Broadway musicals and rock’n’roll.

I watched more TV in the first dozen weeks of lockdown than in the previous dozen years and saw my granddaughter Estelle on Zoom more than I had in real life. I became a virtual babysitter until Estelle got Zoom-fatigue and received a pet kitten — at which point, I lost that job too. In late July, my family quarantined for two weeks, then moved with the new cat to a short-term rental to get out of the cold San Francisco fog and into the sunny Napa Valley heat. We got more than we bargained for with a lightning storm, then fires and finally emergency evacuation.

Morbidity, mortality, unemployment, financial distress, anxiety and isolation became a metaphorical bomb. The year 2020 exposed not only our lack of preparedness for pandemics, but also class and racial divides that exacerbated health disparities, made established public health measures controversial and endangered public health doctors. I cried a lot, and I’m still worried.

In September 2020, my spirits lifted as I restarted fluoroscopy and reading room coverage. I felt I was in the game again, especially working in-hospital through the Thanksgiving, Christmas and New Year’s holiday surges.

By March 2021, I and almost everyone I know were vaccinated, case counts were low and life became closer to normal. We saw the proverbial light at the end of the tunnel. In August 2021, however, the light seems like it might have been a mirage. The delta variant has reversed progress, we remain at risk and await booster shots. Nevertheless, I’m pretty sure I’ll get out of this alive, and when theaters reopen, I’ll perform my one-person show about war, courage and what it means to be a doctor, offering immeasurably more insight than before COVID-19.

2020 fires near San Francisco, CA, turn the mid-morning sky an unnerving orange.