Hektoen International

A Journal of Medical Humanities

Remembering your COVID birth

Laura Kahn
Chicago, IL

 

Artwork by Jill Littlewood and Morgan Kinney based on photo by author.

The thing about having your first baby at the beginning of a pandemic is that everything seems equally strange, because you don’t have a prior kid for comparison. I wait anxiously for my son to poop, I wear a mask when I leave the house, I sanitize everything, I wake every hour—it all blurs together and the only thing that’s clear is that my life will never be the same.

Dawn breaks our fragmented sleep and you start crying again. We wake, and hours pass in a haze of diapers, breastfeeding, pumping, rocking. You scream from hunger and scream harder when you’re eating. It’s like being on call but it never ends—there is no one to relieve us, no post-call day off. We are alone, the three of us, in our gray bubble.

The birth of my son coincides with the lockdown; I know, because I work until the day I go into labor, taking clinic walk-ins and telling people to get the flu shot. It’s a completely normal workday. By the time my son is a week old, clinic has been canceled and nothing will ever be the same. I watch my co-residents post pictures, and count the short days until it’s me in the N95 mask.

You’ve been crying for days. I’m so tired I can’t think, and am starting to panic in the evenings, knowing we face another night without sleep. We try to take shifts but your wailing fills the house, and when you do sleep, I jolt awake, thinking I hear you.

My parents are both in their 70s, and start quarantining immediately; we video chat once a week. I know they want to do it more, but it’s exhausting to translate my days. I have no idea what happens during a day with a newborn.

It’s 11 pm and we’re on the couch. Your cries have subsided into residual hiccups, and the low light is warm on your dad’s flannel shirt as he hums with your blond head against his chest. My throat is tight with how beautiful you are.

I’ve started to get targeted marketing for face masks with designs in floral, paisley, plaid. At first this strikes me as dystopic and almost funny; little do I know how normal it will become.

Leaving you to go back to work is shockingly hard. I cry myself to sleep before my first 24-hour call, listening through the wall as your dad tries to soothe you. I dream of you and wake up missing you. It’s like going through a breakup: though I perform my tasks, when I close my eyes, all I can see is you. I’m unprepared for this magnitude of emotion.

At work I wear an N95 mask beneath my glasses, covered by a pale blue surgical mask, covered by a face shield, topped by a pink surgical cap, and finished off with a blue plastic gown and gloves. After every patient encounter, I throw out the surgical mask, gown, and gloves. I wash my hands, get a new surgical mask, and wipe down the plastic face shield and my stethoscope. Donning and doffing PPE is laborious, but we’re grateful to have it. PPE is still scarce enough that there’s a limit on how many people are allowed into a Code Blue room; we crowd by the door, peering through our masks and face shields, putting in orders as a skeleton crew tries to eke out a few more moments of life. There are a lot of Code Blues. Everyone is exhausted. Some of the staff have died.

I stare at a patient’s lab results, the numbers gibberish on the page, astonished that a few weeks ago I could effortlessly compress the information into meaningful decisions. I cry in the bathroom by the scrubs machine, wondering if you’ll get used to my absence, baffled by the creature I’ve become.

Pumping breastmilk at work is herculean. To avoid contaminating the milk, I take off my scrubs top, wash my hands and arms, wipe down the table and pump parts with antiseptic wipes, wait for them to dry, start pumping, and try unsuccessfully to prevent the bottles and tubes hanging off my chest from touching anything for fifteen minutes, before doing the whole process in reverse. My hours pass in a cycle of patient admissions, pumping, and codes.

My mind disobeyingly flashes to you between every chest compression, momentary glimpses of the curve of your cheek or your curled fingers. On rounds, I can’t let myself think of you, or tears will mix with the sweat and condensation from my masks and glasses and face shield, and I won’t be able to see.

Hospitalized COVID patients are unpredictable, limping along on the pulmonary side before suddenly crashing with renal failure. Guidelines change frantically, with dozens of emails each day. We discuss potential treatments in the call room—steroids, remdesivir, proning. During the day, we sit on opposite sides of the room, dutifully typing, but at night the white coat comes off and we sit at semi-adjacent computers as we chart and pull up chest x-rays. Despite the masks we never remove, it’s the closest I’ve been to normalcy since the birth of my son. In the morning, we don our white coats and face shields and disposable gowns as we return to the grim ritual that rounding has become. I feel like I’m in the boiler room of the Titanic as I slog up and down stairs, swathed in plastic, sweating through my scrubs.

At home, your first smiles are mesmerizing, and quickly become addictive—your dad and I troubleshoot hours of fussing for one of those flashes of joy. We would seem pathetic to ourselves, if we weren’t so consumed.

My outpatient clinic has become mostly telehealth COVID triage. I talk on the phone with a patient who is immunosuppressed but has no symptoms, counseling her to stay home instead of going to get a test “just to be sure.” Tengo miedo, she says. I’m scared. I look at my white coat hanging on the door, my handbag and pump equipment. I picture the virus, the spiky globe floating toward my newborn son, his total lack of protection, the inevitable ER visit if he gets a fever. I’m scared too.

Coming home takes nearly an hour: I strip in the garage, wash my shoes with bleach, put my “driving scrubs” in the boiler closet to decontaminate for three days before washing. I bleach wipe my keys, phone, watch, purse, lunchbox, water bottle, pumping supplies. I wipe the door handles, light switches, sink faucet and handles, car door, steering wheel, garage opener, and bottle of hand sanitizer. I shower and go upstairs to get dressed, then bring the pumped milk upstairs to wipe down again and refrigerate. I wash and sterilize the pump parts. Finally, I get to go upstairs to relieve your dad, exhausted from continuous one-man childcare. I pick you up, smell your baby smell, and let it all fall away as I hold you, soft and warm in my arms.

 


 

LAURA KAHN, MD, MPH, completed her medical training and Master of Public Health at the University of Colorado School of Medicine, and Family Medicine residency at Northwestern McGaw/Erie Family Health Centers in Chicago. She is currently a Palliative Fellow at the University of Chicago. Her clinical interests include end-of-life care, primary palliative care, maternal and child health, and strength training for older adults. She hopes to have an eclectic clinical practice.

 

Submitted for the 2022–23 Medical Student Essay Contest

Spring 2023  |   Sections  |  Covid-19

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