I started this narrative 17 days into my “house arrest” resultant from the COVID-19 pandemic. Unfortunately, despite having more free time than I cared to admit, I was too worried and preoccupied to continue my chronicle. I had been confined to “house arrest” several times previously. Twice while recovering from extensive orthopedic surgery and again as a precaution secondary to life-threatening neutropenia. But this time is very different. “House arrest” is the norm, especially for those in my demographic group. I don’t have a friend or family member to help navigate the outside world for me. I can’t invite the outside world in. My usual “security blanket” – my doctor’s office or hospital – is now a death trap in waiting … a place to avoid at all costs.

Yet, I consider myself “lucky” as if that concept even exists in these times. My husband, myself and our four-legged child are privileged to live in a big, beautiful house with plenty of amenities to amuse ourselves. We have more TVs and computers than we know what to do with. We are lucky that our new build is complete, our previous house sold, our move and all important repairs have been completed. We are lucky that we are “retired.” We’re not at risk of losing a job or business. We don’t have kids to home school or to keep amused. Barring a total economic collapse, we are able to pay our bills and shop online. We have health insurance and can pay for our medications.

Like everyone else, scoring food deliveries and essential paper products are at a premium. In the beginning, I was able to schedule several Whole Foods deliveries for limited items and one Giant Eagle curbside pickup seven days later. Of course, half my shopping cart wish list was out of stock by the time my “shopper” shopped. I have become a slave to Amazon … searching several times each day for those precious paper goods, cleaning supplies and hand sanitizer to populate. It’s an exciting day when the cherished products make it through to my shopping cart without disappearing! Again, we are lucky. Money is not an impediment nor is the time to shop. My mind wanders to the stories in the news and the associated pictures of lines of desperate neighbors waiting for their “box” from the food pantries. The lucky ones actually get a box. But what about all the others? Over the years, I’ve read a lot about food insecurity and food deserts. I once tried to volunteer to deliver food pantry items. But I was actually rejected by the organization because my schedule didn’t fit the organization’s strict regimen. Little did I know then that despite my otherwise privilege in life, I would now too feel twinges of food insecurity. My special diets and finicky GI tract further limit my options. It makes me wonder about the numerous discussions I had with my patients about healthy eating and how I totally missed their food-related issues of limited budget and restricted accessibility. I wonder how many of my patients tacitly listened to my “harangue” but were too chagrined to properly educate me.

My career has been punctuated by occasional bursts of “cowboy” medicine. As a student, I worked for months in a rural clinic without adequate supervision. There were no licensed physicians or hospital beds in those counties. Our clinic director (who was licensed) was rarely present. We did the best we could for our patients under the circumstances. There were no electronic devices to FaceTime or even cell phones to call for advice. Later, as a resident and in practice, there were the episodic obstetric “horrendiomas” – post-partum hemorrhage (lasting greater than 8-10 hours, using in excess of 30 units of blood and other blood products), amniotic fluid embolism, etc. We were “lost” in those emergencies without food or bathroom breaks much like the descriptions from the ER and ICU docs on the front lines. But we never worried that we could die from caring for our patients. We knew that at some point, our shift would end, our patient would likely get better. We would move on to happier times. I’m struck at times by “survivor’s guilt.” I wish I could help out in some way. It is indeed a strange time that we are experiencing.

This topic has taken on a whole new meaning given the most unusual circumstances that we all find ourselves in. Who knows if this article will even be relevant by the time it is published? I am both relieved and guilty that I am relegated to house arrest as I am in an extremely high-risk category – older age, primary immunodeficiency, secondary immunodeficiency and more comorbid conditions than I care to enumerate. My husband is at risk because of his age and is fearful that his travels to the outside world could inadvertently infect me. So, we stay isolated together. Our most important daily tasks are managing our various online orders and deliveries. Once per week, my infusion nurse arrives for my life-saving immunoglobulin infusion. Yet, that exact contact with the outside world also could be my demise. What if my nurse transmitted the deadly infection to me? Doubtful that I would be lucky enough to only manifest mild symptoms. My survival chances would be slim if I needed hospitalization, let alone intubation and ventilatory support.

We watch the news to stay informed and to be “entertained,” as if there is anything about the coverage that is entertaining. My husband is grateful that I am no longer practicing. I feel guilty. I would love to “fill in” in some capacity, even though I know I wouldn’t even last a full day. I worry about the uninsured and underinsured. I worry about those expectant moms and how their fears must be amplified many times over. I worry about all those serious medical conditions that are being ignored. I can’t think much more than a day in advance. Each new day is a victory.

Author profile
Andrea G. Witlin, DO, PhD

Dr. Witlin, associate editor of the ACMS Bulletin, is a retired maternal/fetal medicine physician and researcher.