It’s here

March 20, 2020.

It’s here.  It’s been slow in arriving, but it’s here.

My journal entry two weeks earlier had read very differently. I had been exploring lucid dreaming and had logged some whimsical experiences including a trek in the jungle and rocketing from the base of the ocean into outer space.

Six days later, whimsy didn’t have space to exist. We’d been hearing about it in the news, and our health system had been preparing for it, but the gravity of the pandemic hadn’t hit us. Not until we learned an emergency physician was intubated, on a ventilator, in Seattle because of COVID-19. As an emergency physician and the medical director for my emergency department, I would spend every waking hour of the next eight days protecting our patients and our providers from the mysterious, invisible threat.

However, on this night of the journal entry, I felt something was wrong. I had been working continuously over a week and hadn’t given myself time to reflect. Despite existing on four hours of sleep, I took a precious hour to create another journey entry.

I took care of a woman 4 days ago who tested positive. I might… I probably will get it. Not from her. But eventually.

Reading my words two months later, I can still feel the anxiety through the page. Overwhelming numbers being infected, hospitals spilling over, makeshift morgues being erected, PPE completely absent, being forced to choose who received treatment and who would simply perish. This was their reality in New York and Italy, and it was about to become our own. The only question was when.

I never imagined I’d be an ER doctor, but it has shaped me and given me so much in return that I cannot be upset. I mean I could. But I choose not to be. This life is too short to be wasted being upset or resentful. They’re defaults and they’re okay, but there’s a better way.

I’m not sure if I was convincing myself or already convinced. Either way, it was this moment of writing when everything would change for me. I didn’t want to feel anxious anymore.

You might have it. You will get it. You might die.

Now what? What in the meantime? We live, we appreciate – people, things. What is this we?

I wondered about my potential erroneous use of pronouns.

It’s my soul, my spirit, my mind, and my body.

Oh. That answers that.

If I get sick, I will have lived as well as I could, and I will regret nothing. 

The whimsical self-inquiry led to a deeper question, one about purpose. About how I wanted to live my life. Over the prior eight days I experienced a recurrent, but fleeting desire to run away. To get away from all of this. To come back when it was all over, without risking or wasting my precious life.

Prior to this day, I had immediately rejected that desire, knowing it to be selfish. But now, I reflected on it. I allowed myself to feel it, to imagine myself running away – to feel that potential relief. I imagined myself drinking a frozen cocktail on the beach of a deserted island, and it felt marvelous.

But I thought about what I would feel when I returned.  I thought about my elderly parents and what they would do if their doctors also bailed on their jobs. I thought about my incredible team in the emergency department and their loved ones who depended on a safe work environment to allow them to come home. I thought about what my own heroes would do.

It was in this moment of writing that I decided that I would rather proudly lie on my deathbed in two weeks, knowing I did everything I could do to help the world, than live for 60 more years knowing I could have done something more.

Life is created by the choices we make, and while it’s natural to make choices for the immediate results, it’s so much more fulfilling when we make choices targeting the future. The desire to flee has never returned since I made this entry, and I’m left with a greater sense of purpose and appreciation – for my team, for my community, and for another day on earth.

Luckily, the pandemic hasn’t hit us as hard as we initially thought it would, but my journal entry on this date would end with seven words that continue to guide me:

Life is beautiful. Don’t waste it worrying.