For many doctors, COVID-19 turns home life upside down

For weeks this spring, however, Dr. Akhtar found just silence when she opened the door. In the midst of the COVID-19 crisis, she sent her children to live with her parents temporarily. Dr. Akhtar is a family physician, working now at her hospital’s COVID-19 assessment centre. Her husband, Dr. Asim Alam, is chief of anesthesia at North York General Hospital.

“We needed time to understand this new upside down situation, and made a decision to try to isolate from them,” she says.

So hugs and family meals were replaced with FaceTime calls. Dr. Akhtar and Dr. Alam aren’t the only ones whose home life has been upended by the pandemic. Across Ontario, doctors are working tirelessly for the well-being of those they care for – not just patients but members of their households too. That means taking steps to reduce potential exposures to their families.

Doctors have established strict detoxification protocols before entering their homes.

Dr. Akhtar now uses the garage as a decontamination zone. Bags are emptied, everything gets wiped down, and clothes come off. Some doctors have gone further, choosing to sleep apart from their loved ones, or occupy separate rooms. Others have moved out completely or dispatched their children to relatives, enduring prolonged separations. It’s another casualty of the COVID-19 fight.

Dr. Akhtar and Dr. Alam worried about possibly contracting the virus and passing it on. They agonized too about what would happen if their children became vectors for whoever was caring for them.

Before March break, they decided to keep the children home entirely, in order to quarantine them in preparation for going to their grandparents.

They had to explain that they were both part of the response to COVID-19, and that their jobs were to look after patients and get the hospital ready. Then came time to pack their children’s bags and drive them to Dr. Akhtar’s parents in Mississauga. It was a painful but necessary choice.

At first, some calls with the children were teary. So she spaced them out. It got better. Dr. Akhtar occasionally dropped off groceries and toys at her parents’ house, “to remain part of their lives, but at a distance.” When she talked to her parents, she was glad if she heard the kids having fun in the background. That helped to keep her going.

Still, after three weeks of the children being away, she and Dr. Alam had to make another decision. “There was no foreseeable end, and we needed to think of a long-term sustainable solution.”

If they brought the children home, there was no going back. The children couldn’t go back and forth from their house to the grandparents. Dr. Akhtar was fortunate to find a nanny who was willing to stay for the duration.

“A lot of people are fearful to work for a physician at this time. We told her we’re being very careful, but there is risk,” she says.

Having the children back made her and her husband happy, but worried too. COVID-19 is rarely far from her thoughts. When she comes home now, she has to add another step beyond the detox procedures: clearing her mind.

“More than ever, we have to manage our own anxieties and preoccupations about what’s going on at work before we can engage with business as usual with family,” Dr. Akhtar says. “Some days are scary, others are exhausting. It’s a work in progress.”

Going on Deployment

All days are now also uncertain, adds Dr. Brendan Munn, who practices in anesthesia and critical care at Hawkesbury & District General Hospital.

“When I leave for work, it’s like being deployed. I don’t know when I’m coming back,” he says.

As of early April, he had been apart from his family for almost two weeks, with no reunion date set.

Dr. Munn shares a home outside Hawkesbury with his partner and their two boys, ages 2 and 4. Normally, they’re there half the time. Every second week, they go to another home in Mont Tremblant, Quebec, about 80 minutes away by car, where Dr. Munn’s stepson joins the household. Now, the rest of the family is at Mont Tremblant full time, with Dr. Munn staying put in Hawkesbury.

“This is a stressful job to have on a regular day. Add a pandemic and family considerations, and things get very hard,” says Dr. Munn.

Even before this forced separation, his household routines had changed dramatically. For the four weeks prior, his children and partner had been in Mont Tremblant, not going out for anything except a walk. Dr. Munn went there just three times during that period, for two-three hours maximum at a time. He was their sole connection to the outside world.

Coming home to Mont Tremblant became an ordeal. At the hospital, Dr. Munn would remove his scrubs in the change room, put on his street clothes, and clean his keys, phone and wallet with alcohol sanitizers. Then it was the long drive. When he got home, he left his car outside, entered his garage, and commenced an elaborate routine.

It went like this. Clean everything in his pockets again, and place them in a clean bin. Remove his clothes inside the garage and put them in a pile. Scrub his hands before touching the handle of the door that leads into the house. Step into the slippers waiting inside the door, without otherwise touching the floor. Be quiet so the children don’t realize he’s home and try to get to him. Go directly to the shower. Walk down the middle of the hallway to avoid touching anything on the way.

Only after the shower would Dr. Munn greet his partner and kids. The process took about 20 minutes.

“It’s definitely an adjustment,” he says. “This is the reality, and there’s no other option.

As the designated grocery shopper, he had to repeat the process for that too. Dr. Munn would put on his oldest clothes, and left them in the garage when he got back from the store. The pile of clothes in the garage never even made it into the Mont Tremblant house. Dr. Munn would take them back to Hawkesbury.

He had designated a spare room downstairs as his quarantine room if needed. Instead, with worries increasing, he’s just staying in Hawkesbury. In April, Dr. Munn learned that a hospital colleague had a breach of his PPE, and was exposed to a patient who had tested positive for COVID-19. The colleague didn’t realize the breach at first, and Dr. Munn subsequently had contact with him. The colleague was fine. But Dr. Munn saw it as another reason to distance himself from his family out of an abundance of caution.

He calls his sons often, and they ask when he’s coming home. He doesn’t have an answer. His 4-year-old asks, “Is this because of the virus?” Dr. Munn had explained about a little bug that can live inside you and make you sick. “I don’t know that he’s worried, but he sees how we’re afraid of it,” Dr. Munn says.

Every night, he reads a bedtime story by FaceTime until his kids fall asleep. Thomas’ Snowsuit by Robert Munsch is a favourite. “I don’t have it with me, but I know it by heart,” says Dr. Munn.

He’s preparing himself mentally to perhaps not see his family for an extended time. He doesn’t want to get used to that. At the best of times, he says, the demands of work require certain family sacrifices. You can’t always be there. It goes with the territory. This is different.

For a lot of the population, being cooped up at home has an upside. It’s unexpected time with family. “We’re doing the opposite,” Dr. Munn says. “We’re spending less time with family, with more stress and more things to do. That difference is fundamental.”

Duty Calls

Putting work before family isn’t unusual, agrees Dr. Kanna Vela. “It’s my job, my duty. I took an oath,” she says. Yet the magnitude of the situation now is of a whole other order. “We’ve never been strained this way.”

That’s true professionally and personally. Dr. Vela works in emergency for Lakeridge Health (Ajax Pickering Hospital), and for the Scarborough Health Network (General and Birchmount sites). She’s also now added on shifts at a COVID-19 assessment centre.

When the day is done, Dr. Vela returns not to her home but to that of her parents. Meanwhile, her parents have moved into her home to stay with her daughters, ages 5 and 2, and her husband (who is running his business remotely from home).

The decision happened in March. The family was supposed to go away for March break week, but of course cancelled. Dr. Vela spent the week at home thinking of what would be best upon going back to work.

“Even with strict decontamination procedures to enter the home, I was concerned about my level of risk,” she says. “Most of my shifts are with COVID-19 patients. If I was to exhibit any symptoms, I’d leave the home anyway. Then my husband would be alone with two children. And I wouldn’t feel comfortable bringing my parents into a possibly contaminated house. I decided that before I returned to work I’d move in with my parents.”

The two homes are just five minutes apart in Ajax. Dr. Vela has resisted the temptation to drive by her home, just so she and the children could get a glimpse of each other. “That would be a tease, difficult for them and for me,” she says.

She FaceTimes, and does some online reading modules with her older daughter. “We click together at the same time,” she says.

“My 5-year-old is very mature. I said I need her to be brave. She knows quite a bit about coronavirus, and understands why I have to go to work. She’s not happy about it, but gets it. My 2-year-old has a completely different comprehension. She’ll look for me in the house. Especially when she wakes up and goes to bed. I tell her I love her and will try to see her soon. That part is hard. The good thing is that she won’t remember this.”

Dr. Vela says her mom is a great cook, and is doing the family dinners now. Her husband does a porch drop-off of meals for her every day. He loves his mother-in-law’s cooking too. “It’s like being on a cruise for him: unlimited and all-inclusive,” she jokes.

It’s tough being away from her family, but the level of anxiety she had before, wondering if she’d bring the virus home, was high too. There’s no win-win here. At her parents’ home, Dr. Vela takes all the necessary precautions. “If I have to go back home, I have it as my automatic routine.

How long will this arrangement continue? “We’re taking it week by week,” she says. “Some people are complaining how they’re stuck at home with their kids and going crazy. I wish I could say that.”

She misses the comforts of home, as in being comforted by her family’s presence. “It’s very isolating,” says Dr. Vela. “Especially when you’re stressed out, at this time of crisis, you want the people who are your social supports to be there with you.”

So what does comfort her? “I’ve never felt so alone, yet also so connected to humanity. The entire planet is going through this. And we’re all trying to do this one thing together at work.”

Having that collective experience and mission gets her through. So does this thought: “I feel that my most precious loved ones are safe, and that gives me peace.”

Stuart Foxman is a Toronto-based writer.