Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

Cape Cod

Love in the Time of Covid: Sunday musings…3/22/2020

Sunday musings…

1) Pace. None.

2) D. As in Vitamin D. Get outside and get you some.

3) Mask. For whatever reason we are in the midst of a national shortage of highest quality protective masks. As an ophthalmologist, an eye doctor, I am not in any way a front line, at-risk specialist. I do, however, get very close to my patients during an examination. Like 6 inches close. As such my staff and I could really use at least a little bit of a barrier.

Enter Beth, stage left, to the rescue. After about an hour of Google-fu she discovered how to make cloth masks that can hold a filter liner (originally quilt batting, soon HEPA filter paper) and can be washed after a day’s use (replacing the HEPA filter if necessary). I am living with one of our Better Angels.

But you already knew that.

4) Non-essential. You always know where you really stand in the food chain of life; the pecking order of importance, where you fit individually and where what you do fits in collectively. You can imagine it differently, behave as if what you do has greater meaning, but deep down you know where you stand. Where you fit. Although I already knew this any doubt about my own little place was erased this past week.

What I do is non-essential.

Along with dentists and perhaps dermatologists, eye doctors were among the first medical specialties to be so informed. My largest national organization, the American Association of Ophthalmology, sent out a letter demanding that all ophthalmologists immediately cease providing all but emergency care. Not suggest, not request, but demand. Patients were continuing to come to our door. The phones continued to ring. No matter. It is rare for a cataract and LASIK surgeon to do emergency surgeries. 15,000 ophthalmologists now sit idle. While their national organization held out for a week or so, 47,000 optometrists are now also mothballed.

Thus I was brought to the most agonizing decision of my professional career. After days of internal strife and nights of ceiling gazing it became clear that in order to save our practice, a business that supports some 20 families, we would have to shut our doors and close. My staff was almost entirely furloughed. We provided assistance in applying for unemployment, and we will continue to fund health insurance premiums for as long as there is cash in the till. On Wednesday I chaired the most difficult meeting of my life; on Thursday we turned out the lights.

It’s a rather sobering thing, to be told that what you do is non-essential. Let’s be honest, it’s a particularly bitter pill for a physician of any sort to swallow; we are, as a hole, rather impressed with ourselves. All work (that is legal) is honorable. All work has value. Saving, restoring, or improving sight certainly does. But times like this reinforce that some jobs are simply more equal than others, at least for the duration of our crisis. Think airplane, 36,000 feet, passenger down with chest pain. You want the 25 yo EMT in row 30, not the 60 yo ophthalmologist in row 10.

The longer this goes on the more we will be needed. What we do, what dentists, etc. do, will rise to ever greater levels of essential over time simply because there are very real problems that exist in our specialties that cannot be ignored forever. Our patients will determine what becomes essential and they will demand (not suggest, not request) that we re-enter the arena. My prayers will go out to my staff and their families. Not being there to provide for them is my greatest burden.

Until then I take my place on the bench, stay loose, and watch as the game unfolds. Like the proverbial back-up quarterback I will do what I need to do to be ready when I am called back to the field. When I am, once again, essential.

5) Dominoes. There was a video making its viral rounds on various social media places of a rather earnest-looking professor-like guy talking about the power of a tiny domino falling and hitting a bigger domino on its way to the ground. He starts the dominoes tumbling. The cascade of 15 ends with the fall of a domino weighing 100 lbs. and measuring >1 meter in height.

All from a domino so small he needs tweezers to place it.

The Professor ends the video with the observation that a 29 domino cascade would finish with the fall of a domino larger than the Empire State Building. Pretty vivid. As is so often the case on Sunday mornings I let the video rumble around between my ears for a bit. What I saw first was a vast space filled with thousands, nay millions of those tiny dominoes, falling down over and over again, never striking anything but the ground. Every now and again a tiny domino would fall against a massive domino, either bouncing or slowly sliding off, eventually finding its way to the ground either way.

It was discouraging to think about. It made me a little sad, to tell you the truth.

But as I thought about it a little more, spent a bit more time in my imaginary vastness filled with tiny dominoes perpetually falling, it occurred to me that in order to fall over and over again it was necessary for each of those tiny dominoes to somehow rise up to stand. More than that, each time one fell it moved a little bit. Sometimes further into the vacuum of the vastness, but sometimes closer to another tiny domino. Another domino falling.

Another domino that kept getting back up.

It’s probably trite–some would say I specialize in trite–but what stayed with me in the end was not the image of the massive domino falling at the end, but that of the tiny, delicate, fragile domino in the front of the line. The one that started the whole thing. What most of us ever see is the last couple of dominoes falling, the last tumblers settling into place. Who knows how many times that first, tiny domino fell and struck nothing but earth?

And got back up.

That’s the message, isn’t it? Always. Get. Back. Up.

I’ll see you next week…

2 Responses to “Love in the Time of Covid: Sunday musings…3/22/2020”

  1. March 24th, 2020 at 12:19 am

    Alan Weinberg says:

    Dr White,
    I feel your pain. Being deemed non essential and having to send your employees home is not easy. The financial and emotional impact on you and the staff during this time are overwhelming. The good news is that I am sure I speak for many of your patients who highly value the caring and quality services you provide and when we get through this we will be calling and rescheduling our missed appointments and procedures. You are essential to us and we care for all of our friends at Skyvision. Hang in there. You will be put back in the game.

  2. March 24th, 2020 at 12:59 pm

    drwhite says:

    Thank you for your kind words Alan. We all look forward to seeing you soon.

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