The Atlanta Journal-Constitution
A year of risk, fear and loss
Families in medicine suffer anxiety, fatigue and grief while helping others.
Gabrielle Dawn Luna sees her father in every patient she treats.
As an emergency room nurse in the same hospital where her father l ay dying of COVID l ast March, Luna knows f i rsthand what it is like for a family to hang on to every new piece of information. She has become acutely aware of the need to take extra time in explaining developments to a patient’s relatives who are often desperate for updates.
And Luna has been will i ng to share her personal loss if it helps, as she did recently with a patient whose husband died. But she has also learned to withhold it to respect each person’s distinct grief, as she did when a colleague’s father also succumbed to the disease.
It is challenging, she said, to allow herself to grieve enough to help patients without feeling overwhelmed herself.
“Sometimes I think that’s too big a responsibility,” she said. “But that’s the job that I signed up for, right?”
The Lunas are a nursing family. Her father, Tom Omaña Luna, was also an emergency nurse and was proud when his daughter joined him in the field. When he died April 9, his daughter, who also had mild symptoms of COVID19, took about a week off work. Her mother, a nurse at a longterm- care facilit y, spent about six weeks at home afterward.
“She didn’t want me to go back to work for fear that something would happen to me, too,” Luna said. “But I had to go back. They needed me.”
When her hospital in Teaneck, New Jersey, swelled with virus patients, she struggled with stress, burnout and a nagging fear that left her grief an open wound: “Did I give it to him? I don’t want to think about that, but it’s a possibility.”
Li ke t he Lunas, many who have been treating the millions of coronavirus patients i n the United States over the past year come from families defined by medicine. It is a calling passed through generations, one that binds spouses and connects siblings who are states apart.
It is a bond that brings the succor of shared experience, but for many, the pandemic has also introduced a host of fears and stresses. Many have worried about the risks they are taking and those their loved ones face every day, too. They worry about the unseen scars left behind.
And for those like Luna, the c are t hey give t o coronavirus patients has come to be shaped by the beloved healer they lost to the virus.
Working through grief
For Dr. Nadia Zuabi, the loss is so new that she still refers to her father, a fellow emergency department physician, in the present tense.
Her father, Dr. Shawki Zuabi, spent his last days in her hospital, UCI Health in Orange County, California, before dying of COVID on Jan. 8. The younger Zuabi almost i mmediately returned to work, hoping to keep going through purpose and her colleagues’ camaraderie.
She had expected that worki ng alongside the people who had cared for her father would deepen her commitment to her own patients, and to some extent it has. But mainly, she came to realize how important it is to balance that taxing emotional availability with her own well- being.
“I try to always be as empathetic and compassionate as I can,” Zuabi said. “There’s a part of you that maybe as a survival mechanism has to build a wall because to feel that all the time, I don’t think it’s sustainable.”
Love tempered by risk and horror
In the same way that medicine is often a passion grown from a set of values passed from one generation to the next, it is also one shared by siblings and one that draws healers together in marriage.
One- f ourth of physicians i n the United States are married to another physician, according to a study published in the Annals of Internal Medicine. Maria Polyakova, a health policy prof essor at St anford Universit y, said she would not be surprised if the number of physicians in the United States who had siblings with medical degrees was about as high as Sweden’s approximately 14%.
In interviews with a dozen doctors and nurses, they described how it has long been helpful to have a loved one who knows the rigors of the job. But the pandemic has also revealed how frightening it can be to have a loved one in harm’s way.
A nurse’s brother tended to her when she had the virus before volunteering i n another virus hot spot. A doctor had a bracing talk with her children about what would happen if she and her husband both died from the virus. And others described quietly weeping during a conversation about wills after putting their children to bed.
Dr. Fred E. Kency Jr., a physician at two emergency departments in Jackson, Mississippi, understood that he was surrounded by danger when he served in the Navy. He never expected that he would face such a threat in civilian life, or that his wife, an internist and pediatrician, would also face the same hazards.
“It i s scary to know that my wife, each and every day, has to walk into rooms of patients that have COVID,” Kency said, before he and his wife were vaccinated. “But it’s rewarding in knowing that not just one of us, both of us, are doing everything we possibly can to save lives in this pandemic.”
The vaccine has eased fears about getting infected at work for those medical workers who have been inoculated, but some express deep concerns about the toll that working through a year of horrors has taken on their closest relatives.
“I worry about the amount of suffering and death she’s see
ing,” Dr. Adesuwa I. Akhetuamhen, an emergency medicine physician at Northwestern Medicine i n Chicago, said of her sister, who is a doctor at the Mayo Clinic in Rochester, Minnesota. “I feel like it’s something I’ve learned to cope with, working in the emergency department before COVID started, but it’s not something that’s supposed to happen in her specialty as a neurologist.”
She and her sister, Dr. E se os at. Ig ho daro, have regularly talked on the phone to compare notes about precautions they are taking, provide updates on their family and offer each other support.
“She completely understands what I am going through and gives me encouragement,” I ghodaro said.
The seemingly endless intensity of work, the mounting deaths and the cavalier attitudes some Americans display toward safety precautions have caused anxiety, fatigue and burnout for a growing number of health care workers.
Nearly 25% of them most likely have PTSD, according to a survey that the Yale School of Medic i ne pub - lishe din February. And many have left the field or are considering doing so.