Strength, Sacrifice, and Sequestering in Philadelphia

Awed and appreciative of all the personal sacrifices that medical professionals in the OB-GYN field are making in the midst of the coronavirus crisis, we are spotlighting Dr. Lauren Jenkins as an extraordinary example in these extraordinary times.

Ever since the onslaught of COVID-19 in Philadelphia, life has become nearly unrecognizable for Dr. Lauren Jenkins. Like the other doctors in her OB-GYN practice, Lauren now works three consecutive days of 12-hour shifts, providing care for her pregnant patients and delivering babies at Pennsylvania Hospital in downtown Philadelphia. The next three days are devoted to telemedicine or office visits, followed by three days on back-up call. This new system was designed to limit the number of essential healthcare workers in the hospital being exposed to the virus at a given time.

By the end of each long day, Lauren feels like the bridge of her nose is bruised from wearing a mask all day. She sheds her hospital garments as soon as she walks through the door and drops them onto the concrete floor of her “COVID Corner,” which she appreciates for its sterile simplicity. But the place she returns to after work is not her comfortable home and she is not greeted by her loving husband and joyful two-year-old twins. Instead, Lauren has chosen to live in a lonely Airbnb a few blocks from her hospital. How Lauren came to be in this situation is an astounding tale of self-sacrifice and perseverance.

When an anesthesiologist in her group tested positive for COVID-19, Lauren found out a full week after she had worked side by side with him in surgery for nine hours. At the time, the coronavirus surge seemed like a distant threat and her practice hadn’t yet come across any infected patients. Lauren was living at home with her family in Voorhees, NJ, snuggling her boys at night and sharing a bed with her husband. But in that moment when she learned of her potential exposure, everything changed.

Lauren’s identical twin boys, Pierce and Ashton, were born three months prematurely in 2017. The two of them spent months in the NICU and their mother did not miss a single day at their side. In his first year of life, Ashton had five surgeries and was diagnosed with EoE, a chronic disease of the esophagus. Soon after the twins crossed the milestone of their first year and things seemed to be looking up, Lauren’s husband Jay was diagnosed with late-stage lung cancer.

All of the sudden, Jay had to quit his physically demanding job, which was a tough blow for him mentally, and their household was reduced to one income. After an aggressive round of radiation and chemotherapy this past fall, Jay’s tests have remained stable as far as his cancer is concerned. The side effects of his treatment have been debilitating, though, causing a large ulcer in his esophagus and a cardiomyopathy [meaning his heart only works half as well as it should].

Lauren mentions these hardships without dramatization. She reflects on the irony of her husband’s condition, given her own father died from the exact same type of cancer four years prior to her husband’s diagnosis. She is even able to find humor in the fact that her son Pierce feels left out because his brother and father have matching feeding tubes.

After everything that they had done to keep Jay as healthy as he can be, discovering potential COVID exposure and waiting in self-quarantine for her test results was too much for Lauren to bear. The thought that she had inadvertently exposed Jay or their sons to something deadly was terrifying. When her results came back negative, Lauren and Jay sat in bed weighing the risks and benefits of her continuing to live at home throughout the coronavirus crisis. They knew that if Jay ended up getting sick and it was ultimately Lauren’s fault, she would carry that guilt for the rest of her life. Living apart from her family was the right thing to do, and so on March 25th, Lauren moved out.

“Not working was not an option.”

Given her family’s compromised health, Lauren’s employer offered her the option of being pulled from the front lines and staying restricted to the office and telemedicine. But Lauren felt very conflicted since she herself is not at an increased risk, whereas some of her medical partners are older or have pre-existing conditions. Showing an unwavering work ethic, Lauren couldn’t imagine sitting on the sidelines while decades-older colleagues continued to work. In spite of the impact on their family life, Lauren and Jay agreed that she couldn’t leave her team behind.

Overcoming so many personal obstacles in the past three years has made Lauren tough. Even so, this separation from her family has been especially difficult and two weeks have felt like an eternity. Those hard times in the past have taught her what she needs to do for self-care: exercise when she has the energy, meditate every day, and pray. She also has a very close network of friends with whom she checks in over Zoom and social apps. Though Lauren has had a rare cry while unburdening on loved ones, she tries not to think about everything that’s happening in weeks or months, but takes each day as it comes.

“It wouldn’t make sense for me to go back home until the health crisis subsides. Otherwise all this time away from them would be in vain.”

A self-admitted germaphobe (since long before it became trendy), Lauren wonders if she has managed to escape the clutches of the coronavirus because of her obsessive hygiene. The day she worked with the infected anesthesiologist she remembers lending her pen to someone and then immediately scrubbing it with a bleach wipe. Prior to moving out, she had always wiped down her hospital shoes with bleach several times a day and had left them in a designated, off-limits area at home.

Now, for the first time in her life, Lauren washes her hair every night because there’s evidence that the virus particles can penetrate a hospital cap. The virus has also shown to cling to eyelashes and eyebrows, so she foregoes her morning application of eyeliner and mascara. For Lauren and other healthcare workers struggling to stay safe, the coronavirus cruelly continues to strip away every last shred of one’s former self.

“I have the privilege to walk through so many good and bad times with my patients, and that’s what makes this job special.”

Lauren values the human connection she gets to have with her patients in the OB-GYN profession. Now she tries to preserve that connection behind a mask, afraid to hug them or even shake their hand. Her practice has come up with a complex algorithm for paring down in-person appointments and postponing non-urgent surgeries. Relying on telemedicine for most routine care, Lauren laments that she has had to add physical distance on top of her patients’ pregnancy and pandemic-related concerns.

Even though all routine wellness checks for gynecological patients are being postponed until it’s safer to be seen in person, the volume hasn’t decreased in obstetrics. In her practice, a COVID-designated team takes care of all the infected patients or patients with suspected infection. Though a number of COVID-positive pregnant patients have been in and out of the hospital under her team’s care, Lauren’s greatest fear is the patient who doesn’t demonstrate any symptoms but carries the disease.

As many as 25% of people infected with the coronavirus may exhibit no symptoms at all. Lauren knows that she could be interacting with asymptomatic carriers on a daily basis; so she takes universal precautions, treating every patient the same way and doing everything in her power to minimize the spread of the virus. Because the coronavirus is so new, nobody knows how to identify the asymptomatic carriers or whether they are as infectious as symptomatic ones.

“This disease has created a whole new subset of questions to which there are no great answers.”

Lauren credits her family’s au pair Elena with making her current home situation possible. Elena sends photos of the boys and facilitates FaceTime calls between Lauren and her family whenever possible. Lauren was even able to attend her son Ashton’s telemedicine consultation virtually. Besides keeping her connected to her family, Lauren is grateful for the way technology has enabled her to have meaningful conversations with old friends she hasn’t spent much time with since residency.

Social media has even facilitated a more comfortable home away from home for Lauren and her colleagues. On April 6th, she was able to leave the AirBnB and move into the downtown condo of Denise and Steve Warfel, who generously offered their two-bedroom space to Lauren’s team for sequestering close to the hospital over long call stretches. Many of her OB-GYN colleagues are making their own adjustments and sacrifices for the sake of their patients. As they fight this war together, the doctors in her practice are becoming more strongly bonded than ever.

Perhaps personal history has trained her to seek out the good within the bad. Lauren points out that through life’s challenges — like a health crisis — it’s important to find the positives. Though she’s not one of them, Lauren hopes that parents will ultimately cherish this precious time with their children without outside distractions. Lauren, like everyone else, is just trying to keep her family safe and to make the best out of a really bad situation. She is willing to go to extraordinary lengths to do so.

“At the end of the day, when we’re faced with adversity, we always have a choice in what we want the end result to be. You have to find something good or else it will consume you. I refuse to give in and let the coronavirus take anything else from us.”

With Warmth and Wellness,

Your EmmaWell Team