In college I was a psychology major and learned that memory is a construct rather than a record of what happened. The process of recollection alters what we retrieve from the mysterious functioning of the brain. Perhaps after 2 years enough time has elapsed that I can write down some of my recollections of the pandemic, especially the early period. I was, after all, a witness to history and I think that I ought to try preserve it.

On March 6th, 2020, I had plans to get on a plane to fly out to Los Angeles to meet a watch collector who had paid me a large sum of money for a rare watch. I had taken the day off of work and had to call into a conference call for my medical group. During the call we were told that the novel coronavirus had been found in Westchester County and we were to cut our office hours by half in order to prevent spread. I found the announcement both baffling and disconcerting. Like many other doctors wondered what that meant for my livelihood since I was on a reimbursement model that paid according to productivity.

I am not sure if I knew at the time but 3 days before a man had tested positive for SARS-CoV-2 after being transferred from Lawrence Hospital to New York Presbyterian for severe pneumonia refractory to treatment. His synagogue, Young Israel in New Rochelle, soon became the epicenter of COVID-19 in the United States where a superspreader event had taken place at a bar mitzvah or a wedding. Numerous members of the synagogue contracted the deadly disease. By March 12, Governor Andrew Cuomo sent in the National Guard and locked down a one mile radius around the synagogue with a strict stay at home order. If I had known the severity and contagiousness of the virus that would soon upend life as we knew it I would have cancelled my trip.

As it was, I didn’t know much about it so I took a surgical mask with me. I was surprised to see new, free standing hand sanitizer stations in the airport, and that the airport bathrooms had been emptied of soap from others washing their hands. I remember being in line for airport security, not sure if I should don my mask, but deciding to put it on when I saw another Asian person with a face mask on. I used plenty of hand sanitizer on my hands and on the armrests on the plane and was a little disturbed when my cab driver in LA said that his son, who was a young healthy guy who went to the gym a lot, had recently been very ill with pneumonia. When I met up with the watch collector the next day, he had a running nose and I was a little concerned and washed my hands after meeting him. He called me up after the meeting and asked about feeling sick and a little feverish which he thought was due to drinking brown water from his kitchen sink a few days before which made me even more nervous. However, I did visit a number of watch stores in Beverly Hills while I was out there. I had sold the watch I had bought for my 40th birthday, so this trip was meant as a birthday trip and I was determined to enjoy myself. In retrospect, it was shocking that I didn’t get COVID-19 on this trip.

The following week it was business as usual except that I cancelled my elective vein procedures and half of my office visits. However, on the 17th I received an alarming phone call. I had surgery scheduled and had consented and marked the patient already when I got a call on my cell phone from my office manager that someone in the office had tested positive for COVID-19. Since I was in the office on Monday, I was to quarantine. I wasn’t sure what I was supposed to do or whether I could be around my family so I drove to the bank parking lot near my house and sat in my car waiting for the head of infectious diseases to call me. I was not able to get in touch with anyone at the New York State department of health. Eventually, about 45 minutes later, she called me and told me to stay in a separate room, take my meals separately, use a separate bedroom. I think this went on for 2 days because I see in our medical records that I saw patients 2 days later. My brother-in-law got married in my in-laws house that weekend and I stayed home because I wanted to stay away from my wife’s elderly grandmother. The celebration was to be in Jamaica the following week but it never happened.

The following week, although my office remained open for urgent visits mostly related to wound care, everything else was essentially on pause. I think the overwhelming feeling here in New York was fear, and that extended to fear of going to the doctor. My practice had to furlough most of our office staff because we basically had no revenue. The irony of health care workers losing their income during a pandemic was not lost on me. I and the other 3 doctors in my section all took no salary for an entire quarter so that we could continue to pay for health insurance for our furloughed employees. Elective surgery was suspended which meant that surgery was slow to recover. It turns out that about half the beds in a hospital are meant for recovering surgery patients, so by suspending elective surgery the state government meant to make more beds available for COVID-19 patients. Hospitals were also ordered to increase capacity by about 50-100% and eventually a more organized transfer program was put into place to move patients from hard hit to less occupied areas.

Most of what we knew in the beginning was actually coming from doctors in Italy who were the first in Europe to get slammed with COVID-19. Facebook, for all its flaws in promoting misinformation, particularly regarding politics and later on, the vaccines, was helpful in this respect. A lot of doctors were posting the experiences of our colleagues in Italy and although early on it seemed unbelievable, very soon we were turning to them for guidance. For example, splitting ventilator circuits to run multiple patients off of one ventilator was an idea that quickly crossed from Italy to New York. Later on, doctors in New York would get calls from colleagues in other parts of the country for advice. The usual mechanism of years of data gathering and analysis and peer reviewed publications in medical journals was way too slow to keep up with this disaster. The lack of data and the unfortunate public airing of quack cures by Trump led to a variety of misconceptions. Hydroxychloroquine was probably the first, which led to a huge run on pharmacies and a lack of the drug for people who actually needed it. Later it turned out that it caused cardiac arrhythmias and had no effect on the natural course of COVID-19. Although my wife and I were not immune to this type of hopeful thinking. We started taking vitamins and zinc supplements, hoping that this would somehow magically boost our immunity against this deadly plague.

One of the biggest problems early on was that the FDA had somehow screwed up the reagents in the testing kids so many of them were defective. The person in my office who tested positive had tested negative a day before and only went back because his symptoms were severe. There were simply not enough testing kits to go around. I had a patient at the beginning of March who had returned from a trip to California and was hospitalized with atypical pneumonia with a horrible looking CT scan of his lungs. In retrospect, he definitely had COVID and I believe he tested positive for antibodies later on. However, the hospital had no testing kits at that time so he wasn’t tested. I did a minor operation on him and he went home a couple of days later. Who knows how many people he infected because of the lack of testing kits. Fortunately for me, the procedure was done under sedation. If he needed to be intubated on a ventilator for the surgery, I am pretty certain I would have gotten infected from the aerosolized virus. I was wearing just a normal surgical mask, after all, and I spoke to him without a mask on.

Most of the work that I did involved placing dialysis catheters for emergencies, and occasionally amputating a limb that could not be saved. The hospitals at this point were overwhelmed with patients with severe COVID-19 pneumonia. One thing that was not expected was that patients with any problem other than not being able to breathe stopped coming to the hospital. What I have heard from other doctors as well as from my patients is that even people with heart attacks or strokes would just stay at home and hope for the best. The increasing dire predictions of the height of the coronavirus wave did not come to pass largely because people stayed at home with their other medical problems. Other normal causes for hospitalization, such as car accidents (ceased due to no driving) or other respiratory infections or the flu (ceased due to mask wearing and stay at home orders) also dropped to near zero. Of course the stringent lockdown, closure of nonessential businesses, and the daily exhortations of Governor Cuomo to stay at home had a strong effect in mitigating the spread of COVID-19 as well. To use his famous expression, we “flattened the curve” at a great loss, economically, socially, and from the perspective of our mental health.

I think one of the worst things for me was that the hospital, which for me as a surgeon is like a second home, became a place of fear and dread. This was the first time that I truly regretted becoming a doctor. After all, I became a doctor to help people and to provide a good income for my family. I am not a soldier and did not expect to have to potentially give my life in service of medicine. I did my duty and never refused a call. I spent terrifying, sweaty, exhausting hours in close proximity to patients with severe COVID-19 pneumonia, doing life sustaining procedures. On the drive home, I was terrified to rub my eyes so sometimes my eye would water and the oil from my face would start burning and I would just blink furiously until I got home and could wash my hands before touching my face. Eventually I started keeping boxes of tissues in my car purely for this purpose. Strangely, I was able to almost entirely stop picking my nose and the one time a week that I did, I washed my hands like crazy.

I then spent time decontaminating myself, changing my clothes, leaving my shoes in the garage, running into the shower as soon as I got home instead of hugging my kids. Every touch, every surface was suspect. I learned about the different types of sterilizing wipes because we were always running out and having to use a different one. The purple one wasn’t bad but the red top stung my hands and made them tingle when I used it to wipe off my face shield, even with gloves on. This was the time when people were terrified of going to the grocery store and would wipe down their household items with bleach when they got home. My wife and I bought large gallon bottles of hand sanitizer. This was based on the since debunked belief that the virus lingered on surfaces and was primarily spread by contact. Now we know that the major source of transmission was airborne and all of this ended up as hygiene theater, providing a false sense of security. Some of my physician friends in NYC were sleeping in a hotel because they were terrified of giving COVID-19 to their wife or small children. If they gave it to their wife and both of them died then there would be no one to take care of the kids. My son was only 7 months old when the pandemic hit. I had purchased additional life insurance and now I called my insurance agent and asked him to rush the paperwork to me. I tried to do estate planning as well but the lawyer and I were both exhausted and didn’t follow up. I eventually completed that about a year later when I got some energy back.

The shortages of personal protective equipment in the hospital were especially alarming. In order to get PPE you had to line up, sign your name, and get an individual brown paper bag with one surgical mask, one gown, one set of gloves, and one N95. As time went on and the hospitals depleted their supplies, we were told to reuse N95 masks by setting them aside for a few days, or zapping them with home UV light kits. Some hospitals developed protocols for recycling these single use items by a chemical process but sometimes health care workers found old lipstick or other grumous material inside. Two out of the three hospitals where I work started issuing an N95 only once a week. The variations of the PPE were also a bit disturbing. Normally an N95 mask is issued after a fit test where a hood is placed on your head and the inside is sprayed with a bitter substance and you make sure you can’t taste it with your mask on. Now when they ran out of large masks, they gave out small, then extra small, then KN95s, then N95s with exhalation valves like the ones from home depot. It seemed there was a new mask every week as the hospitals desperately scrambled to get PPE.

The gowns also were sometimes extra small, or ill fitting, or fragile. It was very bizarre for me have surgical masks be rationed. Normally there are a few big boxes of surgical masks all over the operating room and there is no problem for that or for shoe covers, but they all got locked up and we were issued one surgical mask per day and shoe covers were nowhere to be found. I had a system where I had gotten 4 very decent 3M made green colored large N95 masks and I rotated them between 4 paper bags. I would write in marker the date of use on the paper bag and then rotate to the oldest paper bag mask from at least 4 days before. They smelled like coffee, sweat, and bad breath sometimes but most of the smells dissipated by the time I used them again.

Eventually by the summer or fall I got an Envomask, which is a mask made with a gel cushion on the inside and a changable N95 filter which gets sandwiched with an outer piece of plastic. It has an exhalation valve which you can cap. It’s more comfortable because it makes a good seal without being as tight as a regular N95 but it does turn into a air condition in a NYC street if it’s cold, with condensation dripping down at times and has to be shaken out. My brother and sister-in-law on Long Island were getting issued one N95 mask a week. Some of the anesthesiologists and emergency room doctors and some of the residents at my hospital had acquired gas masks and wore them around the hospital which was outright frightening for many of the patients. I remember one anesthesiologist who was trying to get an anesthesia consent before one of my surgeries. The patient didn’t want to look at him and kept turning her face away. He turned to me and asked me if the patient had dementia but I knew that the patient had nothing of the sort. I replied that I thought that the patient was simply afraid of his mask.

Face shields disappeared quickly and were not replenished very often. The day I was quarantined the operating room manager gave me a face shield and I used and washed that thin piece of plastic so many times that the dye washed out of it and I had to tape it in place when the plastic nubs that held the shield to the forehead strap broke off. Ultimately my wife found some networks on Facebook where people with 3-D printers or who manufactured small numbers of other plastic materials were now making face shields. I was able to gather about 20 or 30 of these from a woman’s house, and some more were mailed to us. I immediately went to the hospital and gave them out to our operating room nurses who had been assigned to the ER, to the outdoor COVID testing tent, and to the ICU. I also gave them to the family medicine residents who were on the front line of this disaster. The relief and happiness of our embattled front line medical workers was immense. Honestly, giving out face shields was one of the most satisfying things I did the whole pandemic. Eventually I found a company in New Jersey, Rodkey, who turned into making face shields and I was able to stock up on good quality reusable face shields.

At one point the Chief Medical Officer of my group called me and asked if I wanted to volunteer at one of our hospitals. At this time it was not unusual to be “drafted” into taking care of COVID-19 patients. For example, at one large hospital system in NYC, surgeons were ordered to lead “platoons” comprised of a normal surgical team of senior and junior resident trainees, along with office staff such as medical assistants. These “platoons” were “deployed” into the satellite hospitals in hard hit areas such as Brooklyn and Queens, and sent to staff emergency rooms and ICUs. If you participated in the program, you were paid your usual salary during the pandemic. If not, you simply stopped being paid. Naturally, most surgeons who were healthy participated. Locally, I was offered an opportunity to work night shifts essentially as a hospitalist. There was no information about pay or whether adequate PPE would be provided. It also wasn’t clear whether I would be relieved of my surgical duties for doing emergency procedures and taking call. I didn’t say yes or no but neither the CMO nor I followed up. At the time I felt some guilt about not volunteering but I think only one or two surgeons signed up for this in our area and I think only a handful of the medical specialists participated. It seemed to be not very well organized.

The thing about being a doctor, nurse, or other health care personnel during this time was that we are not soldiers. We came into these careers to help people and for some expectation of financial stability. We didn’t go into it expecting to put our lives on the line in service of humanity. But here we were. It was especially infuriating to see Donald Trump on the news downplaying the severity of the pandemic and throwing out all sorts of misinformation and quack cures such as hydroxychloroquine. Here in New York I felt relief and pride seeing Governor Cuomo at his daily press conferences giving accurate, sensible, practical, easy-to-understand information. He didn’t sugarcoat anything and gave us a sense of his own concerns about ventilator and PPE shortages but he also boosted our morale with his “Italian family dinner” commentary about how love and New York toughness was going to get us through the pandemic. “Flatten the curve” became part of our everyday conversation. I especially appreciated how in response to Donald Trump’s use of the term “China virus” Andrew Cuomo took great pains to emphasize how the virus came to New York from Europe and to not direct anger at our Asian population. I was greatly disappointed later on when his sexual harassment and suppression of information about nursing home deaths came to light and he eventually resigned. His wrong actions deprived us of a strong voice against anti-Asian violence which would soar later on. As an Asian-American, reading about all of these horrific attacks was supremely saddening, especially after so many Asian-American health care workers have served on the front lines of this pandemic since the beginning. Having the nurses at my hospital be terrified of taking the subway and having their children subjected to verbal abuse at school really hurt me deeply.

I think having people stuck at home created a rapt audience, first for entertainment such as “Tiger King,” but later on for police brutality against African-Americans. The Black Lives Matter movement really drew strong attention to the racial injustice in America and got broad support. Somehow I think in all the negative feelings of anxiety and depression, that at times, an outpouring of empathy was also brought forth by the pandemic.

An emotional aspect was seeing the videos posted by my friends in NYC of people cheering, applauding, and banging on pots and pans to support health care workers during the lockdown. In the modern age of healthcare where as a doctor you often feel overworked, underpaid, and unappreciated, it was quite shocking to see this spontaneous display. Along with Andrew Cuomo referring to us as “healthcare heroes,” it was one of the things that helped keep me going during that first few very difficult months.

Personally, for several months and maybe for more than a year I felt the anxiety and fear of the pandemic like a heavy, smothering, suffocating weight. My shoulders felt like I was carrying around a 1,000 pound blanket every day. At first I was afraid that I was going to die and leave my family without me but later I was mostly worried about my kids, especially after I got vaccinated in December 2020. My daughter was in kindergarten in March 2020. Governor Cuomo created a school-based day care system for the children of health care workers and essential workers. My wife and I were not sure if we should send her because we were not sure if she might contract the virus. Ultimately we decided that it was too isolating to stay at home so she went. Fortunately she did not get sick and I think she did well emotionally. I know that some of the kids in our neighborhood really struggled with the isolation and stress of that time.

The following year there was intermittently remote school which was terrible both educationally and socially for our daughter. At that time there was no evidence that schools spread COVID-19, and there was emerging evidence that places with universal mask usage had lower rates of infection than the surrounding communities. There were many bitter disagreements over whether schools ought to be open or closed and as parents we suffered immense stress when schools were closed and we believed they ought to be open. Deciding whether to send my son to preschool was another struggle. Fortunately, both of my kids are very good about wearing their masks. Later on, when they rescinded the mask mandate, we were also shocked and didn’t quite know how to respond. We kept my son out of preschool for a week but we eventually sent him back with a mask on. My daughter continues to wear masks as well, even though her classmates are mixed in their usage. The one thing we were clear about was that my daughter would take the vaccine as soon as it was available.

One particular incident illustrates some of the stress we were under. My daughter developed an infection around her knee and my wife was afraid that she might have an infection in the knee joint, which is a surgical emergency. It was a weekend when I was on call, and we could not call our parents to watch the kids because we did not want to potentially expose them to COVID-19 and we couldn’t get a babysitter because of COVID either. So my wife took my daughter down to an emergency room while I stayed at home with our 1 year old and I called my partners to see if they could cover for a few hours. I then got a call that there was a life-threatening surgical emergency but I couldn’t go help with it so my partner went in. It was a harrowing experience to be torn between caring for my kids and my duty as a surgeon. My daughter’s emergency room visit took several hours but eventually they found that it wasn’t serious. I ran to the hospital as soon as my wife walked into the door but my partner had about finished the surgery when I arrived.

Another difficult situation was over that first summer of 2020 when we went to my in-law’s vacation home in the Andirondacks for my kids’ birthdays. There was still a shortage of testing kits and on the day of my daughter’s birthday party she developed a fever, runny nose, and cough. There was no testing available locally and certainly not rapid testing. The grandparents and aunts and uncles had to drop their gifts off at the door of our cabin and we drove nearly 300 miles back home to get a test at an urgent care center that turned up negative. Fortunately nowadays we have a large supply of home rapid antigen test kits so that if anyone develops symptoms of a cold we can test right away. There are a number of birthdays and holidays that wouldn’t have been able to be celebrated otherwise.

My 40th birthday was shortly after the pandemic started and took place on zoom. My wife made a special video tribute with my family and friends and it was a very special birthday but it was also very hard to have to cancel the in-person party. Another hardship which sounds a bit trivial was that I was afraid to get a haircut. I think a lot of us experienced pandemic hair. I hadn’t really appreciated how important haircuts were to my well-being. It was just a daily reminder of the circumstances that we found ourselves in. There were shortages of home barber equipment so I had to pay scalping (no pun intended) premiums on eBay. My wife cut my hair and it was a sad experience. I was very happy when I resumed getting haircuts, albeit with a mask on. Other shortages were well-documented but we also experienced empty shelves at the supermarket, particularly in terms of meat (meat packing plant outbreaks), toilet paper, pasta. Oftentimes the usual brand would be gone and a substitute would be have to do. Costco had early bird admission for the elderly and immunocompromised and health care workers were allowed as well. By taking advantage of this, my wife was able to stock up on a few items. Starbucks also offered free coffee, but it wasn’t until the tail end of this promotion that I felt safe going back into a coffee shop. Ultimately I did end up going to Starbucks more because the app made it easy to order for pick up, and a perception that the generous leave policies might prevent people from working while sick.

The one good thing about the highly contagious Omicron variant is that it revealed how much our system has changed. The health care worker vaccine mandate turned out to be a damned good thing as it meant that health care workers generally did not have severe symptoms, and were able to return to work after 5 days. The high vaccination rate in our area helped to keep hospitalizations down. The hospitals were able to continue to function, with patients seeking care for non-COVID related conditions. Elective surgery was never suspended and we continued to operate more or less normally, which was really a triumph compared to March 2020. There was a shortage of home testing kits for a while particularly around the holidays when people wanted to test before family get togethers, but now we seem to have them in abundance.

I think it’s the small things that still drag me down sometimes. Putting my envomask on when entering my office building. Keeping hand sanitizer in my car. Eating in my car with a small desk I hook into my steering wheel instead of eating inside. Not taking the kids out to restaurants. Wearing my envomask during surgeries and getting so sweaty that I have to go outside and shake it out and wipe it down afterwards. Sitting outside instead of sitting in the hospital cafeteria between surgeries.

Currently, there are some subvariants of Omicron that are spreading rapidly. Fortunately, with high vaccination rates in our area (particularly of the vulnerable), lower virulence, and wide availability of home testing we are managing. The booster for my daughter’s age group was recently approved so we are taking her for that next week. For her first dose my wife found and made a reservation at an urgent care in Manhattan on a weekday so I sat in traffic for 3 hours on the way back up the West Side Highway to get her the first shot. The booster should be a lot easier. We are still waiting on approval for the under age 5 group for my son which is the last thing that we have to do before we start to feel more comfortable after more than 2 years of pandemic life.