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I thought I was careful enough. I washed my hands frequently, wore my N95, and limited lung function testing and rhinoscopy procedures on patients. But in the early going, I didn't stop entirely.
Then, I closed the office and switched to practicing telemedicine, which I really enjoyed. I found that this remote medicine was in some ways more intimate and rewarding than the face-to-face encounter. Here, patient and doctor are on more of an equal footing—both of us often speaking from home and both in the same vulnerable position, coping with fear and social isolation. My patients were scared and some were sick. We connected on a virtual and a personal level. Some of my patients got emotional about the special doctor-patient bond we shared.
A few days later, my kids had "colds" and aches, and my wife had a bad headache and low-grade fever for a day. I developed a mucousy cough but nothing else.
Then, in the middle of one night, I awakened, feverish and sick. I shook my sound-asleep wife and ordered her out of the bedroom. And so my saga began.
It's the next morning. I seem okay but see a family physician friend with a nearby office for a COVID-19 RT-PCR.
I stay in my bedroom, which fortunately has its own bathroom. My wife leaves food for me outside the door and I am not doing that badly.
Then my wife has to restrain my daughter from hugging me. She cries. And my heart breaks.
My fever is now slightly elevated. I have a headache but wonder whether it isn't just caffeine withdrawal. I order the smallest pod espresso machine I can find. I am still well enough to do telemedicine. I have twinges of nausea but have not entirely lost my appetite.
My wife is overwhelmed with the kids and their schooling. I call out for food but, preoccupied, she doesn't reply. I jokingly remind her of the Geneva Convention.
Without picking up my kids or climbing stairs, I already begin to feel deconditioned.
After dinner, the kids are restless, and I think I am just making a big deal out of nothing. I leave my isolation room, tell my wife that I am really fine, and decide that I will take the kids to the building playroom. As I am about to exit the apartment with them, a pulmonologist friend calls to check up on me. She is horrified that I could think about leaving the apartment, possibly exposing vulnerable persons to the virus. Feeling chastened and embarrassed, I return to isolation.
I awaken, thinking that I'm indulging myself too much. I clean up the messy bedroom, do some yoga stretches, and lift small weights. It's good not to be dependent on my wife for my morning coffee, but I wonder why I spent the money on that new coffee machine, anticipating the lean times ahead.
Later, I get the call that my COVID RT-PCR is positive, and I realize how close I came last night to doing something dangerously irresponsible. That poor judgment was not typical of the good doctor I know myself to be; the prior evening, I was a patient in denial and a parent trying to entertain his kids.
The news that I am positive is a bit of a relief. I can get this over with and move on. At night, my fever comes back. I start the second wave of COVID-19 symptoms.
My fever is fluctuating. We have ibuprofen, but there are reports that it may not be safe with this virus. Luckily, a physician friend who lives nearby delivers some acetaminophen. A few days earlier, I had given her some N95s that I brought home from the office.
I use a cold washcloth, which is soothing—and a reminder of how my dear late mother managed my childhood fevers. My appetite is diminished and I miss my family. I also worry about the economic impact on my private practice.
When not febrile, I do telemedicine visits and chat with a friend about the Paycheck Protection Program. Oddly, I am thinking more about that than my immediate family's health, but my wife had a fever before me. I am sure she and the kids had it.
Meanwhile, I have no cough or dyspnea, but I follow my oxygen saturation closely. A drop from 98% to 95% is hardly a concern. Still, I start to worry. I know that this can get a lot worse. I nap more than usual and skip showering. Nighttime is difficult and I sleep fitfully, awakening with sweats. For the first time in my life, I start to think about my mortality. I am healthy but still a male in his 50s. I am the sole breadwinner for two young children and also look after an elderly father.
Day 6 of COVID—and day 2 without a shower. I see myself in the mirror. I am looking haggard. And I know I'm sick because I no longer yearn for coffee.
My wife, from 6 feet away, detects a stale scent in my cloistered space and suggests I open a window.
Overnight I have sweats, nausea, and fever. I stumble to the bathroom to get another cold washcloth. I feel terrible, but—having no respiratory symptoms—I assume that I'm past the danger point. I speak to an internist friend who has been advising me (my own doctor is unavailable, having been pulled to work in an inpatient COVID unit). I tell her that on day 7, my worries must be over and that I have passed the danger point. She does not reassure me; there is only dead silence. Again, I consider my mortality.
Another overnight fever. My appetite is fair. It seems like the kids have forgotten me, but then again, at times it's too much of an effort to stand by the door and chat.
Between naps I watch streaming media; it's a good distraction. I still have no pulmonary symptoms to mention, but I run around the room to see if I desaturate with exercise. I don't. I think hopefully that getting past the virus should equate with a much lower risk for reinfection. With small children and an elderly father to worry about, I previously could not afford to take any chances. Maybe I will finally be able to visit my dad. My thoughts also drift to recovery, volunteering, and making a plasma donation at my institution, Mount Sinai in New York City, which is leading the charge against the virus.
And another day with food left at my door by my wife, from a distance. It certainly is room service but without the rolling cart. I joke that I am fed like the family cat—meals on the floor.
Meanwhile, my kids have adapted to Dad trapped inside his bedroom and figure out a way to tease me. They thumb their noses at me from a distance and it makes me laugh. Dinnertime is about the only time we share a meal together (by video), but again, I am not up for it due to a low-grade temp. I wonder how long this will go on.
That night I sleep well and have no overnight temperature.
Day 10. I am looking gaunt but have a bit more of an appetite, albeit for very bland foods. I entertain the thought of leaving isolation. The count begins: First day without a fever.
Days 11 and 12 pass with no fever. I am looking forward to release from isolation, to playing with my kids and kissing my wife. As miserable as I have been feeling at times during the acute illness, I have also indulged in long chats with friends and in streaming media. I have not had this much "time off" from family in about 8 years. That is about to come to an end. I guess that's selfish of me. My wife has been under extraordinary stress and I should be very grateful to her. Yet this last night in isolation, we argue. Signs of normalcy?
Tomorrow night is the first night of Passover, our Festival of Freedom, and appropriately, today I am released from my COVID-19-imposed bondage.
At last, I am free to move about; isolation is over. I get big hugs. My kids also want me to pick them up, but I can't. I have lost 11 pounds, which is 8% of the body weight of this skinny guy.
The Next 2 Weeks and Beyond
A few days pass but I feel weak and still need to nap. From my research, I find that I will need to eat about 3000 calories per day for a month to regain my lost weight. I am the envy of some of my friends. I put on weight but lose it quickly after resuming more physical activities with the kids. I sometimes have to cancel telemedicine appointments due to sudden-onset lightheadedness.
Since my isolation ended, my wife and I have grown even closer. I appreciate her more than ever. I have also gained a greater understanding of what my family has been enduring. The kids are restless with remote learning, and I learn that this is normal because it is not appropriate for their developmental stage. We indulge them with screen time and try to cajole them into going outdoors, but they resist. It's hard to know whether it's because they are comfortable indoors or because they fear the outside world. That fear is reinforced by the masks and other restrictions that make New York City seem like a dangerous place—which it now is.
On a sunny day, we finally go to a park a few miles from our apartment. At this stage, the kids no longer exhibit fear around masked strangers. They are free to scooter around and run. We share a picnic, and for a few hours, life seems normal.
I know that I have been extraordinarily fortunate. Mine was a relatively mild case. The only enduring issue I have is regaining weight despite my ice cream supplementation. I know this garners little sympathy.
It has been over 2 weeks since the end of isolation, and my repeat RT-PCR is negative. I now meet all but one of the screening criteria for the Mount Sinai plasma study. I will soon have my IgG measured, and if my titer is high enough, I will be able to participate and donate plasma. I hope I can.
Gary J. Stadtmauer, MD, is an allergist-immunologist in New York City. His areas of clinical interest include asthma, latex allergy, chronic cough, and sinusitis. He has been a Medscape contributor since 2014.
Medscape Allergy & Immunology © 2020 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: COVID-Positive: A Physician's Diary - Medscape - May 08, 2020.