Doctor, Mother, CEO: Balancing Competing Needs, and Opting for the Front Lines

Yesterday I woke up on an island.

I am temporarily – but purposefully — isolating myself and my two children, ages 10 and 12, in a familiar place that carries with it a slower rhythm from a different time. It’s our second home.

It also happens that, on the first day of spring, there are still no cases of suspected or confirmed COVID-19 on this island. Talk about isolation.  

A week ago, I left Philadelphia to come here for the safety of my family.

But I didn’t leave our communities, or our world, behind. I’ve decided to come back, and put my medical training to work on the front lines during this time of urgent need.

We are all struggling with, distracted by, this new reality that has been thrust upon us by the completely predictable intersection of a rapidly transmissible, emerging infectious disease and a fatally neglected public health infrastructure.

Our current administration is adding fuel to this fire through characteristic and striking ignorance. The administration’s actions — and inaction — will have profound long-term effects on our fragile healthcare system and on our economy. But while the temptation to place all the blame at the feet of elected officials is strong, we are in this situation because of many decades of broken policies and misplaced investment.

I am angry and frustrated. But I don’t have time for this now, because I am consumed by the balance between being a CEO of a company with 36 employees, a mother, a daughter, a sister, a friend, and, a practicing internal medicine physician who also works as a hospitalist in Philadelphia to care for acutely ill inpatients.

I am profoundly wrestling with the obligations of these roles, which, in this new reality, can be both fully aligned and simultaneously in stark conflict.

I have a fiduciary duty, as CEO, to not take undue risks as a “key person” at my company. But the healthcare system will collapse under the weight of this pandemic if healthcare workers don’t step up. And they are stepping up in droves, despite the lack of supplies. My employees need decisive leadership. They also seek my medical advice at a time when the mixed messages of state and federal officials, combined with certain media outlets with irresponsible tendencies and partisan biases, is deafening. It’s hard to know what to believe. I am balancing my passionate dedication to patients with a fierce instinct to protect my children.

I jumped on the front lines in 2014 as a first responder against Ebola and was a (pregnant) medical resident taking care of patients with H1N1 flu in 2009. I will not sit on the sidelines and watch my colleagues fight this battle.

In the end, despite the risk I know it will pose to me and possibly my kids, I will have to leave the temporary isolation of my island retreat. I will have to make arrangements for child care, and then go to the front lines. I need to help care for not just patients with COVID-19 infection, but also for the many patients with heart failure exacerbations, complications of uncontrolled diabetes and hypertension, renal disease, heart attacks and strokes who are admitted in greater numbers because their routine clinic visits have been cancelled to make way for the surge of pandemic victims in dire need. We are going to see a chain reaction of more sickness in these patients, because they won’t get adequate telemedicine consults. That’s because this country has never prioritized, nor authorized reimbursement for, telemedicine services.

As CEO I made the decision, like many others, to make working remotely mandatory. I am trying to keep a company of now fully remote workers engaged, productive, motivated and safe – a company that I co-founded, that I lead, to which I am passionately dedicated. The employees are people to whom I am deeply connected and feel a tremendous responsibility. In a world where the financial markets went from soaring to reactive, trepidatious and emotional, I am also trying to steer our company through an unprecedented time, at a moment when we were, and are, poised to do great things to impact patients.

We all have our version of this struggle. We are all some combination of parents, kids, friends, leaders, colleagues. We will redefine what social engagement means. We will find new ways to fulfill our need for community. We will get sick, and help others get well. Realistically, some of us will die.

But, as a community, a nation, and a world, we will get through this. I can only hope that when we do, we indeed come through to the other side stronger.

I implore everyone to learn from this unprecedented moment in history; in a nation so fundamentally short-sighted and focused on the value of the individual, can we become a country with a longer view? One informed by science, epidemiology and the value of basic principles of public health? The decision is ours: as a world, as a nation, as a community, but also as individuals.

I do not have the answers. I can – we all can – ask questions. Today, I am back in Philadelphia preparing to go on service on nights and weekends to treat patients. This is my contribution.

We must all contribute in our own way: Don’t hide. Don’t let fear paralyze you: find facts and resist the noise. Be kind to each other. Find empathy. Resist hoarding food and supplies — especially masks that medical workers and people on the front lines desperately need and are in dangerously short supply. Build virtual communities. Support a friend or coworker or family member who is alone and at risk.

And vote. Especially, vote.

Together we can use this remarkable moment to catalyze the change our nation and our world so desperately needs. The time is now.

What will you do?