COVID-19: Social Distancing is Like Bedrest – KevinMD version*
March 17, 2020
Did the picture above catch your attention? The large Pokemon bean bag belongs to my children. The other object is a plastic bag I made from plastic scraps. I know it’s weird, but I have embraced my off-kilter personality as Dr. Plastic Picker. Our children consume enormous amounts of clementines. Clementines come in orange plastic mesh bags. I am now master of the glue-gun which is how I make trash art. With my glue-gun, I reuse bits of plastic. I reuse the orange mesh bags as my base. I make pretty sturdy bathroom trash liners! Every time I finish one, I show it to my in-laws, children and sometimes husband. They all exclaim at how marvelous my bags are.
I bring up making these trash liners because I understand everyone’s anxiety over the COVID-19 crisis. It’s easier to DO SOMETHING rather than to be asked to sit at home and social distance. I have been a student of medicine and human nature for 20 years. It is so hard to be asked to do nothing, even when that nothing can save lives.
We have two children. The two beings that eat all those clementines. I was on bedrest for both pregnancies for 8 weeks apiece. I was placed on strict bedrest for cervical incompetence. Having your cervix called incompetent is hard even though it’s your cervix and not your brain. I did not feel pain. Yet ultrasounds showed a shortened cervix. There was less than 0.5cm of cervix keeping these still not viable fetuses in. I think there are more treatment modalities than just asking a pregnant woman to lay flat, but 15-years-ago I did just that for 8 weeks and got up only to go to the bathroom and shower occassionally. But mostly I was flat on my back.
COVID-19 social distancing is like bedrest. You don’t see the danger when you look out the window. The weather looks fine and the sky is clear. There are not gasping senior citizens on the street. But health officials are telling you that the signs don’t look good. Soon there could be catastrophic social change as the most vulnerable of us could die if we don’t #flattenthecurve. They are asking you to stay home. The high-risk Ob-Gyn doctors asked me many years ago did I want to terminate my 18-week-pregnancy or did I want to to save it? Was I ready to go on bedrest without any guarantee of how this baby would turn out? I opted to try bedrest. At that time my body felt fine. I couldn’t actually see the danger but I trusted my Ob-Gyn doctors.
When I went on bedrest it was one of the hardest things I ever did. Everyone thinks bedrest is easy. It’s horrible. This was pre-social media. I had to lay on my back and dwell on jumbled thoughts of the possibilities of how life may or may not end up. One painfully sees the world go about its rhythms while one just lays there. I did finish one scientific paper while on bedrest. But my other grand ideas about brushing up on foreign languages did not happen.
But I made it through bedrest because I am an analytical person. I wanted each of those babies however they came. I did what many of you are doing now holed up at home. I made schedules. I did ankle and arm exercises. I talked to my family. I read medical articles. I was upset. I had taken care of other people’s babies. Why couldn’t I just have a little girl of my own? What got me through the hardest times was my analytical brain. I had calculated out roughly that for every minute I stayed on bedrest, a certain number of alveoli (the end-unit of respiration where there is gas exchange at the capillary level in the lung) were opening in the fetal lung. Every day the baby stayed it had a better chance for the baby. It was due to lung maturity. When I wanted to give up, I would sing to myself “pop pop pop.” I knew alveoli were opening up.
To all of you who are having a difficult time with social distancing, I realize that you want to do something. Just like my making the plastic bag with my glue-gun because I want to do something about the plastic pollution crisis. You want to do something, so you are hoarding toilet paper and reposting crazy conspiracy theories. You are reacting to this abstract existential threat. But my advice is to instead think of (1) every hour you stay in and every human contact you do not make by social distancing and think of (2) the breath of a grandmother or the tap of an elderly friend’s cane as they make their way down the nursing home hallway still alive. Think of that incremental life and human moment you are saving by doing nothing.
For me though, I have been on bedrest. My two children did not require prolonged intubation. Enough alveoli popped open. The world is in a similar situation. You have to social distance. I feel your hardship. But now I am a doctor and my uterus is voluntarily closed for business. I get to go to work and help save the world. I am lucky to be a bit player in this historic moment. But for you friends who are not in healthcare, who are brilliant attorneys, educators and engineers, I know you want to DO SOMETHING. But the best thing you can do is do nothing. Social distance and stay home. You will be saving lives by slowing the spread and #flattenthecurve. Think of the sound of your grandmother’s breath or the tap of an older friend’s cane. Tap tap tap. Whoosh whoosh whoosh.
*I am grateful that KevinMD accepted this blog post to be published among the academic COVID-19 articles. It was an interesting and useful exercise, as I had to edit the original blog which was almost 2500 to 1000. Mr. Plastic Picker helped quite a bit as he used to be the editor of magazines at the Pingry School and Harvard College back in the day.