‘Motherhood in medicine’: Returning from parental leave was hard. Covid made it worse

Earlier this month, I steeled myself for my return to work after giving birth to my second child. The transition back to the workforce after parental leave is challenging even in the best of circumstances. Due to the pandemic, I’ve experienced the worst.

On my first day back, I had patients lined up to see me in my virtual clinic. They recounted harrowing stories of infant loss, betrayal, and isolation. Faced with this onslaught of anguish, inflamed by Covid-19, I realized my time away while recovering from childbirth offered me a small breath of fresh air. My patients noted how happy they were for me and my growing family, while adding how much they struggled in my absence. Their emotional difficulties were not unexpected — I’m a psychiatrist, after all — but the guilt I felt made me wonder: How was I doing this work before? And how was I going to do it again?

I felt overwhelmed trying to catch up on the care of the 160-some patients I’d accumulated in the few months I worked at my new job before going on leave. Between patients, I fielded prior authorizations and demands for return calls, all while trying to understand the Medicare billing overhaul that went into effect when I was off — and while hearing the heart-wrenching cry of my baby downstairs from my makeshift home office.

This is motherhood in medicine. This is pandemic parenting. I tried to take it all in stride, telling myself that I would adjust and rise to the occasion. Then on the next day, I lost my sense of taste and smell, and I eventually tested positive for Covid-19.

After a year of living like a recluse, sacrificing birthdays and holidays with my family, I was diagnosed with the disease that has destroyed so many lives. I felt frustrated that my parental leave delayed my vaccination against the virus until my return to work. Most of all I felt afraid. As I’ve written before, my family has been afflicted with rare diseases. It’s an experience that has left me struggling to find statistics of recovery reassuring. Needless to say, I survived, but not unscathed.

All of these feelings underscored the burden of being a disappointment to my patients. Quarantining and caring for my young children meant I couldn’t be in the clinic, even virtually.

My Covid diagnosis detonated a hole in my schedule that left many of my patients, many of whom have been on waiting lists for several months to see me, in the lurch.

Before the pandemic, the supply of psychiatrists in this country already could not meet the demand for care. The demand grows as the death toll climbs, livelihoods are lost, and our socioeconomic health is further taxed by the snowballing trauma of Covid-19. I have never felt the collective weight of my patients’ distress so acutely.

As a physician, I’ve learned that taking time away from work — for any reason — is a complicated experience often fraught with guilt. As a Black psychiatrist, my guilt is compounded by the dual burden of the shortage of mental health professionals in this country and the fact that only 2% of practicing psychiatrists are Black. After informing a Black patient of my pregnancy and preparing her for my upcoming leave, she wished me well. She also had a wish for herself: “I’ve never had a Black doctor before,” she said. “So I hope you’re coming back.”

Her wish was underscored by studies that show Black patients do better when they are treated by Black doctors. I felt her cling to me with the same desperation and determination with which I clinged to the Black OB-GYN who cared for me during my pregnancy — even if it meant my prenatal appointments would be delayed, I refused to see anyone but her.

While my colleagues and supervisors, many mothers themselves, have been supportive of my back-to-back absences and diligently made contingency plans, I knew that as mental health professionals, they too feel the burden of being one of the few tasked with the care of so many. In balancing the Covid-induced upheaval in our homes and the hospital, they too had no choice but to rise to the occasion. In weathering this difficult transition, I’ve learned that the resilience of the other mothers in medicine around me reinforces my own.