Who knew that chicken tenders at the hospital are so delicious?
I’m also interested to hear that doctors might be drinking more wine (like some of the rest of us) in the Time of Corona. Nancy is an oncologist, Mark is a pulmonologist, more on that at the end of the post…
Hi, Mark and Nancy! Thank you for going to work every day. Thank you for sharing your insights with Bacon readers.
What is your state of mind? Does it change a lot, day to day, or do you feel like you’ve settled in and adjusted to Life in the Time of Corona?
Mark: It has been all over the place! I’ve been a doctor forever, trained when residencies were unrestricted, and spent ten years active duty in the Army, yet I still found myself unprepared to deal with this unprecedented combination of medical risks and social disruption. The vast amounts of conflicting data we received each day has been overwhelming (especially with regards to treatment plans for COVID). I’m feeling much better now, but still holding my breath. Social distancing seemed like an over-reaction when I first heard of it, but now I cherish the effect I truly believe it has had for our city. New York City is burning down, but our COVID ICU is only a third filled.
Nancy: I have been unsettled. The schedule disruptions have been tough. Most of the time I am fine when I spend my time learning as much as I can about the virus, the pandemic, and how to treat sick people in this very difficult time. That’s what keeps my mind settled and when I feel like I have some control.
But the effects of this pandemic are going to be far reaching. I have spent a good part of my life trying to support causes I love like the arts and higher education and I know how significant the social separation and economic issues caused by this pandemic will be.
What does daily life look like at your medical practices? I know you have to be discerning in what you say. But for those of us on the outside, we would appreciate your perspective and insight…
Mark: The hospital has become a bit surreal. Everyone is stopped at the few entrances left unlocked for a temperature check and screening questions – if the border guards approve, you get the sticker for that day to put on your ID badge. Next, I go to the doctors lounge to sign out the one surgical mask that I will wear all day while in the hospital. Then upstairs to a quieter than usual hospital. All elective surgery has been cancelled, and there are no visitors for the patients – trust me this is really strange to experience. Then you try to act normal seeing your patients while the whole time wondering how bad will this really get. This past weekend I worked in our COVID ICU – eerily like a SciFi movie. Our predicted surge peak date is April 17, but that has been changed several times. Honestly, I think we are ready.
Nancy: I take care of a population of people at high risk for complications and death if they develop Covid-19. We are being very careful with them and making treatment decisions with an abundance of caution.
We have an emergency plan for all of our outpatient clinics that was partially developed before the pandemic but has been shaped and shifted as we have learned more about the disease and the speed of travel to Tennessee. Our current practices are designed to keep our patients, providers, and staff safe.
We screen patients when they come into the clinic for fever, cough, possible recent viral exposure. If they appear acutely ill we might be able to test them in our clinic (we have a limited number of test kits) but if they call with symptoms of Corona virus we direct them to an outside testing center. They must now come in unaccompanied unless they absolutely need someone to assist them. All of our docs and NPs have learned how to perform telemedicine visits and are trying to use this technology for patients who aren’t receiving active treatments. That has been very challenging for us. Our providers and staff are masked throughout the day. We are deliberately sequestering some of our providers at home. For instance, my NP will be out for two weeks with the goal of keeping her uninfected and able to return to render care for our patients if I become ill. Also, each of the five medical oncologists in my office at St Thomas Midtown are taking a week out of the office in order to try and keep us from all becoming infected at the same time. As a company we also have strategic plans in place to concentrate care at certain clinics if the pandemic gets really out of hand and our staff become ill.
How worried are you about the coronavirus?
Mark: For several weeks I feared the worst; I really thought it would be inevitable that a couple docs in my group would get infected (with no certainty to outcome) and that we would be out of ICU beds and ventilators when the surge occurred. The most recent data are much more encouraging and my resting heart rate is improving.
Nancy: I am less worried today than when I first wrote this draft. Last week was a very dark time as we anticipated what might happen. But there are so many aspects to this pandemic that have implications beyond infection, illness and death. I feel the social isolation is the worst. My sister and I decided to move my Mom out of her assisted care center about a week after they locked her facility down. It was clearly taking a toll on her and we were so worried that we couldn’t see her on a regular basis. She has some dementia and a lot of needs. My sister and brother-in-law are working at home and they took her in because Mark and I pose a risk of infecting her. I still can’t see her but know my sister and her husband are doing a really good job taking care of her.
What do you plan to do this Friday night in the Time of Corona?
Mark: Clean up the kitchen, maybe catch up on WestWorld, recheck the U of Washington COVID website several more times.
Nancy: I will walk when I get home from work and then cook dinner. Clearing my head after a day in the office is important, walking my dog is important. Eating dinner is important.
What would you rather be doing on a Friday night?
Mark: Dinner at Etch and then the Symphony after. And I have a much greater appreciation for our Predators season tickets – I so miss all the hockey “experts” that sit around us!
Nancy: I do like going to hear the Nashville Symphony but I like relaxing at home on a Friday night equally well. I have spent my entire life doing something outside of my house on a Friday night so I don’t mind the down time. I miss having time with my friends though.
Who will cook? Or will you order in?
Mark: Nancy will cook, I will clean. I have had a lot of great deals in my life, but this is one of the best. Expert cancer care is not her only skill set! Of course she is fastidiously healthy with her cooking, so I still sneak chicken tenders at the hospital.
We have been ordering from Etc. as well; I fear how this social realignment will affect our local restaurants.
Nancy: He is exaggerating my culinary skills but I do try to have a plan each week and prep what I can ahead of time. I am trying to stay out of grocery stores as much as possible. Even prior to the pandemic I used a couple of great delivery services (Dinner Belle for locally sourced and healthy entrees which come prepared and ready to heat and eat and Meel for locally sourced produce and market items and some pre-made dishes or meal kits). I have to be super organized to use them because they both require an order that has to be submitted 5 to 7 days before they are delivered.
Jennifer: Gotta take just a moment here and say: Etc. is my favorite restaurant in Nashville. We are ordering take-out there on the regular. Nancy: I didn’t know about Dinner Belle or Meel! They look amazing!
What beverage will you enjoy?
Mark: Something from the cellar. As this has been dragging on, I have become more willing to open bottles that were saved for more formal events. So we are having good Bordeaux and big California cabs much more often than we should when “normal” comes back.
Nancy: We are diving into the wine cellar nightly.
What are you secretly or not so secretly enjoying about Life in the Time of Corona?
Mark: No question here. The lack of traffic. I still drive to the hospital every day and getting home is now so painless! Also, doing this job is considerably easier when you have no plans after work!
What I secretly appreciate is that I am allowed to go to work everyday rather than having to shelter and for now I appreciate that my children are independent adults living out of town. I cannot imagine what it must be like to have to shelter at home with school-aged children.
(Oh, and there’s plenty of toilet paper at the hospital.)
Nancy: I love not having to think about where I have to be at 7:00 every morning and which meetings I need to attend in the evening. I’m not sure if I will be physically or mentally capable of going back to that packed schedule. I would bet I’m not alone in this.
What’s the biggest hardship? What do you miss most?
Mark: The personal hardships are minor – trip to Europe cancelled, trip to see our son cancelled, Symphony cancelled, eating out cancelled. The real hardships are for those who will lose jobs and more without hope of recovery.
Nancy: I miss my family and my friends the most. I also miss my church family. This season of Lent is so important to Christians, a time of sad reflection followed by great joy when we celebrate Jesus’ resurrection. As a Christian I know that God is here, with us, no matter what. For that, I am grateful.
What has not changed at all?
Mark: I still won’t drink the coffee in the SICU, Nancy still tolerates my multiple idiosyncrasies, our dog is still aloof, and for now I still get to walk in Percy Warner park.
Nancy: I still do the laundry on the weekends.
What are you reading and watching? Any great podcasts? What would you recommend?
Mark: Our recent trips to France and Germany have made me very interested in WWII history, so this has been the focus of my reading. (Though a recent SNL monologue not too kindly described reading WWII history as a classic Boomer Dad activity!)
Two of my recents favorites:
In the Garden of Beasts by Erik Larson. A recounting of the rise of Hitler’s control of the country as viewed by the American ambassador to Germany and his family.
Madame Fourcade’s Secret War by Lynne Olson. A history of a female led, highly successful component of the French Resistance during WWII.
But when the library opens back up, I am going back to pure entertainment and get caught up on the last few years of Harlan Coben novels.
Watching “Westworld” and the new Star Trek (when I take the time to figure out CBS full access.) Not watching “Tiger King”!
Nancy: The Podcasts I have been listening to are available to anyone who wants to listen and I feel that they are so much better than watching the daily White House updates. This Week in Virology is a series that has been going on for 10 years or more, hosted by a PhD virologist and his friends. Obviously, since January every show has been on Covid-19. I also listen to a similar podcast titled Immune. It is only one show a month.
I also just finished Ronan Farrow’s new book Catch and Kill. I actually listened to it on Libro.FM which I joined when they offered a 2 for 1 deal this month and I learned that it would directly support Parnassus, our local bookstore.
Other forms of stress relief in the Time of Corona?
Mark: Walking in the park, for sure. The normalcy of getting to go to work. Praying the Rosary. And I think we mentioned the cellar.
Nancy: I cleaned out our garage while Mark was working this past weekend. I was so physically exhausted I couldn’t think about how worried I was about him.
How do you think you will be changed by Life in the Time of Corona?
Mark: After 35 years of working in ICU’s, I will finally take Nancy’s concerns about the risks I bring back home seriously. No more call clothes in the house!
I also think telemedicine will stick around as an integral part of outpatient medicine.
Nancy: I want to develop a skill set for dealing with the problems of society in a post-pandemic world. I don’t know what that looks like for me yet but I have a few more weeks to contemplate.
Jennifer: Again, my sincerest thanks. Mark, it’s always a good idea to listen to Nancy. And Nancy, I have no doubt that you will figure it out! xoxo
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A brief history of Nancy & Mark & their professional journeys, according to Mark:
We both went to the University of Missouri – Columbia for medical school and that is where we met – I still remember the first time I saw her and having the absolute knowledge that she was way out of my league.
I graduated in 1986 and went to Brooke Army Medical Center for my Internal Medicine residency. We married right before she graduated in 1988. She then came down to San Antonio to do an Internal Medicine residency at the University of Texas – San Antonio. Over the next years I completed a Pulmonary/Critical Care Fellowship while she completed a fellowship in Oncology. Nancy subsequently joined an oncology practice in San Antonio. In late 1995 my military obligation was finished and Tennessee Oncology hired Nancy as its first full-time female physician. I will always be grateful to Charlie McKay for bringing us to our new home town. After a brief stint at the Frist Clinic, I joined MidState Pulmonary at Baptist Hospital and for that I am extremely thankful. We both have stayed put since. I served a term as Chief of Staff and Nancy spent ten years as the Chairman of the St. Thomas Network Cancer Committee. And as a shock to us both, the Saint Thomas Foundation gave us the Seton Award as a physician couple in 2018!
You’ll have to ask Nancy if you want her version.