I’m an ICU doctor in the middle of a global pandemic. I am trained to manage ventilators and care for the critically ill. My city, along with others, is preparing for a surge of patients requiring hospitalization and intensive care.
And I’m nowhere near a hospital.
Haven’t been for a week. I am home, with my family, living a different life than my physician partners and colleagues of fifteen years. I am on the sidelines, forced to watch from afar, by a set of circumstances I would have thought impossible. But then again, in a world now ravaged by the novel coronavirus, many things once thought unimaginable are now our reality.
For a week I’ve been at home. A TV on in the background with a constant flow of repeated information. New COVID-19 Cases displayed via logarithmic graphs shooting towards the sky, while the Dow and S&P careen into the earth. Twitter is constantly refreshed on my iPad, while my laptop displays the Johns Hopkins COVID Dashboard. All are unhealthy distractions from my new medical issues.
Facing one’s own mortality, whether from an invisible viral pathogen or a cluster of hidden cancerous cells lurking on the side of my tongue, can activate a few coping strategies. My brain has rapidly cycled through both emotional and intellectual responses. In the time BC (Before Corona) I was doing a mediocre job of adjusting to my middle age. Now, I am forced to sit with the reality that my health is far more tenuous, and less under my control, than previously thought.
Eleven days have passed since I heard the pathologist say the words “squamous cell carcinoma in-situ” over the phone. Forced social distancing has both the benefit of decreasing viral spread and giving me plenty of quiet time to think. Now I am finally ready to stop cycling between either my emotional or thinking brain and maybe hold space for both. There are so many thoughts going on inside my head. Like painting when I was a kid, mixing all those water colors together. The colors would start out vibrant and bright, but when brushed altogether, I was left with just a dull watery black. It has been easier to let these emotions blend together into a kind of white noise, muting their individual impact. But it’s time to identify and make room for how I feel. Fear, Anger, Guilt.
FEAR. I have felt fear a few times before. A nightmare. An irrational thought gone rogue about something bad happening to my children. But now that my own cells have betrayed me, there is this fear of my own body. Fear that maybe a cell or two might have escaped. Fear of surgery and pain. I fear the hospital, my home away from home. The surfaces, counter tops, door handles and keyboards. I fear the harm I might suffer by doing my job, taking care of the sick.
ANGER. Anger at ratings and politics are driving communication and decisions, instead of science. Anger that my colleagues have inadequate PPE’s. Anger about ventilators that should already have been made. Anger that empathy and compassion are so foreign, so unknown to our president, that he is incapable of even faking them.
GUILT. I sit here at home. Waiting for a surgery on my tongue that prevents me from working. I’m not allowed in the operating room until I am 14 days free of COVID patient exposure. So, I get a pass. From an increasing hospital census and shrinking supplies of PPE’s. From an ICU with the specter of COVID-19 permeating everything. And guilt, maybe, for feeling a little bit of relief, not to be there.
Fear. Anger. Guilt. They are uncomfortable. But I try and stay with these emotions. Not push them away. And by doing so, these isolated notes combine to form the more complex chords of loss and gain.
LOSS. Some quick thoughts jump out first. A sense of loss for my kids, home from college, their newfound independence abruptly taken away. Waving goodbye to my yearly goals or New Year’s resolution, which seems now quite superficial and vain, in light of the global medical and economic havoc. But the majority of changes in my family’s life are more disruption than devastation. I am acutely aware of the privileged and lucky life my family and I lead.
But this feels bigger. Bigger then the quiet roads, empty parking lots and barren shelves. There is something more profound that has shifted internally.
I no longer feel free and safe to move and travel within my community and the broader world.
For the first time I am concerned for access to food and medication.
I no longer am secure that there will be a health care system available and capable around the clock for my family’s medical needs.
I know that for many in America, and around the world, these have never been given. That my life and experiences being a doctor in this country is not universally shared. But I do believe we are all reconciling the loss of an illusion about our safety and security. We, as individuals, a community, a country, now know we have always been more vulnerable than we presumed just a few short weeks ago.
GAIN. Loss leaves a vacuum. Physics demands that void be filled and I can feel, more than see, what the shape and contours of what that will be.
The comfort of friends and family, reaching out with love and concern. Because I’m a physician facing unprecedented times. Because of a cluster of shitty dysplastic cells in my tongue. Friendships new and old recharged via Zoom conferences and Face-Time phone calls.
The power of a community. A neighborhood that sends me N95’s. The fraternity of health care workers at the different hospitals where I work, that show up and do their jobs, despite the increasing challenges to their own safety. To draw blood, take x-rays, set up vents, administer meds, diagnose and treat, and clean and sterilize the rooms. Every day. Every shift. Every patient! I hope to live up to the high bar they have set when I recover and am back out there.
The frailty of our health security has always been there even if not recognized by the majority of us. The same is true for the powerful impact our varied communities can have. It is unfortunate that it took an invisible virus and in my case tongue cancer to bring these truths to light and inject them into the fabric of our everyday life.
I have surgery scheduled next week. It will be my first. A complete role-reversal for me. I’ll be on the other end of a breathing tube and ventilator. There will be some sort of laser scalpel to remove part of my tongue. My MD degree will not spare me from being a nervous pre and vulnerable post-operative patient.
But I will go under anesthesia, in this time of coronavirus, buoyed by the multiple tribes I belong too. Family, high school and college friends, co-workers, neighbors, teammates. The ties that bind me to them have never been stronger or felt more important than right now.
I will wake up from surgery. My tongue will heal. My voice will reappear. And I will be ready to leave the sidelines and start doing my part to fill the vacuum of loss with what I have gained.
Prayers and love go out to you and your family
Thanks Ted for reaching out and for your positive thoughts! Best to you and your family during these crazy times.
Jeremy you don’t know me but I am your dads cousin and your mom and I keep in touch on Facebook. So sorry to hear about your diagnosis. My family is sending prayers for a speedy recovery and getting you back to do what you do best.
Hi Jeremy. This is Haydar. Thinking of you, Becky, Madison and Maya. Stay strong, as I have always known you to be. All we can provide you nowadays is love and support from far away.
Thanks Haydar! Back at you and your family!
I am sending you my healing thoughts & prayers… you have always been so kind & found ways to use humor/smiles to help patients & families through their difficult times. Thank you for all your years caring for others. Hoping for your speedy recovery.
Thanks so much for reaching out and for your thoughts. Surgery done, home recovering. Typing more than talking at the moment! Sending safe and healthy thoughts for you and your family!
Myra, thanks for reaching our and for your positive thoughts! Much appreciated right now.
In my 75 years on this planet, neither I nor anyone else my age has ever lived through a 2-front war. Until now. And you, Jeremy, are fighting a 3-front war thoughtfully and courageously. Our prayers are that you are back on the front line sooner than later. And that when this all ends, you will be one of the heroes standing on the stage receiving the gratitude you and other first responders deserve.
Thanks Michael for the high praise and confidence in me. I hope to live up to that when on the other side of this surgery!
Good luck JT. I am sure you will be a model patient. I look forward to you joining us in the trenches in the near future.
We have not seen you in a long time. Your Mom and I commiserate on Facebook. I have heard about you becoming a physician and your family. So happy for you. So sorry to hear your diagnosis!! I have survived 2 cancers and still moving on. All our best to you and your family. You are young and healthy and have all the prospects for a great recovery. 😷. God bless and be a good patient !
Thanks for reading, replying. Best to you and the family. I still am impressed with Tim and his round house kicking, brick busting abilities every time i see him on facebook. Stay safe and healthy!
Thanks LJ. Miss you and NWP at the moment. Those patients at RMC are getting amazing care. I hope to learn quickly what you guys have all learned taking care of all these COVID patients the past few weeks. Best to you and Liesel and the kids. Stay safe.. Be out there with you guys soon!
Jeremy, you live up to every high bar there is, and then some. Love from Anita and Bob!
Thanks to both of you. I plan on both of us writing for good long time to come!
Thank you for sharing in such an eloquent fashion. I am so sorry to hear and am optimistic that all will go well. Know this is a difficult time for you personally and professionally. Keeping you and your family in my thoughts and prayers. If I can help in anyway, please reach out. 949-275-8955
Be safe! Be strong! Mark
Thanks Mark for reaching out and your kinds words! Best to you and your family as well. Wishing you guys safety and health!
Thank you for sharing these deeply personal thoughts.
I am thinking of you.
Thanks Becky! Wishing you and your family the best. Hopefully catch you back at LGH when I’m recovered from surgery!
That was beautifully expressed
We know you wil be fine
We love you and all ypur family
Gayle and Mike
Thanks both of you! Cant wait till we are all on the other side of this world turned upside down!
Best wishes for an uncomplicated surgery and recovery! To be the patient when you are used to being the provider is truly a humbling experience. It’s awe inspiring to realize the trust that is placed in the hands of the healers. You will be changed, but life is transformed by our experiences, as you well know. My prayers go out to you and your family.
Thanks so much for your kind words and positive thoughts!
We know you will be given good and deserving care during your surgery and recovery….. and we hope for a speedy recovery.
So glad your mom forwarded both of your posts to us so that we could be included in the group that has learned about your amazing story and the selfless good you have accomplished in helping others. I have a strong belief in silver linings and I believe your health issue will turn in that direction. Whether it will make you even more sensitive to the unfortunate sick people for whom you’ve already shown great compassion or something else…. something good is waiting to happen. Good luck with all you want to do
Thanks to both of you for your kind words and positive thoughts. Best to you and your whole family!
You’re amazing. F—k cancer. That’s all I’ve got tonight.
That all I need! Lol
So sorry to hear your diagnosis. Thoughts and prayers to you and your family. You are strong and you will get through it.
Stephanie!! Thanks so much for reaching out! Hope you and your family are all safe, healthy! Maybe enjoying your place in WI? Surgery yesterday and recovering at home. Again, best to you and your family and wishing as much serenity as can be found during these times.
I am sorry and saddened to hear what you are going through. Hang in there my friend. I’m a firm believer that things happen for a reason, including the good, the bad and the ugly. Hopefully one day you will discover the reason God is challenging you in this way. I pray for you and for the doctors who are taking care of you. I pray that your surgery and recovery are successful. I pray for your wife and kids, that they remain healthy and strong to help you through this. You have a friend and neighbor who can lend a hand in any way, don’t hesitate to reach out. On a side note, your are a brilliant writer!
Hey Luisa..Did I see that you are second in command at RMC for Corona Response? I hope you are getting a chance to breathe with all this crazyness and all that added to your plate!! Thanks for you thought and prayers! Look forward to helping out back at RMC when Im on the other side of this surgery!
Peace, love, and hugs to you and your family, Jeremy. We will all be here when your surgery is finished, and beyond. 🙏🏼❤️
Thanks Cathy.. when social distancing is over, we need to set up a brunch date again!
Love this. Love you. 😍😍❤️❤️
thanks Mom!Love you too!
Sorry to hear but…you got this !!!
Hey Sam! Thanks for reaching out! wishing you and your family health and safety during these crazy times!
God bless you and thank you for your thoughtful expression of how so many of us are feeling. Prayers for a successful surgery and recovery.
Thanks so much for your kind words and positive thoughts!
your writing is beautiful
It’s all due to becky’s editing really…
Thank you Dr. Topin for your candid article and for a glimpse of your life. Wishing you safe and speedy recovery. Peggy Madden
Thanks Peggy! wishing you health and safety during these crazy times.
Hello Jeremy, you don’t know me either, I met you once when you were very young. I am you dads 2nd cousin and all of the extended family out here in Southern California wish you a speedy recovery.
David, I remember. I think you and I got the “height” genes in the family. Thanks for reaching out! Much appreciated.
Jeremy, sending all best wishes to you and Becky and your family. I hope, for you, a speedy and full recovery.
Thank you Cari! Appreciate the positive thoughts.
Wishing you speedy recovery Dr. Topin.
Thanks Sanish! Appreciated you reaching out! You stay safe and thank you for all the work you are doing!
Thinking about you, Jeremy. I have every confidence that you will meet and conquer this challenge. You are an outstanding individual. A great doc. And a compelling author. Remain strong
Jeff, thanks for your positive thoughts and wishes. As well as your calming influence and help the other day. Look forward to working with you and the whole ED soon , helping to care for people during this pandemic!
I’m Eric Wollins’ cousin and so feel like I know you through all of his stories! Wanted to send positive thoughts and hugs to you! You are clearly strong and will beat this!
Lauren (Levine) Foer
thanks for reaching out and for all your positive thoughts! Home from surgery and recovering. Wishing you safe and health!
Jeremy, Harriet and I have you in our prayers
Howard, thanks for reaching out! Surgery done and recovering at home. Doing more typing than speaking at moment. Thanks for the positive thoughts. We are all in this together… See you out on the curbside!
Jeremy, you are in my prayers. As a dentist, i am curious as if this was found by your dentist. If so, was it seen clinically or was an adjunct used to detect it? Was it on your ventral tongue? Any symptoms? Godspeed to your recovery and blessings to your doctors as well as they treat you. I look every patient for this and hope I do not miss it.
Erin, the spot was small, on the side of the tongue and slightly underneath. Found just at the end of the appointment when my dentist did the routine tongue exam, grabbing it and looking at it all around. No adjunct. No symptoms. She asked me if i burned it? Said i had no idea what she was talking about. A few days later the office kinda shut down per society reccomendations. I got VERY luck. Shes getting a big giant hug from me when this is all over!
Hi Jeremy. Not sure if you remember me from our college days. Joanna was my roommate and we all got together a few times. I’m sorry to hear about your diagnosis. Facing a storm in the middle of a storm must feel a bit overwhelming. I think it’s okay and totally normal to feel angry and scared. We all do and we aren’t facing a cancer diagnosis. We have all been reminded that our health is not a given but a gift. Every day is precious and even days when we are stuck in the house with an uncertain future are a gift we should hold dear. Perhaps the timing of this isn’t so random for you – maybe you were supposed to sit this one out. Try not to feel guilty about where you are right now (or where you are not). Maybe you were meant to tell a different story this time. Whatever direction your story takes, I know that you will tell it beautifully and with great depth. You are a beautiful writer and I can feel your heart in everything I read. I believe you have the strength within you to overcome this obstacle. You and your family are in my thoughts and prayers.
Danielle, I absolutely remember you! thanks for reading, reaching out and your kind words. Surgery done and on road to recovery! Wishing you and your family safety and health during these times! Thank you!
Jeremy, I was stunned when I heard this news. In our profession, and in today’s society, we are so conditioned to the highs and lows of every day life, that not much can move the emotional needle, but this news shook me to the core. I am terrible with social media. Megan caught it and passed the news on to me. I have been thinking about you since I heard this. If you have a few minutes, I’d like to catch up by phone or Zoom. Hang in there, man. As always we truly miss you and Becky.
Jason, thanks for reaching out. Been thinking about your family too and hoping things are good. Love to connect. Zoom, facetime, or whatever. You got my cell..look foward to connecting and catching up. Safe and health to all of you!
Dr Topin, I trained under you as an ICU resident at Lutheran General. You taught me how to approach a complex ICU patient with a holistic framework and thought process. You will beat this thing with the same skills you taught us residents. Good luck and sending prayers your way.
Irshad, Thank you for reaching out and your kind words! Hearing from former residents has been truly been a blessing during these times. Wishing you and your family safety and health!
Dr Topin ! I just learned about what you have been going through and my thoughts and prayers go out to you! Your blog is wonderful and you describe your feelings so well.
Praying for a complete recovery and hope to see you soon.
Dear Dr. Topin, I was so sorry to read about your health problems. I will keep you in my prayers and thoughts. I know it is really hard to be on the other side of the “bed”. I call it the looking up as opposed to looking down syndrome. As health care professionals, we are the ones usually looking down. I know you have great wisdom and strength, that for so many years you have given to others . You have certainly made an impact on my family. I pray that the strength you have given to others will help you on the journey. Take care.