the show must go on

December 23, 2021

Our BeeperMD tester did not show yesterday afternoon. This was the second time this happened and I fear they have just . . . given up?



(((I tried contacting them via phone, email, and their chat and received 0 responses.)))

At this point, the testing is specifically because if all 3 kids remain negative, I would be able to send them to camp next week. She is still coughing quite a bit, but I’m hoping she will be better by Monday, an entire 4 days away?

Work has been busy, but since my outpatients were rescheduled it has been doable. I went to the hospital for ~4 hours and finished notes at home. Last night = 2 overnight calls, mostly because every kid in the county seems to be sick right now, either with COVID or other things. It’s a viral cesspool out there.

Every day I don’t wake up feeling sick I am grateful (for vaccines + luck) and mildly surprised.


Rounds (with resident) + notes

Maybe go for a run for my mental health

Work on filling out first few weeks of my 2022 Hobonichi – now starting to be out of necessity as things are filling up and I seem to have some thing written in my current (EC) and some in the new, and I am becoming wary of double bookings.

At least 2/3 kids got some outside time in our yard yesterday!
Playing with chalk + the hose = 1.5 house of entertainment.
PS this is still our old house, we have not moved yet!

I feel like I am limping to the finish line of 2021. Oh well!

Here’s an interesting question from Diane:

Oh this sounds like such a hard and stressful balance!
Your post made me realize that I’m lucky (?) that my job is not one where people rely on me for their health and well being, so I can take time off when I need to and the dominos won’t keep falling.
It must be so hard as a physician to balance patient needs with your personal/family needs. Out of curiosity, as a thought exercise, what do you think would be an ideal system for healthcare providers to be able to feel like they can balance professional and personal crises in a way so that doesn’t feel like they’re “half available”? Do you think the solutions lie in better child care or in a different workplace structures? Or…? Or maybe it’s the nature of the work to feel constantly invested in many different directions? (Or maybe just the nature of being a working caregiver? Or just a working human?)

I think for my particular job, being on call requires full time flexible childcare. Which usually I have! When I volunteered to cover Christmas (because I felt I was due to work a major holiday), it was August 2020. Yes, 2020. We do our full year of call schedules many months ahead of time, because we book outpatients quite a few months out, and the outpatient templates vary if you are on call.

When I made that choice, I really didn’t think there would still be a pandemic going on . . . but obviously, I was wrong. I did anticipate that our nanny would likely take vacation around that time, but knew the school offered ‘camp’ and figured finding a babysitter wouldn’t be a big deal for a week. I also (erroneously) figured Josh could be off, not realizing that this is very hard to arrange during the holidays given the size of his group. This still would have worked out fine, except that A got exposed at the wrong time and then developed symptoms (whether actual COVID or not remains unclear). AND our backup babysitter getting it too!!!!

So in summary, I think the answer is full time flexible childcare, but nothing is 100% because %(*#&$ happens, and during a pandemic it seems like a LOT of %*(#$ is likely to happen. I do think I have truly learned my lesson that if I am taking call while our nanny is away, Josh must be entirely off and able to be the main caregiver. Next week (Tuesday going forward — I’m still on call + working Monday) when he is on call, I will be fulfilling that role. At least he is off this weekend.


  • Reply Omdg December 23, 2021 at 7:34 am

    Honestly, you did all of the things you’re supposed to, it’s just that rarely the stars align and you’re screwed anyway. In those cases, you do what you need to do to survive. We used to be able to bring our kids to work and plop them in an office while we did stuff. Now that this option is gone, sorry work, you need to figure out a way to accommodate the fact that people – all people – have lives.

    • Reply Sarah Hart-Unger December 23, 2021 at 8:50 am

      Yes triggering. Memories of chronic trauma and panic.

  • Reply Sara December 23, 2021 at 8:37 am

    Someone yesterday mentioned the word “triggering” when these childcare challenges arise and I completely agree. We’ve been dealing with this pandemic for so long at this point 😣 Trying to balance a demanding job, even while working from home, and asking my husband for 6 months straight in the early months of the pandemic “what does your schedule look like today” made me a bit nuts and now whenever there’s a childcare curveball, rather than being flexible, I go back into panic mode (even though my kids are older now and technically we’ve developed ways of dealing with it!) Hope you get through the next several days OK and you receive negative results so the kids can enjoy camp next week!

    • Reply Holly December 23, 2021 at 2:50 pm

      Sara, this is EXACTLY what it’s like in our house too juggling two demanding work from home jobs and a 5 year old in school and also after school childcare. It’s like a PTSD response when we have to keep our kid home for cold symptoms or Covid exposures. It is SO DRAINING.

      • Reply Irene December 23, 2021 at 8:48 pm

        My work is a bit more flexible sometimes (in part because I have chosen not to pursue several opportunities over the past 2 years that I think I would have liked and probably been qualified for) but I agree 100 percent. Triggering in a very non-helpful/productive way. My husband seems to feel similarly despite me doing a lot of the covering, it must have been really hard for him to do the parts he did.

        We are just so discouraged to have most plans canceled again. Our kids just wrapped up a quarantine but schools have closed so will be out almost 3 weeks total, plus many other days since late October for mild cold symptoms. I just wish we could enjoy this extra time with the kids but it’s been a struggle- my older one did not react well to her quarantine…

        • Reply Sarah Hart-Unger December 23, 2021 at 9:32 pm

          I am at the point where the hint of a runny nose in a kid absolutely ruins my day. Because inevitably it means significant disruption, reconfiguration, etc. It really sucks.

  • Reply Stephanie December 23, 2021 at 9:01 am

    Reading your post from yesterday made me realize that my one day without a nanny today will be fine. I’m a lawyer and don’t have anything scheduled but plenty of work that needs to be done. Instead of working my normal time, I’ll likely break it up into different chucks and use screen time and nap time and when husband is home plus work slightly fewer hours. My job is somewhat flexible if I don’t have court or mediation scheduled, and with video court thanks to the pandemic it’s both easier to have a coworker cover and easier to work from home. I know some judges are wanting to be back in person, but I hope some things stay remote indefinitely. It has made my workload better (no more time driving to different courthouses). I hope you get through these next few days. Having sick kids is the worst.

  • Reply Marina December 23, 2021 at 9:10 am

    I’m sorry to hear about your week, Sarah. I agree that you did everything you could to prepare but lots is out of your control in a pandemic. We have two small kids and busy but flexible WFH jobs, with daycare/public school, but we still basically rely on my retired dad to be available whenever emergencies or quarantines pop up. I am really grateful for that family help otherwise it would feel like we are constantly on edge (which we still are, but a little bit less).

    Do you have family nearby that could watch the kids if they’re negative but camp is not an option?

    • Reply Jane December 23, 2021 at 10:01 am

      This sounds so tough, I’m sorry! Yesterday my 10 year old (fully vaxxed) daughter suddenly developed a fever and, sure enough, tested positive for Covid on an at-home test. The rest of the family (my 7 year old is vaxxed and my husband and I are boosted) is completely without symptoms (but haven’t tested bc of a lack of tests). I’m grateful we are off work and school for the next two weeks and able to isolate at home, although we had to cancel all our (minimal) holiday plans. Your situation sounds so much harder!

      I also wonder if we’re going to learn that omicron is much more transmissible among kids, given that we have zero known infected close contacts and have been very cautious, but we live in the DC area where omicron is on the rise. We can’t find a test to confirm the variant but the pediatrician said there have been a massive number of sick kids this week alone.

  • Reply Gillian December 23, 2021 at 9:24 am

    I am an adult endocrinologist and our hospital went to a hospitalist consult model which has been amazing. If you are seeing patients in the office, you don’t see patients in the hospital basically ever. The endocrinologist hospitalist sees all the in patient consults with the fellow and residents. We still take overnight call for patient emergencies (there are soooooo many right now). But you are never trying to see patients in the office and cover an inpatient consult service at the same time. It has been revolutionary!

  • Reply Lisa of Lisa's Yarns December 23, 2021 at 10:39 am

    Oh man the no show situation is very frustrating. I wish tests were easier to come by. Here in MN, it’s very easy to get a saliva PCR test – that’s what I did yesterday. I did not need an appointment and the line was not bad and I should get my results today. I wish I could have done a nasal swab in clinic, but it’s very hard to get an appt these days… I miss the fall/winter of 2020 when I could wait in line at a clinic and get my results in 12-14 hours most of the time. But that is ALL I miss about fall/winter 2020! My kids obv can not do saliva PCRs so it’s really tough to find appts for them when we do need to test. The at home tests are a good starting point, but after my false positive I don’t fully trust them…

    I don’t think you could have done anything differently about this call season. It would be hard to know your nanny was going to request time off, and I am sure you felt you could not say no as I know you appreciate all she does for her family. It’s just a bad bad combo for you and J to have overlapping call. And gosh, he must have a lot of call as I think you said it’s split between 3 people? Eeks. Your posts are a reminder that at least no one’s health is dependent upon us in our line of work, although there are high expectations for people in my line of work and I wonder when I will deplete the understanding of my coworkers/boss? But I am the only one in my little group with really young kids. The 2 people I work with have kids in HS/college so they are in a completely different stage of life and are rarely sick. And if their kids are home, it’s so not an issue whereas for me it’s so disrupting with a 1 and 3.5yo – especially the 1y who has earned the nickname Mr. Mischief since he’s drawn to cords/things he shouldn’t play with!! I’m trying not to catastrophize and think about what we will do if I do have covid as they will be home for like 24 days as their quarantine doesn’t start until day 10 of mine unless I quarantine from them, which is impossible – unless they consider wearing a mask quarantining? I’m trying not to go down that spiral of panic until I have the results of my PCR, though…

    Hang in there! I hope your kids are healthy and able to go to camp next week!!!

  • Reply Annie December 23, 2021 at 11:26 am

    Sarah, you are doing your best. I think all of us physicians in clinical medicine with young kids can commiserate. If your employer is anything like mine (well actually my former employer, I switched jobs over the summer but I can’t imagine things were all that different where I am now in 2020), your employer has made it clear in so many ways that it is your job to solve all of their problems (revenue cycle, patient coverage, protecting other higher-risk employees from exposure – not that that’s a bad thing, per se, but it adds in) while making it clear the hospital takes no responsibility for solving your problems (childcare and otherwise). Times two if your partner is also in medicine (as mine is) and without any help whatsoever from society at large (I am not sure I will ever quite recover from the betrayal (yes, a dramatic word, but that’s kind of how I see it) of being able to count more on my local gym than my kids’ school in supporting my kids and family last year). Of course, we are all devoted to our patients (otherwise we would have quit by now as so many people have) but we are only human-
    I think sometimes we have staked a lot of our identity on being ‘superhuman’ and thus it feels like even more of a painful failure when we aren’t. I know this is true for me. trying hard to go easy on myself (especially when I am inpatient with my kids) and I hope you can do the same-

  • Reply Lori C December 23, 2021 at 11:26 am

    I wish I lived near you. I would say just send the kids over here so you can work! I am still on maternity leave and we just had COVID… But seriously do you have any community locally of mom friends, or from your faith community that could help? Trying to brainstorm. So sorry you are going through this!

  • Reply Holly December 23, 2021 at 2:56 pm

    So sorry you are dealing with all this Sarah! And the layers of stress: call stress, illness stress, flakiness of testers stress, childcare stress, it is all too much after two years of being resilient. I don’t blame you for feeling, triggered and frustrated. We are limping out way to 2022 as well (waiting for our Covid test results after an exposure last Saturday and 2 of 3 of us having fevers) and I feel like I don’t know which well to pull from. It’s all too much.

  • Reply Diane December 23, 2021 at 5:04 pm

    Thanks for exploring my questions, Sarah! I agree that you were super uber prepared for this week, and then… stuff.
    I do feel like it is kind of indicative of a larger issue when even highly paid and successful parents can be left in the lurch by a lack of childcare despite doing everything right, being so prepared, and having so much forethought. It seems like you hit a perfect storm of circumstances that torpedoed everything. But even still … why are there not better solutions or resources for people who need to work and look after children (or the elderly too, for that matter)? I think Annie’s comment above is so spot on about the lack of support for caregivers on a big picture level. It seems like everyone feels so isolated and alone when these situations come up because we don’t have the tribe and support networks that people used to have. And especially these days! Time was, you could send the other kids to school/camp/activities/the neighbor’s house, but now a sore throat for one child impacts everyone.
    I hope that everything comes back negative, and you can continue with the regularly scheduled winter break programming! And that you can take time to do all your favorite self-care things!

  • Reply Sophia December 23, 2021 at 7:58 pm

    You can’t win with pandemic child care and I’m so over it. The only silver lining is that at least I didn’t have to deal with this as a trainee. Hoping you catch a break soon.

  • Reply Erica Sparkenbaugh December 23, 2021 at 8:44 pm

    Sarah I’m sorry you are going through this! Life is tough right now, and you are doing your best. <3

    We were actually in FL this past week (leaving tonight) and just spent the day at your beloved Flamingo Gardens! My kids loved it!!

    I booked this trip to the Keys back in June when I thought Covid would be over by now. Turns out we spent last week rapid testing our 4 yo daily and getting a PCR test because of a PreK classroom exposure 🤷🏼‍♀️🤦🏼‍♀️ Luckily we remain Covid free but I feel like this upcoming winter season is really just a matter of time, especially with a kid under 5.

  • Reply Lara December 26, 2021 at 1:31 am

    This sounds awfully stressful and anxiety inducing. Your patients will have to wait and/or see another physician if necessary in the meantime. I hope this doesn’t sound cold but we are replaceable at work, we are not replaceable at home… your three babies only have one mom — they’re sick, and their sitter has COVID; no one will fault you for having to care for them versus going in to work 💗

    • Reply Sarah Hart-Unger December 26, 2021 at 11:06 am

      Yes and no – outpatients can definitely be moved. But in my specialty, when you are on call during a holiday, it’s hard for colleagues to cover the inpatient part (many are off on their own much deserved breaks!). Thankfully, my husband and I were able to split things up and care for the kids. And this weekend he is off (and after Monday, I will be entirely done with work until Jan 4 – so that will be great!).

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