Front-line health care workers in Los Angeles, the current epicenter of the COVID-19 pandemic in the U.S., are stretched thin, working under grueling conditions. The long days spent treating so many seriously ill patients — some of whom end up dying alone, forced to say their goodbyes to loved ones over the phone — take a toll.
Russell Buhr is an assistant professor of pulmonary and critical care medicine at the University of California, Los Angeles and an intensive care doctor at two UCLA hospitals. For him, a strong support system has become essential to getting through these difficult times. His husband of four years, Will Murtaugh, also works in the medical field but in a different capacity. He oversees clinical trials of new coronavirus treatments and has previously worked on infectious disease research for HIV and tuberculosis.
“I’m not sure how I’d be holding up without him at home,” Buhr told HuffPost.
So how does a couple cope when both partners are consumed by the ongoing public health crisis?
“We strive to maintain as much routine as possible, but the phrase ‘expect the unexpected’ has become the overarching theme of our pandemic life,” Murtaugh said. “We are not only dealing with the consequences of the pandemic on our daily lives like everyone else, but because we are both involved in the pandemic response, albeit in different ways, it’s become a constant presence in all aspects of our life.”
Below, the couple opens up about their pandemic experience, how they support each other and what they wish more people understood about COVID-19.
What does a workday look like for you right now?
Buhr: My time is usually 75% research on health care delivery for chronic lung disease and critical care and about 25% clinical work in our intensive care units and lung disease clinic. Lately, my ICU time has gone up about two- to three-fold and I’ve been covering our ICUs for most of the last month.
On a typical day, I come in around 5 to 6 a.m. to try to get my administrative and research work caught up, then go see patients in the ICU all morning. Depending on how busy it is, that can bleed over into the afternoon. I otherwise usually have operations and research meetings all afternoon since I’m part of our pandemic response team.
I usually get home from work around 7 p.m. lately and am on email and writing research papers or grants until 8 or 9 p.m. When I can squeeze in a Peloton ride, walk the dog, watch some “Great British Bake Off” or listen to a podcast to turn off my brain a little, I’m pretty happy about it.
What is a typical day like in your house at this stage of the pandemic?
Murtaugh: Both Russell and I start the workday around the same time. We keep a constant supply of cold brew coffee in the fridge, so Russell can quickly and easily get his caffeine fix in the morning.
I am fortunate enough to be able to work from home, and have been since around mid-March 2020. The workdays are long for us both. We do a lot of texting back and forth throughout the day for moral support and to gauge when he might be able to return home. It helps us determine our dinner plans. Planning meals is challenging these days, and we admittedly do a lot of takeout during the week simply because it provides the needed flexibility when he inevitably gets delayed. Otherwise, I’m often eating dinner alone or it’s a lot of reheated meals and leftovers.
I find it important that we eat together as much as possible because it’s our mostly uninterrupted space together for catching up to commiserate about the challenges of the day and, however small, identify something each day for which to celebrate and be grateful. Some days it’s that a patient came off of the ventilator and is pulling through, and on the tougher days, we simply say “cheers” for our own continued health.
It’s common for Russell to have an hour or more of work to do when he gets home, making phone calls and finishing documentation for his patients, so that things go as smoothly as possible until he heads back in the next day. After dinner, we’ll unwind with a favorite show and maybe make it through one episode before he falls asleep on the couch.
Can you describe how you feel after working a long shift?
Buhr: It’s honestly been exhausting. ICU doctors like me are used to having patients die, but the magnitude of death and suffering has been so much more than usual. Additionally, because of infection control measures, patients’ families can’t come be with them in the ICU anymore in person. We use video chat to try to keep them involved, but it’s not the same. It also means I spend a lot more time calling people instead of involving families on our rounds. It’s really challenging to connect with people and have difficult conversations about what is often the end of someone’s life solely over the phone.
The physical aspect can be challenging ― we do a lot of procedures and I’m on my feet 10 to 12 hours a day typically. The flip side of this is that I do feel very fortunate to have work right now and to be able to contribute to our recovery through the pandemic.
Murtaugh: Even the mentally tough reach a limit at some point. What I notice more of in Russell now is a darker tone of frustration when the hospital is overwhelmed because people are not following masking and social distancing guidelines and the precarity of basic supplies like personal protective equipment and oxygen. It comes from a feeling that the severity of the pandemic and burden on the health care system was largely preventable. There is also more sadness from the increased amount of death he has seen, especially in young, otherwise healthy people that have died alone in the hospital as a result of COVID complications.
“Because we are both involved in the pandemic response, albeit in different ways, it’s become a constant presence in all aspects of our life.”
– Will Murtaugh
I do my best to be supportive by giving him a chance to talk about his day if he’s up to it, or just give him a bit of alone time and space to decompress if he needs it. Decision fatigue has been common as a result of caring for a lot of very unstable patients. So, simple things like doing household chores, planning dinner and ensuring there is a glass of wine in his hand when he gets home go a long way.
Do you have any house rules or safety protocols in place to keep each other healthy?
Murtaugh: We are stringent with following masking and social distancing guidelines, so our biggest risk of exposure is through Russell being at the hospital. He will usually bring a change of clothes to work to have on hand, and when he gets home, he leaves his shoes outside, says a quick hello and goes straight to the shower before anything else. Recently, he has been fortunate enough to be fully vaccinated, so we are grateful for the added layer of protection.
What toll has this public health crisis taken on you personally?
Buhr: We haven’t seen our families in months, which is tough. Will’s family is on the East Coast and it’s been over a full year since we’ve been together with them. Mine is in Oregon and we saw them briefly when we drove up there to go camping over the summer, but that’s already six months ago. We have a very small quaran-team pod of four to five friends that we’ve seen only outdoors for the last 10 months. We’re really hopeful that vaccination will allow everyone to get a little more normal.
Watching people not take public health guidance seriously — both on the leadership side and individual people — has been disheartening. I do a fair amount of media interviews with the lay press. I’ve gotten hate email because I have criticized things like hydroxychloroquine or other unproven treatments for COVID.
How has Will supported you through this challenging time?
Buhr: Honestly, everyone should be so lucky to have someone like Will — who, by the way, in his own right has been doing the hard work as a scientist during this whole thing. He probably doesn’t give himself enough credit, but he’s basically been responsible for making sure all of the testing for a whole set of studies on antibodies has been appropriate and that there’s quality assurance that the studies are doing what they need to be doing to get good quality results.
“I’m not sure how I’d be holding up without him at home.”
– Russell Buhr
I have someone who is able to talk about work when I need to decompress but also talk about not-work, who helps make sure we don’t starve, our pets are cared for, and that I don’t force myself to work into the wee hours. I feel for my colleagues who are single. It’s isolating enough to go through this without seeing friends and extended family much. I’m not sure how I’d be holding up without him at home.
What’s something other people wouldn’t know or realize about being married to a health care worker during the pandemic?
Murtaugh: As an ICU doctor, he is rarely ever completely off the clock. The amount of work that is required outside of the hospital is huge. The documentation, phone calls with insurance companies, and meetings with patients’ families are all part of a patient’s care. Even when he’s not in the hospital, he is often on call, so we have to plan our life as if at any time we may need to stop what we’re doing so he can make it into the hospital to manage an emergency.
What has been the toughest part of being married to a health care worker during this crisis? If there has been an upside, what is it?
Murtaugh: The toughest part has been the worry that he is at increased risk of exposure to the virus while caring for infected patients, and that he could possibly bring the virus home.
There are not many upsides, but there have been opportunities to be a source of trusted information about the severity of the pandemic that I would like to believe has helped improve the behaviors of our friends and family and contributed to keeping them safe and healthy over the last year.
What do you wish more people knew or understood about COVID-19?
Buhr: The biggest thing at this point is the way we talk about COVID as if it’s either you die in the ICU or you’re totally fine — and if you’re young and healthy, there’s nothing to worry about. I have seen people in their 20s and 30s without previous medical problems in the ICU for six weeks on life support or die. The road to recovery after being even moderately sick — and not necessarily hospitalized — can be long and hard. I see patients in clinic who had COVID and weren’t admitted, but three months later are short of breath when walking up a flight of stairs or can’t remember anything short-term anymore.
This is truly a situation where prevention is the best cure, and right now the best prevention is physical distancing and getting vaccinated as soon as one is able to.
Also, since it’s the hot topic right now, the new mRNA vaccines were shown to work really well in large studies of about 40,000 participants and have a great safety profile. I had my second dose this week. And aside from some fatigue and some body aches after — which is just the sign of a good immune response — no major adverse side effects.
I know some people feel like the timeline is rushed. But honestly, if we poured a basically unlimited amount of money into science, had a disease that was affecting the entire population, and had the whole world working on it all the time, we could probably get treatments and vaccines to market on whole hosts of disease fast. It’s a good example of how well science can work when we give it adequate resources and provide government assistance in getting it across the finish line.
This interview has been lightly edited for clarity and length.
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