Family Physician Hunkers Down to Fight COVID 19

My name is Stephanie Segal and I’m a Family Medicine physician at Kaiser. Denver, CO

First *confirmed* case of COVID-19 in Denver area was Thursday 3/5.

Over the next week, cases increased every day. We put clinical teams in place to react to positive “screening questions”, but watching things escalate in Italy a couple of my co-workers and I wondered if it was enough. I started stripping down in the guest bathroom as I walked into the house and taking a scalding hot shower every day after work.

Monday 3/16 I moved out of the house. The day before I made my big Irish meal a couple of days ahead of time, knowing I wouldn’t be home on St Patty’s Day.

Monday morning at work, we started mobilizing. In one week we are switching to 2/3 virtual care, 1/3 face to face care. We have a plan to have COVID testing/suspects in a few specific locations, “clean” clinic sites for other health issues. We’re bringing in military tents to set up testing centers. I feel like we’re mobilizing for battle, and we’re actually using military terms like “deployment.” Urgent care docs will be “deployed” to hospitals. They’re begging family docs to sign up for urgent care shifts.

I told my kids I’d be gone a couple of weeks to start, but I knew it would be longer. I told them all yesterday I’d probably be gone for months. Thank God I can video chat with them every day. We had a “virtual movie night” yesterday and I amused myself by trying to get our audios in synch.

We also had a serious chat about what they need to do to keep the household going.

My husband and I are updating wills.

My emotions are all over the place.

Intense exhilaration of being on the front lines.
Sadness of being away from my kids.
Liberation from all the stupid bullshit I usually worry about.
Fear. I am the opposite of a germaphobe but I’m really f”**ing scared of this one.
Disbelief that people are still going out to restaurants.
Anger for the families in the neighborhood not listening, letting their kids play close together.
Regret that I have not spoken out more forcefully the past week.
Proud that I can do something to help.
Humbled by the kind words from patients, calling me a hero.

Keeping busy is my go-to reaction in stressful situations.
I’m trying to grow from this and schedule time outs for myself.
I could sit on my computer and do virtual care 24/7, the need is so great.
I could sign up for double Urgent Care shifts. I actually am signing up for extra, because we are keeping doctors over age 60 and with other high-risk factors on 100% virtual care.

So I’m trying to schedule myself SELF CARE blocks and yesterday I actually did it! I called my oldest and gave him a “man up” pep talk. I went for a walk. I closed my computer and stayed off my phone (mostly) for 3 solid hours.

The phrase I keep using is “the bomb is ticking.”

I hear it in every sniffle.

I hear it louder every time there is a new positive.

I hear it in every teacher calling because a student’s teacher tested positive…I hear those silent carriers.

I hear it leaping from the pages if every dystopian virus novel I read as a teenager.

By the time you share this, the bomb may have detonated here.

Thank you, Dr. Segal, first and foremost for the incredible sacrifice you’re making to care for patients and help during this time. Your work is heroic. Stay safe and keep us posted. We are proud of you and very much appreciate all you’re doing.

Heather

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7 Comments

Jane Zendarski on March 21, 2020 at 3:05 am

Wow! A powerful post. Amazing woman, Dr. Segal. I am afraid. I wish I was as brave as her. What concern for older physicians like myself, to put them only in video/telephone visits.

Reply
Lynette Charity MD on March 23, 2020 at 1:59 am

Dr. Segal, first and foremost, thank you! I applaud your ability to be in the fray, but also take time for your self-care. I am retired and over 60 and watching all of this from home. I can’t image the emotional trauma this is producing within you. Well, actually, from your post, I can. My son works for Google and is on “lockdown” in Mountain View, CA. I video chat with him everyday. Like you, it gives me some semblance of “normalcy” in the present abnormal world. That is all we can do right now. And you are doing all you can do right now which includes taking personal time to recharge. Thanks for the idea of “virtual movie night”. I’ll have to ask my son how to do that.

Please keep us up to date on what’s happening on the front lines, but also do not take on more than your physical and mental state can handle. We need you for the future of healthcare. You are dedicated! You are strong! You are wonderful!. Stay safe.

Reply
- Heather Fork on March 23, 2020 at 2:29 am
  
  Thank you both, Dr. Charity and Dr. Zendarski, for your super supportive comments for Dr. Segal! I agree 100%. It takes a lot of courage to risk your life to care for others. We’re wired to run from danger, but she is answering the call to serve. This is the work of heros and heroines and I really hope, Dr. Segal, that you are feeling the appreciation and support of others. You deserve it. I agree with what Dr. Charity wrote, to make sure to take care of yourself and stay as safe as possible. Your health and life matter. I hope that this COVID crisis, with its great demands on healthcare workers, leads to a return of the respect for physicians and others who give so much to care for patients. There has been a disheartening decline in how we treat those who sacrifice so much to care for us that it is no wonder many doctors feel relieved to not be on the front lines. There would be more physicians feeling like Dr. Segal, I believe, if physicians were given more respect and autonomy. Physicians are willing to work long, hard hours, and give up many things to do what they trained to do, but many feel betrayed by the very system that acutely needs them. Thank you Dr. Segal for answering the call. You are making a difference.
  
  Reply
The All England Practice on March 24, 2020 at 5:14 am

WOW! This is very impressive and very helpful.

Reply
- Heather Fork on March 24, 2020 at 1:33 pm
  
  Thank you very much for reading and commenting!
  
  Reply
Aaron Segal on March 25, 2020 at 5:26 pm

That’s my wife.
She’s a badass. In so many ways.
❤

Reply
- Heather Fork on March 25, 2020 at 5:58 pm
  
  Hi Aaron!! Proud of you and her.
  
  Reply

"Heather’s approach was great! She would listen to me and helped me appreciate who I am."

I remember when she said ‘do your resume before our next meeting’, I was about to push back but she gently nudged me along and I’m glad I did exactly what she wanted me to do. We also did interview prep via Zoom and I was offered a great job in UM. She has continued to follow up even after I was offered this job, helping me with pointers about negotiating. I will totally recommend the Doctors Crossing and Heather to anyone feeling stuck like me and looking for a great coach! Thank you Heather!

- Modupe Oladeinde, MD

Family Medicine

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- Tim Owolabi, MD

Family Medicine

“I was at a crossroads in my medical career. I asked myself, "Do I stay or do I go?"

I met Heather at the SEAK conference. She and I revisited this question. Did I want to quit being medicine completely? She helped me to identify my needs, wants, and my vision for my FUTURE, not just in medicine, but in life!!!

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- Lynette Charity, MD

Anesthesiologist

“I am forever grateful to Heather for helping me to recognize, I am more than just my M.D."

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OB/Gyn physician

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Papillion, NE

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Orthopedic Surgeon

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Pathologist

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Colorectal Surgeon

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Through our work, I learned to trust myself to make good decisions for my own future – something I hadn’t realized I was struggling with because as an emergency physician, I make life-changing decisions with patients every day.

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Emergency Medicine Physician

“The simple truth is - Heather Fork totally helped me change my life."

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When I first started working with Heather, I was downtrodden...I’d been practicing medicine for 20+ years and yet had never quite found my place. During the first year I worked with Heather, I left the practice I’d been working at, and recreated an entirely new professional purpose.

I’m now an executive and leadership coach, a university professor, and a Brené Brown Daring Way facilitator, and I have never looked back. I love what I am doing more than at any other time in my professional life and I credit Heather with seeing in me what I was never able to see in myself, until now.

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- Amie Langbein, DO

Family Physician

"After 30 years in academic medicine, I wanted a career change but had no idea where to start. Medicine was all I knew."

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Endocrinologist and Life Coach

"Heather was my source of hope during a time when I felt stuck and confused. She gave me the permission and confidence to reach higher than I believed I could."

After graduating from residency and starting a family, I lost sight of why I became a physician. I struggled to convince myself to stay in a career that was clearly the wrong fit for me and my family. My anxiety about work was at an all-time high when I reached out to Heather. She provided something that my mentors, friends, and family could not – rather than just offering career advice, she changed the way I think about my life so that I could understand how my career would fit into it. I realized I wasn’t ready to give up on medicine and eventually found a job in academic medicine. I finally feel that excitement for medicine that I used to feel when I was in training. More importantly, I feel like I can be the role model to my young daughter who may one day also face similar challenges between career and family. Thank you, Heather, for all your kindness, support, and skillful coaching! The experience was life-changing!

- Yuri Shindo, MD

Internal Medicine Physician

"As a Physician, your personal and even professional needs are often overlooked. I learned how to prioritize my career goals by working with Dr. Heather Fork."

She taught me how to put into practice what I knew in theory, that taking care of myself was a priority. I learned to give myself permission to make the career choices that would give me the work-life balance I desperately craved and needed. The process of confronting fears and insecurities was a bit scary, but well worth it in the end. I am now a happier version of myself with a non-clinical job that I truly enjoy!

- Camille Gardner-Beasley, MD

Family Medicine

"After 10 years in outpatient family medicine I felt stuck and knew I needed a change but I didn’t know where to begin. Thankfully I found Heather and she guided me every step of the way."

She helped me carefully assess my interests, strengths and passions while also providing me with constructive changes to implement in my job search and resume. With Heather’s help, I just landed a fully remote UM position and I am also exploring coaching as well. Now I feel like the possibilities are endless and I’m excited for this next chapter in the nonclinical world! Thank you Heather for changing my life for the better.

- Ana Jacobellis, DO

"I'm truly thankful to have had the opportunity to be coached by Heather, she is not only a resourceful mentor but a wise and supportive friend. I'm honored to recommend Heather to all my friends and colleagues."

I had been a practicing Internist for 20 years when I reached a point when I needed to make a serious change in my career path. While I enjoyed seeing patients, I was not satisfied with my life-work balance. My job was taking me away from my family and left me little time and energy to do other things that are important and meaningful to me. I came across Dr. Fork's podcast; The Doctor's Crossing Carpe Diem Podcast, it is such an informative and enjoyable podcast for any physician who wants to do more with their career and life in general. Then I had the pleasure to get career coaching from Heather, it was truly an amazing experience. Heather has broad knowledge of all the different career paths that are available for physicians, she is so insightful and very easy to talk to. She helped me clarify my goals, examine my own mindset and definition of success. Together we developed a clear plan and actionable steps to reach these goals. I eventually made a career transition to a remote non-clinical position that allows me to do meaningful work which aligns with my personal and professional goals and priorities.

- Abbey Awad, MD

Internal Medicine

"There have been a handful of people who have come into my life and changed it, and Heather is one of those people."

From the very first interaction with Heather, it became abundantly clear that she possessed a systematic approach and a methodology firmly rooted in my focusing on my goals and aspirations. Heather's coaching sessions helped me dismantle limiting beliefs and unearth the capable woman, mother, and physician within me. Under Heather's guidance, I began to dream again. I rediscovered my passion for writing, found the courage to share my stories, and even launched my own coaching practice. Today, I specialize in helping others conquer imposter syndrome and overcome burnout, empowering them to lead meaningful and fulfilling lives. Working with Heather fundamentally shifted my perspective and allowed me to show up authentically in every facet of my life, resulting in a profound sense of fulfillment.

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- Maria Dominguez

Emergency physician and coach

"I'm so glad that I worked with Heather last year."

Making a career shift can be a lonely time, and Heather was there every step of the way with encouraging words. She helped me gain a better understanding of the breadth of careers available to physicians, as well as giving me the tools to make that leap possible. My life is better than I ever thought possible. I'm happier, healthier and doing work that I love. My only regret is that I didn't do this sooner.

Caitlin M.

"Heather provided invaluable insight during our one-time consultation."

She quickly helped me recognize an area where I was limiting myself and encouraged me to explore new possibilities. Her sound and supportive guidance empowered me to take the next steps in launching my parent coaching services. I’m grateful for her support and highly recommend her expertise!

Reshma Shah MD, MPH

"Heather taught me that 'the truth will set you free'."

I sought Heather’s guidance after practicing outpatient internal medicine for many years, as it was getting difficult to balance my role as a clinician while meeting my needs and those of my family. After our first consultation, I felt like I was seen and heard for the first time in my career. Working with Heather helped me identify my strengths, weaknesses, fears, and goals, and ultimately guided me to a non-clinical role that better aligned with my needs and aspirations. I am deeply indebted to Heather for the impact she has had on my personal and professional development. She is one of the most influential people in my life and I continue to seek her guidance years after our initial encounter. She once said that “we are happiest and most successful when we are using our skills and abilities at their highest level.” Heather will help you discover your truth. Thank you for your incredible work and friendship!

Megan Leivant, MD

Internal Medicine