I'm a Mom and a Pediatric Emergency Physician: This Is What Life in the ER Really Looks Like for Kids

As a doctor, I was as ready as I could be to battle COVID-19 on the frontline. But the physical toll I've seen my patients endure from coronavirus is nothing compared to how they've suffered mentally.

Mom and doctor
Photo: Caitlin-Marie Miner Ong

As the number of confirmed cases of COVID-19 started to rise in the United States, hospitals throughout the country, including my own located in South Florida, began to prepare for the surge. We expanded bed capacity and built triage tents to mitigate exposure. Local governments scrambled to make sure we had enough ventilators and personal protective equipment (PPE) for the nurses and doctors.

As physicians working in the pediatric emergency room, we quickly prepared to fight on the frontline by learning proper triage for COVID-19 patients and had algorithms to determine which patients were deemed appropriate to test. We were re-educated on how to properly put on and take off PPE to decrease our risk of exposure.

My colleagues and I were also prepared for the chance we would have to treat adults. (I'm a pediatrician and haven't treated an adult in more than 10 years.) We received PowerPoint presentations on adult dosing and adult vent settings. Fortunately, our adult emergency room colleagues were able to handle the patient volume, and we were able to focus on what we do best—treat kids.

Honestly, I have felt as prepared as possible to fight COVID-19. Our hospital administration has done an incredible job of making sure we are all well-educated and protected. But there was one thing I wasn't prepared for and it's arguably something that can be just as dangerous as the physical complications of COVID-19. That's the emotional toll COVID-19 is taking on my patients and all of our families.

I wasn't at all prepared to comfort the 15-year-old boy who became an orphan after losing his only parent to COVID-19. Or the 7-year-old boy in a complete panic and shivering because of his new cough and the fear of what that cough might mean. I wasn't prepared to wipe away my daughter's tears when I explained to her why she couldn't play with her cousin who lives just 10 doors down from us, or why she was no longer able to give me a running hug when I walked in the door from work.

Life just looks different now. In order to mitigate as much risk as possible, I change out of my scrubs before leaving the hospital, remove and leave my shoes outside, and immediately shower before greeting my husband and children.

I wasn't at all prepared to comfort the 15-year-old boy who became an orphan after losing his only parent to COVID-19.

Overall, we are lucky the virus mostly causes more mild symptoms in the pediatric population and not the same severe respiratory complications that are so concerning in the older population. However, multisystem inflammatory syndrome in children (MIS-C), a rare but serious health condition, has become the recent focus of the pediatric health community. While there is still a lot unknown about the syndrome, we are asking parents to contact their pediatrician if their child has fever for more than 72 hours, abdominal pain, rash, or difficulty breathing.

Since the pandemic started, the number of cases of pediatric illness and injuries being treated in the emergency room has decreased. By staying home to protect the community from COVID-19, we have simultaneously decreased the spread of other common viruses and bacteria we treat during the spring months. But what I am treating more often is panic attacks, drug abuse, and depression among the adolescent population.

It's understandable, as COVID-19 has changed lives of kids in so many ways. It's led to remote learning and canceled graduations, sports, playdates, and events. Structure and routine are gone while uncertainty looms. This can all be incredibly scary and provoke anxiety.

I now really see how important it is for us to help our children with their emotional needs. I've been offering tips that I've been using on my own kids to parents whose children I am treating. (I've also shared these tips on my website Forever Freckled for parents who need more guidance.) My advice: Limit your kids' exposure to the news, which can be frightening, point out the good that's still taking place in the country like those helping out, try to maintain a routine as much as possible, and make sure to focus on your own self-care too. You deserve it!

As we start to reopen the country and life returns to some sort of normal, I know the number of cases of bumps, bruises, and rashes will begin to rise again. Although I will enjoy treating the common pediatric aliments and injuries, this pandemic will continue to remind me, as both a physician and a mother, that our children's mental health is just as important if not more important than their physical health. As parents, we need to check in on our children and make sure they are remaining mentally healthy while navigating this new normal.

Katie Friedman, M.D., is a board certified pediatrician, wife, mother of two, and sister. Along with her two sisters (Alison, a veterinarian, and Carrie, a fashion stylist), she is co-founder of Forever Freckled, a website dedicated to helping people with their pets, children, and everyday lifestyle. Nothing brings her more joy than helping children and their parents with wellness and healthy living. For wellness and health tips for children and pets, as well as lifestyle advice, follow their journey on ForeverFreckled.com.

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