Advocate Stories, Be The Voice, COVID-19, Health and Education

A Message from the Front Line

by Dr. Jessica Tarleton, MD, MPH on Mar 27, 2020

As physicians, we are used to sometimes working in gray areas.

We may feel internal unease when we counsel a patient that we are not sure whether this treatment or that will be better, but we or our patients must choose.  The gray areas of these days, though, feel different.

There is duality of telling people to stay home while continuing to show up for work mostly as usual.  While we always try to reduce the risk of spreading infections, there is no option for standing 6 feet apart when it is a feat in itself to fit a patient, a medical assistant, and myself into an exam room.

While we have reduced our clinic schedule by a third to a half, it’s not quite as simple as deciding whether a visit is necessary enough to keep today versus…. When?  What about the healthy woman with belly pain, which is likely to resolve on its own without treatment, but could be the first signs of an infection or cancer?

The safety of my patients, myself, and my family are dictated by twice daily emails.  They promise hopeful moves towards more testing and more telehealth capabilities, but when these things are actually requested, they are not quite ready.  Half of the text is verbatim from yesterday’s email, copied forward without edits, leading one to question… are we really moving forward?

Meanwhile, for the past 10 years, I have meticulously gowned and gloved for anyone with even a history of MRSA 5 years ago.  Now I am being told that cloth masks and bandanas are probably fine to protect me against a virus that will kill one out of 30 people it infects.

Meanwhile, the leaders of our country and our state are doing worse than nothing, they are actively sabotaging public health efforts to control the spread of this virus.  We know that public health isn’t just defined by epidemiology and biostatistics, the numbers, but also by health behavior and health communications—how we communicate health and risks, and what people do in response.  At every juncture, our president is recklessly manipulating this delicate science to appear infallible and under control.  In medicine, we know we are never infallible.  We learn, we practice, but we can never be sure.

The gray areas of being a doctor these days feel different.  We live in them constantly now, the unease taking over every waking moment.  Even the black and white are harder to define, further apart, and more consequential.

And so we wait for the next email, and wait to see what our reality will be later today, and tomorrow.


Jessica Tarleton, MD, MPH

Obstetrician and gynecologist, Charleston, SC

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