1. Huycke, LaRae DNP, RN,PMHNP-BC, ACNS-BC


Early in the pandemic, a telehealth appointment with a long-term counseling patient takes a terrifying turn.


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The time I spent with her seems so short, but in actuality it made up nearly a fourth of her life. We had traveled though the awkward adolescent years, the landmine of her parents' divorce, the loss of a beloved grandmother, and a failed relationship that ended her dreams of a prom date. She first came to me after hospitalization when her suicidal thoughts became so ferocious she was afraid to be alone. After weeks of individual therapy and family counseling, and then the addition of medication, she started feeling better, and one day she came in smiling. I can't remember what brought the smile to her face, but I clearly remember the day.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

Over time her mother became more trusting of the relationship her daughter and I had forged. We marked the passage of time with birthdays, her first driver's license, and her first part-time job. Then there were college applications and an acceptance letter. Her university would be just far enough away so her family couldn't "pop over" but close enough for her to know they were there.


When she went away, I only saw her during school holidays, though her occasional notes let me know how things were going. When she did come to my office, her words would flow out in torrents. I marveled at all she was learning about the world and herself. She would assure me that she was still in therapy at her university and was taking her medications.


When she called to schedule her appointment for spring break this year, she asked for more time than was typically allotted. Perhaps she wanted this to be the time our formal relationship ended. Maybe she just wanted more time to catch up.


As the spring break came, so did the coronavirus. I moved appointments to video or phone, the university closed its campus, and she moved back home with her mother. I was happy to see her name on my schedule one day when I got to my office. When I called her number, there was no answer. I tried several more times. She had confirmed the appointment several days before, and a sense of unease came over me. This wasn't like her. I decided to call her mother.


Her mother sounded anxious when she picked up the phone. As she carried it to her daughter's room, the image on the screen bounced erratically, revealing a whirling ceiling fan, bookshelves stuffed with items that mark a young woman's life, a sleeping dog. I could hear breathing and a stifled cough; finally, her daughter's face came into view. She was lying on her side propped up on pillows. Her skin was damp and shiny, and her dark hair stuck to her head as if it had been painted there. With effort she said she was sorry but didn't feel well enough to sit up and talk to me. Her mother explained that she had become ill about 12 days earlier and her physician had sent her for COVID-19 testing. Six days later they were informed the test was positive. By then, she had grown more ill.


An ambulance had been called to her home the night before. The EMTs told her frightened mother that, yes, she had a low-grade fever, but her blood pressure and oxygen levels were good; she was not so ill she would need hospital admission right away. Carefully they had explained what to do if things worsened. Now, some 14 hours later, I told her mother to go to the other phone and call the ambulance. I stayed on the line with her daughter, afraid she would die alone. By now only the top of her face was visible on the screen. When her mother came back, she said the ambulance would be there soon. I told my patient that it was time to hang up. She looked at the phone for what seemed a long time-then, blinking rapidly, she said with great difficulty, "I hope I will get to talk to you again." I assured her she would. Then I heard her mother take in a deep breath and the phone went dead.


In that moment and in those words, I had a new appreciation of the unrelenting nature of time. In all the moments we had shared, I had been given the gift of her time and she had had mine. I had not lied to her in all those hours along the way, and it is still true today.


I now know that not all of us will make it to the other side of this pandemic. For those of us who do, our lives will be forever changed. We will need to help those who have lost a loved one and those who nearly lost their lives. The residual effects both physical and emotional will demand our attention and care.


In the beginning of this pandemic we took our time. Now out of financial calamity, boredom, and a need to express our independence, we want to hurry time. But what we as the nation's health care providers must not do is waste time.