I was a fourth-year medical student doing my last clinical rotation when COVID-19 began entering Boston hospitals in March of 2020.
I was told to track patients who came into the emergency room with issues that weren’t respiratory in nature back when the efficacy of wearing masks was being debated.
On my way to work, I noticed how the provisional testing area in the hospital lobby swelled like a pregnant belly, adding more official-looking opaque glass to hide all the activity within.
One night, while she was wiping down her monitor, mouse, and keyboard with numerous disinfectant wipes—a new ritual that would mark the change of shift—the chief resident told the house staff, “Patients with suspected COVID will be attending-only.”
Every day at the ER felt like a dance with the unavoidable. Every patient meeting seemed like it could be my last as a student as more medical schools canceled the curriculum.
Did I consider every possible reason for irregular uterine bleeding in a lady who nearly passed out during her period? Did I address a crucial question to a patient who came in with severe back pain? Nonetheless, I couldn’t concentrate entirely on these clinical problems without being distracted by the pandemic.
The worry of graduating from medical school without knowing everything was masked by the concern of nearly everyone in the hospital: would I catch the coronavirus? Will I pass it on to my family and friends? And, more importantly, for me, what does this mean for my June wedding?
No one was happier than my dog when my rotation was eventually canceled later that month. (A close second was my fiancée.) As I took off my scrubs and climbed in the shower after every shift, his furry face would emerge from the crack of the front door as soon as it opened, tail wagging, feet pouncing. Our puppy was overjoyed to have both of his humans home with more time than we had ever had when that ritual ended with the suspension of medical school rotations.
My companion, an M.D.-Ph.D. the student had just finished her qualifying examinations and was about to start her field study, which had been put on hold indefinitely owing to the pandemic.
We spent our newfound free time walking the dog for miles and studying how to maintain correct social distance.
We worked out the thorny elements of what was quickly becoming an increasingly intricate bicultural wedding during these walks.
There were a lot of perspectives on how to best commemorate the union of their children because each of us had a pediatrician for a mother—and each of us inherited the other as a second.
What started as a nondenominational wedding evolved into a delicate balancing act honoring both my partner’s Protestant upbringing in the Pacific Northwest and my own Sri Lankan/Buddhist ones.
We were initially given three different ministers to conduct two distinct religious services when we wanted a buddy to officiate a single ceremony.
The question of which ceremony would be the formal ceremony was not so much posed as it was asked directly.
We were left wondering who this wedding was for after spending hours going through various color schemes, family accommodations, and dress clothing.
My fiancée and I were fatigued and looking for a way out when the pandemic struck.
At each controversial junction of wedding planning, the stress of qualifying tests and residence applications grew harder.
We used to joke on our walks with the dog that our families’ crazy would push us to be married on the spur of the moment at the city courthouse.
However, as the lockdowns continued and the number of cases increased in March, the chances of our wedding in June dwindled.
During these walks outside, we battled to keep the puppy six feet away from strangers, and a weeks-long decision emerged. Do we wait for the pandemic to end, unsure of when that will be? Or should we be married now and hope for a later party?
My girlfriend began having nightmares in which I was hospitalized due to COVID-19, including one in which family members were debating whether or not to take me off a ventilator after days of respiratory support in the ICU.
My boyfriend insisted that we consider such a situation as I approached graduation and internship amid an ongoing stream of health care personnel and patients dying from the virus.
“I want to be the one to make those choices. And I believe that indicates we should be married right away.”
That’s exactly what we did. We walked to City Hall on a chilly Boston morning to fill out our application for a marriage license in preparation for an unplanned wedding a few days later.
Based on the weather forecast for the week, we chose a Tuesday with the lowest likelihood of rain. Our guests received a hasty e-mail advertising a virtual ceremony that could be viewed online.
My fiancée’s godfather gladly agreed to officiate the wedding outside his home, and the three of us spent most of Monday night revising vows and the ceremonial procession. We were fatigued yet eager when Tuesday morning arrived.
The absurdity of condensing months of planning and 200 guests into a little ceremony broadcast over patchy Wi-Fi was best emphasized by our hunt for flowers: the best we could find was a cactus from CVS.
Fortunately, that was the day’s only issue (some neighbors had collected daffodils from the local church). We were pleased that we had somehow turned the stress of sophisticated wedding planning, combined with the worry and destruction of COVID-19, into a day where we could move forward with only a few socially distant people physically there and despite our relatives and loved ones being miles away online.
My partner’s godfather used a phrase from Arundhati Roy’s latest piece in his processional remarks, saying, “Historically, pandemics have compelled humanity to break with the past and imagine their world anew.” This one is no exception. It’s a portal, a passageway from one universe to another.”
In the days after the wedding, we referred to that portal frequently, believing that by taking these tremulous steps through it, we were acknowledging the coronavirus’s turmoil and disproportionate loss—but not allowing the pandemic to hold us back altogether. We were unsure throughout the procedure and hoped we were on the correct track.
My partner was about 30 weeks pregnant when I finally got COVID in November.
I felt achy and feverish the next day after a particularly stressful hospital day during my first several months of residency, and I was tested the next day.
I cried alone on an air mattress in what would become the nursery for our infant when I was called back with the positive result, my partner and dog on the opposite side of the wall in our bedroom, doing their hardest to stay away from me.
We were quite fortunate. My partner was able to keep virus-free despite evidence that COVID could increase risks and problems in pregnant women.
We were able to get her out of our flat using our resources, information, and networks while I was quarantined. My illness was mild and self-limiting, and I never came close to needing a ventilator. I was cleared to return to the wards ten days after my symptoms began.
The weight of the judgments we made lingered, not any loss of breath or muscle fatigue.
We looked forward to what the future could hold after the high of our chaotic wedding. We saw a flexible window beginning to close as we approached our 30s with an imminent dual-physician household.
The pre-pandemic goal was to try to have a family immediately after marriage, taking advantage of the fact that only one of us was in residency at the time. We paused and revisited this timeline as COVID-19 became more widespread.
Is it possible that we’ll be able to pull this off? Is this something we should do? There was no end in sight to the pandemic at the time, and we didn’t know if we’d be waiting months or years.
Experts recently noted that, in the lack of a comprehensive national guideline on whether to delay or pursue conception, what we know about COVID-19 might not merit a formal, blanket recommendation on whether or not to get pregnant during this time.
We reasoned that if we could be cautious and responsible, then it wouldn’t be ridiculous to at least try? If we were able to overcome our families’ difficulties to marry during this time of turbulence, then perhaps we could take the next steps in our lives together despite the pandemic’s continuous uncertainty?
We had no idea how difficult it would be, as many could have guessed.
It became increasingly difficult to protect my boyfriend as I went to the hospital every day. Every minor cough became a source of concern.
When we passed neighbors who weren’t wearing masks, or when we failed to hand sanitize before entering our house, we’d get a panic attack.
It was tough not to be present at my partner’s ultrasounds and testing, despite taking all the necessary procedures to keep pregnant women safe, including at appointments—though waiting in the parked car with the barking dog helped me feel somewhat connected.
It was also more difficult to manage the expectations of our families, who were accustomed to being involved when our major communication became virtual rather than in-person.
Our landlord’s decision to perform an impromptu refurbishment in one of our multifamily units contributed to our anxiety.
The knowledge that I had exposed my wife and the unborn kid to COVID-19 and its maze of spiraling pathology and sequela was by far the most distressing thing.
During her third trimester, the weeks we were away were spent practically checking in on her symptoms, nervously anticipating test results, and counting down the days until we could be together again.
We had never felt more relieved and fatigued than when her last nose swab came back negative.
My partner and I weren’t sure we’d do it again as we counted down the days until we met our kid.
In early February, he arrived, entire and unbroken as far as we could tell—perfect in our eyes, if not in the manner in which he arrived.
Though we are thrilled and glad to be parents, we have discovered that it is a lot easier to say “I do” in the midst of a pandemic than it is to perform the difficult job of raising a family.
And there is some remorse in adding another human to our lives when so many individuals have lost so much.
We hope the exit of this doorway is within sight as the pandemic’s tide continues to ebb, flow, and adapt.
As people throughout the world consider how the coronavirus shifted the axes of their worlds—and as they consider the decisions, indecisions, and nonchoices made under the shadow of the pandemic—we will continue to assess each action and take careful steps ahead, one at a time.
The author is: Sandhira Wijayaratne is a psychiatry resident at Yale-New Haven Hospital.
