David Rosen, MD, a critical care pulmonologist based in Bergen County, NJ, arrived home from a 3-day stint in the ICU. As usual, he changed his clothes in the garage, put them in a plastic laundry bag, and, clad only in underwear, he headed straight for the guest room shower.

Earlier that day, Rose had seen five patients very sick with COVID-19, in a hospital with only four ventilators. He was devastated by the agonizing situation that had ensued. How could he force a smile and pretend everything was okay when he greeted his young children? On the other hand, he didn’t want to burden or frighten them.

Rosen’s 6-year-old daughter could tell something was wrong. Rosen carefully explained that Daddy was sad because there were a lot of sick people in the hospital and he couldn’t help all of them.

“There’s a constant balancing act between being there for patients, acknowledging my own feelings about their suffering and the horrors I’ve been seeing, and being there for my own family and their day-to-day emotional needs,” Rosen said.

While this balancing act is part and parcel of being a physician, it has been especially wrenching during the pandemic, when the needs of family seem to be pitted against the calling to be a doctor.

What if I Make My Children Sick?

Fear of infecting children has motivated some to stay in hotels, send their children to live with grandparents, self-quarantine in a separate area of the house, or avoid physical contact with the children, according to Sara “Sally” Goza, MD, president of the American Academy of Pediatrics (AAP).

“These are hard, anguishing choices, which contribute to stress and burnout,” she said, emphasizing that it is a very personal decision, based on individual and family considerations, and no single solution will fit everyone.

Rosen said that staying at a hotel was not an option for him because he has a newborn baby, a 3-year-old, and a 6-year-old. “It would have been an unfair expectation for my wife to shoulder all those parenting duties without any help from me.”

He added, “Of course, I’m always concerned about potential contagion and I take every precaution through rigorous decontamination procedures, but I remind myself that it’s right for our family for me to be as present as possible at this time.”

Ilana Friedman, MD, a pediatric ophthalmologist, starts her workday well before she leaves for the Bronx, New York-based hospital where she is the associate director of a residency program.

“I’ve been setting the kids up for school in the mornings, making sure they have the food they need for the day, that they’re organized and ready to begin their online classes, and that their schoolwork is done,” she said.

“They also text me during the day if something comes up, and I check in with them to make sure they’re on task with their work,” reported Friedman, whose children are 10, 11, and 13 years old.