The re-opening of my acupuncture practice last week — with new COVID-19 precautionary protocols — started out as a complete disaster. At least that’s what it felt like at the time.
Now, a few days later and with a good dose of humoring myself, I can look at it as a comedy of errors.
I’ll tell you what happened in a moment. But bear with me as I tell the story from the beginning.
It turns out that shutting down suddenly was a lot easier than opening back up.
Acupuncturists across the country were among the first to close their practices in mid-March when the pandemic started spreading across the country. Both our nationwide professional organization, the American Society of Acupuncturists, and our state-wide organization, the Maine Acupuncture Society, urged us to shut our doors. Although as health care providers we are considered “essential” in most states, given the close physical contact and hands-on nature of our medicine, we felt nearly unanimously that the high risk of spreading the coronavirus did not warrant the benefits of treatment. Plus, we usually do not use any PPE. We practice thorough hand hygiene and follow a “clean needle protocol” that minimizes risks from blood-borne pathogens. So, most of us did not even stock gloves, let alone masks, face shields, or isolation gowns. And given the scarcity of PPE on the front lines, we could not even get our hands on any, nor did we want to take it away from where it was needed much more.
I closed my practice on March 19, in accordance with Governor Mills’ March 14 executive order to postpone all non-urgent medical procedures. At first, we assumed the closure would last two weeks, maybe a month. I admit that initially, I enjoyed the unplanned “sabbatical”. I usually take a week’s vacation and had never taken off more than three weeks at a time in my 22 years in practice.
My favorite part? Not having to deal with insurance claims!
That month turned into seven long weeks. I sent newsletters to my patients to stay in touch, gave phone consults, and mailed out Chinese medicinal herbs. Some colleagues explored telehealth. Chinese Medicine is such a rich tradition and goes way beyond acupuncture: it includes herbal medicine, diet and lifestyle coaching, QiGong, Tai Ji, and acupressure. But I have always struggled with technology and the virtual world. I’m very much a hands-on practitioner. And I find there’s no substitute for the healing quality of compassionate human touch.
The pandemic had turned my professional identity on its head. All that is at the core of my skillset and that I hold sacred — eye contact, human interaction, touch, palpation, using my senses for assessment, feeling, and redirecting energy blockages — was all of a sudden high-risk, even potentially fatal.
In the meantime, my patients, like myself and most everybody else, experienced the secondary fallout from isolation and physical distancing, job loss and financial unraveling: extreme stress, panic attacks, financial worries, high anxiety, loneliness and depression, sleep disturbances, brain fog, a loss of structure and sense of time, sluggishness and emotional eating, much of which led to an exacerbation of previous chronic pain and illness.
It was painful to realize how much all of these manifestations of extreme stress could have benefitted from acupuncture treatment, but being unable to provide the needed relief.
As Maine and the nation contemplated safe re-opening strategies, our profession met in nationwide weekly Townhalls for acupuncturists. Guidance from the CDC, WHO, and OSHA was distilled into the CCAOM Clinic Infection Control Advisory (CCAOM is the Council of Colleges of Acupuncture and Oriental Medicine). Along with my colleagues, I read through web pages and posts, met in online Zoom meetings, spent hours searching for PPE, and gradually came up with a re-opening plan that I considered safe.
But would patients feel safe and assured? Would they come back?
It didn’t help that my malpractice insurance carrier issued a comprehensive screening and consent form that patients are required to sign now: “I knowingly and willingly consent to the treatment with the full understanding and disclosure of the risks associated with receiving care during the COVID-19 pandemic.”
I scrubbed and disinfected my entire office, took out hard-to-clean and unnecessary items, placed hand sanitizer throughout, posted signs on procedures … it all looks a bit sterile now, but also simpler, clearer.
I had instituted a protocol to meet my patients by their car in the parking lot, ask pre-screening questions, do a temperature check, issue them a mask, have them sign the new consent form, and then escort them inside directly into the treatment room.
I was both excited to be back in practice and terrified about the possibility of exposing my patients to the virus, and my anxiety was sky-high. When my first patient arrived, I saw his car pull up and rushed out of the building before he even called me to report his arrival. I grabbed my car-side screening kit — a converted reusable Hannaford bag, equipped with a clipboard, consent forms, sanitizer, masks, gloves, thermometer — and confidently strode out to the parking lot.
I went through the steps I had rehearsed in my head: sanitizer, check; screening questions, check; temperature, check; consent form, check; issue mask, check. I was ready to escort my first patient into the office for treatment … and realized that I had locked myself out of the door.
Yep. There I stood, in my scrubs, my mask, my dedicated office-only shoes, my Hannaford bag over my shoulder. And no key, no phone, no wallet, not even my glasses which I routinely take off in the office.
And felt like an idiot. I have no recollection of what happened. Either I did not turn the lock fully when I unlocked, or my mind was so befuddled and preoccupied that my hand went into autopilot of “last one out locks the door”. It did not matter. There was no way in. And no one else in the building, as everybody worked from home. And all the phone numbers I could have called from my patient’s phone were in my phone, inside the locked building. Slowly my embarrassment and shock gave way to chuckles. We both started laughing at the ridiculousness of the situation. Nothing has been predictable in this pandemic new world, right, so why would I expect anything to go smooth now?!
After weighing my options, I accepted my patient’s generous offer to drive me home. (I live a mile from my office). My doorbell ringing woke my teenager who slept in on her first day of semester break after successfully completing her college freshman year online. In a file cabinet, I found a copy of my lease complete with a list of emergency phone numbers. I called my landlord to relay the quandary I was in. “What’s your address? I’ll just come pick you up and drive you to the office and unlock it for you.”
There, that easy. I just had to ask for help. Half an hour later I was back at my office, with time to change, disinfect the shoes, and ready for my next patient. This time I aced the routine. I also put the second set of office keys into the Hannaford bag, just in case.
It was good to reconnect to my patient and hear how the pandemic work-from-home while single-parenting three kids and navigating co-parenting with an ex had affected her well-being and thrown her off-balance. And it was satisfying to tap back into my skills and let the right combination of acupuncture points work their magic and create much needed deep unwinding release of tension.
That evening at home, I sobbed and laughed through my own release of tension. My own single-parenting, having-been-out-of-work for seven weeks, worrying-about-money, feeling-lonely, overeating-comfort-foods, confused-and-befuddled brain-fog tension. The self-judgment that I had messed up on my first day back gave way to self-compassion and forgiveness. One of the positives about this pandemic experience is that it brings out our humanness.
In the end that is what matters. A patient who doesn’t mind rescheduling and driving an hour for nothing — “Actually, it was a beautiful drive, and I really needed to get out of the house anyway.” The most generous landlord I’ve known in my half-dozen office spaces — “It’s no big deal, really.”
And it wasn’t. My landlords’ company’s pandemic-related losses are in the six-figure range. My office rent, which used to be a drop in the bucket of their revenue stream is now one of the few reliable sources of cash flow. They have every reason to be upset and are as kind as ever.
We are all affected by this, and showing our vulnerabilities brings out our humanity. That’s the gift we can glean from this. We are in this together, and together we will muddle and stumble through learning new routines and new habits of keeping each other safe as we navigate this new way of being together.
And with our masks on, we can still wink at one another and laugh together with a twinkle in our eyes.
This post was originally published on Catching Health With Diane Atwood.