With the outbreak of COVID-19 and approximately a third of the world’s population currently living under lockdown conditions, we truly are living through one of the most extraordinary events of our lifetimes.
While we are all finding our way as we adjust to this ‘new normal’ (on top of managing a myriad of emotions that this pandemic is bringing up for us collectively and individually), we know that the experience of being ‘in lockdown’ is presenting a unique set of challenges for people with eating disorders, and therefore our AED community.
Over the coming weeks, I will be sharing conversations I’ve had with members of the eating disorders community on how this global crisis has impacted their lives and their work. My hope is that these conversations will provide points of solidarity, insight, hope, and courage as we move through and forward.
On this week’s AED Lockdown Blog Series, I speak with Suzanne Dooley-Hash, MD, FAED, Associate Professor of Emergency Medicine at the Department of Emergency Medicine, University of Michigan Medical School. As one of the very few ER doctors in our AED community, Suzanne offers a really unique insight on the current crisis. She was so fun to speak with and I want to do a follow up interview so we can talk about her animals!! Note, we spoke mid-April.
Suzanne Dooley-Hash, MD, FAED
Nadia: How are you today?
Suzanne: I’m doing good today, except it’s snowing! I’ve probably got two inches in my yard and it’s supposed to snow all day. It’s crazy, last week it hit 70 (degrees F). Michigan weather is dumb!
Nadia: Whoa – that’s quite a switch – do you need sandals or snow boots?! My goodness! Anyway, I’ve caught you on a day off… Are you normally off work on a Friday? What’s your schedule like?
Suzanne: So, my schedule is highly variable, and it changes every week. I work some day shifts, some evening shifts, some overnight shifts.
Nadia: Right, the life of an ER medic! So, has life changed significantly since the outbreak of COVID-19 in the US and since lockdown?
Suzanne: My life hasn’t changed as much as many people’s because I’m still going to work. My husband is still working also. The big difference for us is our son who is a senior in high school, and he has been off school since late March. Obviously, we can’t go out with friends and there are some things we can’t do, but our lives haven’t changed as much as other people’s.
Nadia: That rotten for your son with missing the end of his senior year of high school, I’m sorry.
Suzanne: Yeah, he’s in theatre and he got the lead in the Spring Play so that’s disappointing especially. It’s not the end of the world, but you know. Hopefully they are still going to have a graduation ceremony.
Nadia: Yes, fingers crossed. It might not be the end the world relatively speaking, but stuff like that still really sucks. What about work, how are things at the hospital?
Suzanne: I’m lucky. I work at a really good place (University of Michigan) and I think they’ve handled it all really well. But it’s been very very different from normal. We actually have fewer patients than normal in the emergency department but the patients we have are a lot sicker than usual because a lot of them are COVID-19 patients – and so when they come in, they are really sick. So, the patient population is smaller, but sicker and it’s a totally different kind of stress.
I think the biggest stressor is the uncertainty – is today going to be the day when we have a big surge of patients come in at once, all crashing at once? It’s also the unknown. It’s a disease we don’t know, we don’t know how it acts. Every day it seems like something different happens. Like one day, we think we’ve got something figured out and the next day it’s totally different. So that part has been really, really difficult. The news also keeps changing - there’s always a different theory or a different medicine that might work. It’s hard to keep up and there’s a lot of fear we are doing it wrong because we haven’t got the latest update. It’s definitely challenging from a clinical standpoint just to know the right thing to do and how to do it.
Nadia: Gosh, I can only imagine. How are staff managing with that at the hospital?
Suzanne: Our community has been really cool. There are signs all over the hospital saying, “thank you, healthcare workers” and “heroes work here” – people have been really supportive. Our local restaurants have brought in food every day to feed the department. It’s been good. We are also really lucky at our hospital in terms of preparedness. There are hospitals around us who have had it a lot worse.
Then we have a team whose job it is all the time to keep people happy… so I think they’ve maybe stepped it up a bit. There have been potluck dinners and sometimes someone will bring in treats for everybody. But I think generally it’s about keeping people informed. We get daily updates from the hospital, which is really helpful, as well as encouragement to do things in our outside lives, which is really important. There are definitely days when it feels more positive than others.
Nadia: I believe that! Are you having to do extra shifts at the moment?
Suzanne: Yeah, some, which is hard because as I said, we are actually less busy overall, so shifts are actually, in some ways, ‘easier’ because we are not seeing the volume of patients. But we are covering shifts for colleagues who are more vulnerable (e.g., pregnant, immunosuppressed or over 70 etc.) and so are not working at this time.
Nadia: What’s the patient population with COVID-19 at the hospital like? Are they all older?
Suzanne: Right now, there are 200 patients at the hospital with COVID-19 at any one time. Many are older, but not all. One of the younger patients I saw who was really sick was in their 40s. Patients in their 20s and 30s are still testing positive but tend to not be as sick, unless they are immunosuppressed for some reason.
Nadia: Are individuals with eating disorders at increased risk of getting really sick with COVID-19?
Suzanne: Well at this point, there’s no research out there. In general, I think most people with eating disorders probably wouldn’t be at much higher risk unless they fall under any of the other categories (e.g., immunosuppressed). Though some people with eating disorders will be at increased risk due to chronic malnutrition. They could have a low white blood cell count, which puts them at risk, or just generally, their bodies being under such high stress – that is a risk for getting infected too. So, for people with eating disorders who are severely malnourished and have been for a long time, there likely is an increased risk, but for others, they are probably not more so than the average person. The bigger challenge right now for people with eating disorders is likely the reduced in-person treatment provision.
Nadia: Do you have any advice for people struggling with an eating disorder right now, particularly if their treatment plan has changed in response to COVID-19?
Suzanne: It’s super important to stay connected, I mean this is true for all of us, but eating disorders thrive in isolation, so it’s even more important to prioritise staying connected. A lot of therapists, nutritionists, and support groups are providing sessions via Zoom or over the phone so utilising those and then staying connected with friends and family.
Try not to look at the news all the time because it’s too overwhelming. Maybe once a day or if it’s causing too much anxiety, stop looking at it altogether for a time.
Also, remember this isn’t forever. We will return to some kind of normality eventually.
Self-care is really important right now, more than ever. This can look different for different people – whatever it takes to take care of yourself. It’s okay to be doing very little right now.
Nadia: And what about for people caring for those with eating disorders?
Suzanne: It’s really a lot of the same. Caring for someone with an eating disorder is really challenging so it is important that carers are also prioritising self-care and staying connected where they can. Also, look out for resources. A lot of eating disorder charities are putting out additional resources right now.
Nadia: On the topic of taking care of ourselves, what are you doing to take care of yourself Suzanne?
Suzanne: I have been playing with photographs. Photography has been my hobby forever and I’ve been taking the opportunity to go through some old photos and organise them. I’ve been taking a bunch of online classes too. There are lots of free courses online right now, so I’ve been taking advantage of those, pretty much every day. I also have a bunch of animals that keep me entertained and are good company.
Nadia: Oh really, what pets do you have?
Suzanne: Two dogs, two kittens, and three horses.
Nadia: Wow!!!! Now I want to do a whole interview about your animals! I won’t, but how fun!
Suzanne: They are good fun and they are so good to de-stress. They are cuddly and don’t stress out. I’m also speaking with friends and family and having zoom parties, which is fun. Not the same of course, but fun.
Nadia: I do not know where we would be without zoom honestly. Anyway, last question, what, if anything, is making you feel hopeful right now?
Suzanne: I feel really hopeful right now, which surprises even me. But I think there is a lot of good stuff going on. People are being super generous and thoughtful; I’ve had so many people reach out to say, how are you? How are things going? People I’ve not spoken to in years. And I’ve seen so many people stepping up to help others in so many different ways. People are being so nice. It’s making me feel good, I was getting worried that maybe we weren’t very nice people anymore but seeing how people are being right now has been really nice. I hope that doesn’t go away. Crises tend to bring out the best in people, I hope we can hold on to some of that.
Nadia: 100% agree. Suzanne, thank you so much!