Mary Khine '86

Dr. Mary Laine Khine '86, MD, RDMS, RDCS
Neonatal-Perinatal Medicine, Obstetrics & Gynecology
Atlantic Maternal-Fetal Medicine, Morristown Medical Center

There is a calm in the Labor & Delivery (L&D) unit as I write this... a minute to reflect on what I’ve experienced over the past month. I work for a large hospital system in north central New Jersey — a 30-minute drive to the epicenter of a COVID-19 war.


In the beginning, there was chaos. Our days were marked by endless Skype meetings and relentless emails. Add to this hours of rescheduling patients, rearranging staffing only to have yet another policy change. Those few days felt like weeks because of the rapidity in which things changed but also because of the rapidity in which everyone mobilized. Preparations and shifts in paradigms were accomplished in days that would have normally taken weeks! The maternity floors were reconfigured in a mere three days to accommodate two separate wings for COVID-19 patients and pregnant or immediate postpartum patients. All hands were on deck and decisions were hastily made and remade. Only time will tell us which decisions were correct and which were not. Remember, no one has done this before.


We’ve all been working long hours. Days seem like weeks, weeks seems like months. I’m not sure what “business as usual” feels like anymore. Clinical work for me in maternal fetal medicine (high-risk obstetrics) has always been intense but nothing like it has been for my Emergency Department (ED) and Intensive Care Unit (ICU) colleagues. In my area, we’ve had several COVID-19 patients — fortunately only one sick enough to intubate while pregnant (she recovered, still pregnant). I have to continue to remember the small wins and avoid driving past the refrigerated, long, white truck in the parking lot.

As more and more people became sick, and the cautionary tales became personal ones, anxiety and fear multiplied and hearts were broken. My best friend’s aunt was one of our losses. She was a widow, enjoying retirement from nursing, and hadn’t wanted anyone to worry about her. She refused to have anyone in her home while she self-quarantined. No one had any idea how ill she was until friends could not reach her on the phone. The rescue squad had to break down her door.

Those of us with better ability to quell our inner demons helped those of us who were unable to keep composure. Fear existed on both sides of the fence and people’s true colors were revealed. There were some who could’ve helped but sought medical leave or disappeared entirely from the work landscape.


But there is balance in the universe.


I’ve seen colleagues, who I know have serious underlying medical problems themselves, risk exposure and roll up their sleeves to trudge into L&D. I’ve seen people readily signing up for “medical draft“ and redeployment to other areas of the hospital. I’ve seen people giving up their own rationed PPE to colleagues who were treating infected patients. People who were capable (as well as a handful of people who had every valid personal reason to sit this one out) stepped up by putting in long hours either administratively or clinically, volunteering for extra duty, or redeploying to other areas of the hospital.


While we in healthcare were determining the best ways to deal with the logistics of healthcare delivery, learning and relearning best ways to treat respiratory failure, and figuring out how to limit exposures in order to maintain the healthcare workforce, the greater community was (unbeknownst to us) arranging meal trains and care packages for the hospital staff, putting up thank you signs throughout the entrances to our hospital and organizing delivery for as many PPE as they could make or purchase.


I’m grateful for the patients who quietly sit in their car (with Fear in the passenger seat), comply with the rules of our new reality to intuitively understand the need for shorter and less frequent ultrasounds. (We were able to cut down our daily patient load by 75%.) I hear the desperation in every request for service from “NYC refugees”, even in the face of our administrative decision that we don’t have the resources to provide ultrasound services to pregnant patients not already in our system.


As the feverish blur of urgent activity, bad and good, continues to pass by my eyes, I often stop and worry about my staff — we all know that when this is over, when a vaccine is discovered and distributed, and when life returns to a new normal, there will be layoffs.


The other day, I walked into a local pizzeria to pick up dinner for my family on my way home from the hospital. A gentleman saw me in my scrubs and, despite my objection, insisted on treating me and my family to pizza. “Thank you for your service,” he said. His eyes crinkled behind his mask. I felt sheepish as I accepted his thanks as graciously as possible. I am no hero. There are so many of us. I am just doing what I’ve wanted to always do which is to help people. And even though I am an obstetrician, away from the very front line like my fellow ED and ICU colleagues, I pondered why this man’s thoughtfulness and generosity made me uncomfortable.


I have always made it a point to thank our military personnel in uniform for their service. My thanks to them made me feel good because I wanted to show support for those doing work I could not. It didn’t matter to me if the soldier in front of me was to be sent to Iran or if she was going to remain stateside sharpening pencils. I suppose in parallel, I should accept thanks from my benefactor as well. We do what we can for each other no matter the size of the task.


My time at Friends School taught me to be flexible. Preparedness is important. I learned that Life is not always linear and accepting of well-intentioned plans. As time goes on, we adapt, we become accustomed to the gear and masks that seemed so confining at first. We learn to read people’s eyes instead of relying on facial expressions to gauge reactions. The pick-up of resanitized masks and face shields every 8 hours has become routine. We wipe down every surface in our work station before and after use. We review the daily list of active COVID-19 patients list without a second thought. We see that only together can we get through this, and and only together can we draw inspiration from fellow coworkers who rise to the occasion.


Thanks to everyone’s efforts, my community appears to have flattened the curve for now. Admission of COVID-19 patients has leveled off over the past three days. We still have months to go before I think we’ll have any idea if we have this under control. However, I feel more confident than ever that, even though we still need to bear the uncomfortable changes to our usual lives, with diligence, kindness, and care we will pull together. We will be okay.


I want to draw your attention to a viral image of a man holding up a huge thank you poster at my hospital. I don’t think there’s any better way to illustrate the compassion we can give each other. The outpouring of love and support we’ve seen in our community has been phenomenal. Simple tasks such as picking up pizza has taken on new meaning. The drive into the hospital garage and walkway into the hospital is littered with homemade signs thanking healthcare workers. Never before have I been so proud yet so humbled to be a doctor.


Fellowship: Yale University
Residency: Eastern Virginia Medical School
College: Jefferson Medical College