First, you stand on the porch in the frigid morning air. It’s not even 7 a.m., so no one is awake yet to see you. You take a breath and watch as it wafts away from you. That part was easy: the deepness of your breath, the pliability of your lungs, the slow rhythm of your exhale. You breathe without any effort, unlike the patients suffering from COVID-19. You consider this for a moment as you reach for your shoes.

The shoes are always first — you can’t walk inside with the shoes you have been wearing in the hospital all night. You contemplated leaving them at work and changing into new shoes before you headed home, but you would still have to exit the building in those new shoes, and that would defeat the purpose. Your feet hit the cement of your stoop and are immediately chilled, though you are wearing socks. What was it the acupuncturist once told you about never walking on cold surfaces? How it slows the blood and promotes disease? Never mind; there is no time.

The shoes go in a box on the porch, where they will remain until the next shift. There was something about the novel coronavirus living on plastic for two days, maybe three? What about rubber? What are shoes even made of? You know that it seems to survive less readily on porous surfaces, and you’re counting on that, since you know your clothes have been exposed repeatedly.

Next comes your jacket, which you carefully wiped down with bleach before you left the hospital. This is the hardest part, as you feel so unprotected without it: Not only was it your main source of warmth, but it also kept what you do relatively obscure. With the jacket on, you could almost be anyone on the street in a black puffer and blue pants. Without it, everyone will see your scrubs and know where you work, and if they see you, they might run away. You wouldn’t blame them.

The jacket will come inside, but it will rest in a designated spot where no one can touch it. You place it gingerly on the ground. Now you are legitimately cold.

This next part, you will try to do fast — as much because it’s uncomfortably cold as because it’s embarrassing to do this all outside.

Your pants are next.

You try to roll them down from the waist after untying the knot in the front, attempting not to touch the outside of the pants as they roll off your legs. This is tricky, and you have definitely keeled over before, attempting to do this awkward maneuver after working all night. You have left a towel on the porch, and you unfold it now and drop the pants right into the center of it. It will eventually serve as your DIY biohazard bag when you are ready to bring everything inside.

Your shirt is next, and you attempt the same move you did with the pants: rolling up from the waist, trying to slip your head and arms out of the holes without touching the outside too much. There is no evidence that you can catch the virus from breathing in particles that pass over your mouth from a shirt that may be a fomite, but you hold your breath anyway as you pull the shirt past your face. There is no evidence. But there is never any evidence when a disease is so new. “No evidence” doesn’t ease the gnawing anxiety about the statistics from Lombardy, in northern Italy, where 20% of health care workers got sick with the virus. It’s better to be safe. So the shirt gets dropped on top of the pants in the middle of the towel.

Now you are standing in your underwear and socks on your porch in the bitterly cold morning air. You are praying that none of your neighbors are watching this. You quickly grab your phone, which you have kept in a Ziploc bag during your shift and bleach-wiped about 25 times through the course of the night. You text your partner, “Conning in. Pleae keep rhe kids aqway. Will showee first.” You know he’ll understand.

Now you wait. This part is brutal. You kick yourself for not doing this before you started disrobing. Somehow, you always forget. You jump up and down a little, trying to generate some heat. Are the neighbors watching? Is this somehow going to wind up on the internet? Oh God. Finally, your partner texts you back a thumbs-up emoji, and you rip off your socks and throw them onto the towel as well.

You carefully fold up the corners of your towel-bag like some perfectly wrapped parcel from hell, grab your jacket and unlock the door. You hear the children playing in a room down the hall with their father. They have been up for an hour and will be thrilled to see you, but you can’t let them know you’re here yet. It’s only five steps to the bathroom now. You dump the towel and its contents into a special hamper that you have set up for this sole purpose. You will wash it later today.

You turn on the shower, let it become sufficiently steamy, and step inside.

This is your medicine.

The water runs over your eyelashes, through your hair, under your nails, through your teeth. You imagine all the stowaway virions swirling down the drain. You scrub every place you can think of, wondering if any of the patients you have seen tonight have exposed you. Their tests won’t be back for days. Though you tried to ease their worries from behind your mask and goggles, now you recall the terror in their eyes as they reached for the hand of their loved one.

This is only the beginning, you have been told. There will be many more waves of this before it is finally done, and you will have to go through it again and again. You turn your face toward the shower head and let it pelt your face. It tastes salty. You let the water and your tears mix freely now, as they wash over your face.

 

Sabreen Akhter is a pediatric emergency physician who practices in Seattle. She wrote this article for the Washington Post.