The “New Normal”

Words by Dr. Haley Neef.
Images courtesy of Penny Neef.

One morning in May, I logged on to 3 consecutive virtual meetings being broadcast from the two different medical systems that employ me, and there was one phrase spoken more times than I could count: “the New Normal”.  Admittedly, my tally was limited by the inevitable WIFI hiccups, as well as my general distaste for virtual meetings.  But the deed was done, and now I can’t shake the phrase out of my head.

As a pediatric gastroenterologist practicing in Michigan, a state hit early and hard by the COVID-19 pandemic that is now taking baby steps towards re-opening our economy and communities, I hope for a safe and palatable “New Normal” for our country.  What measures stand out to me, as a health care professional but also as another anxious citizen of a world turned upside down – as the most necessary to establish this “New Normal”? How can we best arm ourselves against the pandemic-fueled overwhelming uncertainty that first terrified us, and now tempts us to slide dangerously back into the comfort of the “Old Normal” that allowed a new virus to spread like wildfire in the most powerful nation in the world?

I believe that for the foreseeable future, our measures for a “New Normal” must include wearing masks in enclosed public spaces and maintaining social distancing. These are the same mantras that we are all at least a little tired of hearing, and that some of us are already abandoning. To safely rebuild our communities, these rules must be our foundation.

Hailey Neef in a snapchat picture demonstrating her new PPE requirements.

There are many reasons why embracing the mask as part of our “New Normal” is, very literally, uncomfortable. As elective surgical procedures are again allowed at my hospital, I recently performed a colonoscopy on a 4-year-old boy with bloody diarrhea. I wore an N-95 mask fitted tightly to my face with a surgical mask over that, so I can re-use the N-95. I then Velcro a giant plastic face shield around my forehead. I put on a blue plastic gown, gloves, paper booties, and finally a poufy disposable bonnet to cover my hair. The lights in the OR are blazingly bright, and, after 10 minutes of poop-surfing, I have become a sweaty, breathless animal trying to complete a highly technical diagnostic task on a vulnerable and ill child. How can I advocate for this to be my own “new normal”?

There are lots of other reasons that I dislike masks. I have a mask-shaped gang of pimples on my jaw and chin.  I can find it difficult to understand people speaking to me through a mask- I never realized how much I rely on lip-reading and facial expressions for context and clarity. In a mask, I can’t smile at toddlers in the clinic and expect a grin back because I look like a petite yet terrifying Stormtrooper coming straight for them. 

It may not surprise you- because I am a doctor, after all- that despite my resentment towards masking, I am committed to doing so at work and in all public enclosed spaces as my “New Normal”. Masking allows me to stay healthy so that I can continue to care for children that are not. Wearing a mask helps prevent me from catching coronavirus and either being an asymptomatic carrier inadvertently spreading it to vulnerable patients and co-workers, or falling ill myself, rendering me physically unable to provide needed care to my community.

So, of course, as a healthcare worker, I will continue to wear a mask. My own reasons for wearing a mask likely do not apply to you. So why is this measure so important for all of us?

As I scroll through Facebook during yet another Zoom meeting, I notice some people who used have the #StayingHomeSavesLives frame bordering their profile picture are now posting proud proclamations and photographic evidence that they are now giving in to the mask-free, care-free, shoulder-to-shoulder “Old Normal”. Some Americans see the COVID-19 case numbers falling and arrive at the false conclusion that the very measures that are helping slow down illness, suffering, and death- social distancing and masking- now somehow represent cowardice, naivete, or even blind allegiance to oppressive state authority. All of this misguided rebellion– assigned to a piece of fabric or a square of paper placed over the mouth and nose. 

In my home state, Michigan, an unclothed Barbie-doll effigy of our governor, Gretchen Whitmer, was lynched on a shoelace on the state capitol lawn. For some Americans, masks no longer represent a necessity for preserving the safety of oneself and of others, but rather of weakness and fear. #WhitmerCantStopUs and #SorryNotSorry, have replaced #StayingHomeSaveLives. 

To those doubting the ongoing necessity of wearing a mask in enclosed public spaces, I offer this. Don’t let your political leanings and a waning concern about your own personal mortality make the decision for you. Instead, think of me and all the other caregivers with an obligation to protect our society as we re-open. If you are lucky enough to be healthy, consider all the other essential employees that your family relies upon for your trash services, your toilet paper purchases, your prescriptions, your food, your power and water who need to stay healthy and functioning.

A child running through a field with their dog, who is dragging a large stick

Think of patients like mine, with autoimmune disease that rely on immunosuppressive medicine to stay well. These medicines simultaneously allow people to walk by you in a grocery store looking like a normal, healthy human, but also may put them at increased risk to catch COVID-19 more easily, or even to land them in an ICU clinging to life. Think of your parents, whose advancing age puts them at greater risk for death. Think of the stranger that passes you in the hallway who cares for a frail grandparent at home. 

Make a choice to set aside your discomfort and politics and your concern about what others may think of you when you decide whether or not to wear a mask. Think instead about the hundreds of people you pass by in a day, and let them become your reasons to mask up in public buildings as your “New Normal”. 

Now, to take on the other measure of our ”New Normal” that I implore you to adopt: social distancing. Like many other Americans, I loathe this new distance from my co-workers, the endless Zoom meetings, the virtual visits with patients and families. It’s so much harder to build trust and understanding with a child when the visit is limited to a computer screen with a parent’s floating face reporting to mine. I worry that my medical assessment suffers without a physical examination, and perhaps more importantly, without the non-verbal connections and observations I rely on to feel in my gut that a child doesn’t just have tummy aches, but could be seriously ill.

Outside of the hospital in my hometown of Ann Arbor, I miss sitting cheek-to-cheek at the University of Michigan stadium and cheering “Hail, Hail to Michigan!” as one voice joining 100,000 more. I miss dancing with strangers and friends at crowded outdoor music festivals. There will be no annual family trip south to the Outer Banks this year, where we shack up in a big beach house with my parents, my sister and brother-in-law and their 4 children for a week and wrestle in the pool and share bowls of popcorn without a bottle of hand sanitizer in sight. My last surviving grandparent passed away in Virginia just before the pandemic, and the memorial service and family reunion has been postponed until 2021.

Hailey Neef and family in Michegan gear outside a game

We, as Americans, all feel stranger when we are physically distant from loved ones and strangers alike. We may miss the gesture of a firm handshake sealing an agreement, of a hug that reassures when words alone fail to provide comfort. Social distance and cancelled physical gatherings create, above all, a sense of loss and sadness. But social distance, like masking, must become our “New Normal” as we cautiously venture towards re-opening our country. The reasoning is the same: we must protect one another now so that someday, we can be physically close once again.

One of the reasons my parents and sister left Michigan for Virginia are the long, dark, bone-chilling winters here. I call my parents most days since the pandemic began, and now I look forward to this” new normal “of mine, even though I wish I could see them in person. I don’t really mind hearing about how my dad misses going to the YMCA and how my mom wishes she could hug her five grandchildren. Their own commitment to social distancing despite their sadness about it makes me feel so grateful that they are healthy enough to answer the phone every day. I truly believe that masking and social distancing is keeping them well. My father especially delights in telling me how sunny and mild it is in VA when April snow showers fall in my home state, and it annoys me a little but I am thankful that there is nothing graver than the weather to discuss. 

What is amazing about Michigan- setting aside Barbie doll lynching, snow in April, and the inevitable disappointment of cheering for the Detroit Lions football franchise – is the sudden, joyful relief of the arrival of Spring after months of oppressive winter. As I write this, the trees in my backyard are blindingly green and I welcome the task of stashing our winter parkas and snow boots in the basement until October. It takes a hideous winter to experience the absolute magic of a Michigan spring. Sure, my dad reports mild sunny weather as early as March in Suffolk, but does it taste as sweet as the first sunny day in Michigan that doesn’t come until May?

Hailey Neef and family on a boat, they have caught a fish, which their little black dog is sniffing with great interest.

 In Michigan last week, Governor Whitmer declared shelter-at-home orders lifted, and newly allowed citizens to gather in groups of up to 100 individuals. Last night, for the first time since the pandemic was declared, I stood six feet apart from my neighbors around a campfire and felt the same overwhelming surge of “Michigan spring”-flavored gratitude wash over me. We were doing something normal- a campfire on a Spring evening, albeit with a little extra distance between us. The discomfort of a “New Normal” was nominal compared to relief and happiness at a gathering that, last summer, I took for granted. 

I personally promise to struggle through Zoom meetings and continue to sweat it out under my Stormtrooper gear in the OR. The surprising, overwhelming sweetness of a mundane phone call with my parents and the reward of a warm summer evening at a neighborhood campfire is more than worth it.

Masks in public indoor spaces and social distancing are simple, inexpensive measures that got us this far and can continue to carry us forward. Take these actions and feel empowered that you can play an active role in helping your community and your country make a slow but sustainable recovery. I hope that committing to these measures as your own “New Normal” rewards you, like me, with unexpected joy despite these strange new limitations. After the bleak darkness of the COVID-19 pandemic, we can together create a warmer season where caring for one another leads America to become stronger, healthier, and more grateful for what we have rebuilt together.