Life on the Frontlines: Q&A with Navya Mysore, MD

Doctors are often thought as healers and rarely as patients themselves. But as One Medical’s Navya Mysore, MD, found out early on in the pandemic, COVID-19 does not discriminate. While treating patients in New York, Mysore, One Medical’s National Program Medical Director of Sexual and Reproductive health, tested positive for COVID-19 just as news about the virus began to take off. After self-isolating for a few weeks, she safely returned to the frontlines and has continued to treat patients throughout the pandemic, on top of raising a one-year old. We sat down with Mysore to discuss the challenges of being an essential worker, as well as a parent, during this tumultuous time.

A: It has been totally eye-opening. I am so impressed with how One Medical has really stepped up to the challenge. Even from the beginning. everybody was like, "Okay. We are not going to shy away from this. We are going to really take this by the bullhorns and we're going to figure this out." On top of patient care, there was a lot of work we had to do internally. We had to figure out how our teams were changing and how we were going to shift and adjust, while still being there for our patients. I was worried that things were going to fall through the cracks. I was worried that our team wouldn't feel that sense of comradery or closeness that we typically have. But I have just been so impressed with how everyone has banded together. There is one provider on my team who volunteered to go into the hospitals and practice. And there are other providers who have continued to work, despite really challenging childcare issues. They said, "No, I need to be there for my patients and I will move around my remote schedule to make sure that I'm available during these hours for them." I have just been blown away by how immensely flexible and generous my One Medical colleagues have been despite how taxing the time is on everyone.

A: I was definitely nervous when COVID-19 first began. I have a one year old at home, and at the beginning of the pandemic, he was a little less than six months old. I was worried that he would get sick. It wasn't really about me, it was more just that he would get sick. There was so little that we knew about how it affected babies and kids at that time and we still don't know a lot. But I think over time, as I went into the office each day and saw that we had more PPE, I felt like we were supported. One Medical has been really focused on making providers feel comfortable during this. There is always ongoing conversation about how we’re feeling and what we need to feel comfortable. That has helped me feel more secure and safe in terms of going into work.

I ended up getting COVID in March. The first 10 days were really hard, because I felt like I had been hit by a truck. When I knew I had been exposed to someone who was positive, I stayed home and right away, told my husband to tell our nanny to go home. So then we had no childcare, which was tough. My husband was still working— although he was taking some time off to help — and I actually only ended up using one day of PTO and worked remotely, because I felt like I didn’t want to leave my team. It was right at the beginning of the pandemic when we were trying to figure everything out. I couldn't afford to take time to just be in bed. I think that's partly your life when you become a mom. The days of being able to stay in bed all day very quickly disappear. I felt like this was how I was going to support my team. I couldn't actually be there in-person, but the way I could help was to answer questions, be there for support, and navigate how we're going to be doing things. That was a really hard 10 days. I started to get better and then eventually went back to work.

Overall, I was comforted by a few different things. It was just the support I was getting from One Medical and my team, and the support I was getting from my partner, who I would not be able to do what I do without. Then the fact that I was exposed and now have these antibodies brought me a degree of mental comfort.

A: That was tough. I don't think anyone feels good when they feel lonely. I actually had H1N1 when I was in residency. Back then, I was living alone in a really small apartment and working super long shifts. When I got H1N1, I very similarly was forced to self-quarantine. But I was by myself. I had some friends who would drop off groceries at the door, but then I would very quickly just grab them and go back into my apartment. That was much harder for me. I feel like the symptoms of H1N1 were worse for me compared to COVID, but it very well could have been because my mental health was suffering while I was alone. I felt isolated. I didn’t feel like I had support around me. With COVID, though, as much as it was challenging, I woke up and got to see my son. He would smile and laugh and uplift me and make me feel better. I also feel pretty grateful, because although we still live in a small New York apartment, we actually have a balcony. It was really helpful to just open the window, have light come in, and get a little bit of fresh air.

The presence of my team was also different. When I had COVID, I had 20 people from One Medical texting me asking, "Are you okay? What can I do? Can I do anything to help you?" It just felt so supportive. So the whole experience of self-isolating with COVID was challenging, but not as challenging for me as having H1N1 during residency.

I have had a few patients though who have had a very tough time. One of my patients, for instance, had symptoms for eight weeks. She lived all by herself in a tiny studio apartment that had one window. I followed up with her often, not because I worried about her symptoms, but because I was really worried about her mental health. It’s not easy when you’re by yourself in a small space and there’s not enough light. Especially in the middle of summer when everyone is out and about. Even though this isn’t how most summers go, a lot of people are taking advantage of the outdoors and doing socially distanced picnics and things like that, but she wasn't able to do any of those things, and that's really, really hard. So I've been really impressed with how some of my patients have dealt with all of this.

A: I definitely felt more anxious at times. I still do. I think there's this level of uncertainty about the world. We don't know what cold and flu season is going to look like along with COVID. I think there has also been some sadness over this year. It has not been an easy year and it hasn’t been something we ever expected. To some degree, it just feels like it’s been one thing after another, whether it’s COVID related, natural disaster related, or violence related.

There's just a lot happening. If you take a moment to actually sit back and think about it, you can feel really scared, alone, frustrated, angry, and sad. I try to find the silver lining and stay positive in moments where I feel like that. I derive a lot of strength from my patients. They uplift me. Just talking to them and seeing how they are coping is inspiring. Some of my patients have had family tragedies happen to them this year and yet are managing to find the positives, move forward, and gain strength. That is just remarkable to me. It’s helped to find the silver lining. Yes, this year has not gone the way we all wanted it to, but there have been really amazing moments as well. My son just turned one and we had his first birthday party. It was not what we had planned. It was very small and outside in the park, but it was great. It was amazing. I have awesome memories of it and good pictures of it. But he hasn’t seen his grandparents in six months and they have missed out on a tone of really fun milestones of his. It’s hard, but I try to focus on the positives.

I also try to prioritize things that help with my mental health, like exercising and socializing. Socializing is not the way we’d like it to be, but it’s important to reach out to others so you aren’t isolating yourself. I even have a group text with some of my friends and have said to them, “Hey, I get really busy and may drop off the face of the Earth. If you don’t hear from me in a few days, just text.” And they do. They’ll just check up on me and make sure I’m okay. It’s nice to know that you have that external support system and that they’re there for you.

A: I definitely did. It was, and still is, so unclear, whether you can get reinfected. Also, it was difficult just adapting to the new norms. It felt so foreign to all of a sudden be wearing all of these masks, face shields, and eye covers. In our family offices, we have couches for family members and now those are covered in plastic. Even that was odd. It was strange coming back to an environment that looks the same, but is just so different. We used to have our team huddles in the kitchen. Our whole team would get together, have lunch, and just joke about stuff. It was just a really nice time to just be ourselves and bond with our team. But that doesn't exist anymore. Now, you might pass by someone’s office and stop to talk to them from six feet apart, wearing your mask.

A: I've always been very in tune with mental health. I see quite a few patients for mental health issues. I've always asked them about how they feel, but now it's generally the first question I ask, even before talking about the actual issue they are coming in for. I now ask, "Hey, how are you coping?" I think people feel comforted by that question, because oftentimes many don’t even realize that they are coping. It’s nice to be given the opportunity to open up about how you are actually feeling. I want to be able to create a safe space. Many people in general are grateful and feel that their life is better in comparison to many out there. I feel the exact same way, but I also like to remind people that everything is relative. What you’re feeling is real and if you’re feeling sad, or anxious, or uncertain, or frustrated, you shouldn’t diminish those emotions. So it's definitely impacted my practice in the way that I focus even more so on mental health than compared to what I used to.

I also always like to talk about life hacks. What can you do to make this time easier? How can we work around this issue or this obstacle? And COVID has brought in a whole new layer of obstacles. For example, a lot of people have become very sedentary over this quarantine period. So I like to help them find ways to stay active within their own house. Doing remote care has been really nice to some degree, because patients feel much more comfortable in their homes and are more comfortable broaching mental health topics. They are also able to show me their house, the space they have, and we can find a solution together.

A: Time flies and I can't believe that he's now more than one. He is an amazing baby. It's hard for me to say what the challenges really are, because he's always been an amazing sleeper, which we're really grateful for. He’s just a really happy baby. So I've actually derived strength from him, because he's just so cheerful and laughs all the time, and is so happy to be exploring. It's interesting to see his world as it opens up to him. For him, he doesn't even blink an eye that people are wearing masks. It's normal for him.

It's interesting to see how he's developing in this world that we are in and what his future world will look like. I think if anything that might be the biggest challenge that I've faced — feeling nervous for the kind of world he's going to grow up in. I wonder if I’m doing enough to ensure that he is going to have all the skills he's going to need to feel safe, happy, and secure in a world that at times this year has felt it’s falling apart.

A: That's always been a challenge, even before COVID. I am a firm believer that you need to have your identity as a person, your identity as a partner, your identity as a mom, and your identity as a friend. They all are important to feed and not lose. I love doing what I do and in the middle of this pandemic, taking care of my son, seeing patients, and leading a team at work, I actually took on more responsibility as the National Program Director for Sexual and Reproductive health at One Medical. That’s something that drives me and makes me feel more fulfilled as a person, but it has also added another layer of complexity in my life. The time for a new undertaking doesn’t just appear, it needs to be created. So that new role has pulled some of my time from my other roles as a mom and partner. Sometimes I do wonder if I’m doing enough for my son. Could I do more? Could I be there more? You always hear people say, “It’s impossible to have it all” or “You just can’t have it all.” But I think that’s false. I think you can have it all, but you need to be realistic about how to do that. Not every week am I going to the gold star mom award, and not every week am I going to get all my projects done and do stellar work in all of my roles. And that’s okay. Some weeks you can focus on certain buckets and do really well with them, and then other weeks you might focus on other buckets. I like to tick off a few boxes for each of those roles every week, but not put the pressure on myself to be amazing or stellar in every single box. That is most certainly going to make you burnout and it's just not sustainable. It’s also really important to ask for help and use your support system where you can. This can mean different things to different people. For us, we’ve been able to rely on our amazing nanny to help us both focus on our jobs during the core hours of the day and that’s been a key part of my ability to balance work and parenting during this time.

A:. I remember at one point, especially when I was sick and had to quarantine, I wasn't able to go into the office so I was helping my team remotely. I obviously couldn’t be on the frontlines at that time, but I remember telling my husband I had such an immense sense of guilt about not being there. This is what I felt my calling was as a health provider, to really stand up and be there for patients at a time like this and for those three weeks I felt so useless at times. I could have Zoom meetings and support my team by managing things over email, but I wanted to be there to help. I wanted to see patients and get in there and wear the PPE.

For my husband, I think that was a little scary. He had to remind me that it wasn’t just about me anymore. We have a family and I need to consider that. We were facing questions that we just never had to face before. I think having open communication though and being able to talk about things helped . When you’re in a role like this and have had so much training, it becomes part of your identity. It’s like a calling and I needed to do that. I needed to get back to work as soon as I could and that was something I personally needed to do.

A: Take it day-by-day. There's so much pressure in terms of parental expectations. Try to not get so wrapped up in those expectations. Be easy with yourself. Forgive yourself. I know those weeks where I was quarantined and we didn't have childcare, I definitely can say I subscribed to Disney Plus and I put my son in front of the TV. I was like, “That will hold your attention for at least 20 minutes while I do this Zoom call and answer these 10 emails.” And that is okay. I definitely felt like I did not get the “stellar mom of the week” ribbon that week, but I survived and I got through it. For me what took more priority was to be there for my team, and I felt like I was able to do that. So try not to get wrapped up in the pressure and the expectations. At the end of the day, I think kids understand a lot more than we give them credit for and having open conversations is important. My son is only one so not much conversation is happening yet, but as kids get older they understand what’s happening and it’s worth having conversations about masks, why we’re wearing them, what school is going to look like, and asking them how they are feeling about everything. They hold a lot of emotion and they might not necessarily be showing it or verbally expressing it to you. It’s worth talking to them when there is so much changing in the world around them. I would also tell parents to make sure they carve a little bit of time out for themselves. Easier said than done, I know. But it’s really helpful to just get 20 minutes or half an hour to yourself, even if it’s just going for a walk or grabbing some fresh air.