Dr. Finlay-Morreale attended college at Northeastern studying biology and behavioral neuroscience, worked for several years in research, veterinary medicine and teaching before attending medical school at the University of Cincinnati. She completed her residency in pediatrics at Tufts Floating Hospital and is currently an Assistant Professor at the University of Massachusetts Medical School and practice in Sterling, MA. She is an essayist and avid writer. Many of her works have been featured in JAMA, Doximity, and her own personal website at https://finlaymorreale.com/. Follow her on twitter @FinlayMorreale.
What has been on your heart in the past few days in the context of the pandemic?
Initially at the start of this I was in the emergency room, in West pod, the urgent care pod. Before they built the tent they decided West Pod to be where the covid patients would go-- adults and pediatrics. I’m high-risk based on my medical conditions so I was pretty concerned. I emailed the person who manages West pod if I could work elsewhere or work with non-covid patients. But in this pandemic children are actually not coming to the emergency room or pediatric office. Parents are petrified and not bringing their kids in.
I ended up seeing adults because there were so few children-- it was more helpful if I saw adults as well. Initially I saw one adult who was the sickest patient seen that day and ended up being admitted.
Overall, I was happy to do it. When you walked into the West Pod that week, there was a sign on the door that said “High-risk area.” As I rolled up there in my walker that always gave me a bit of pause-- but I walked through that door and I did my duty.
In this pandemic, I see a lot of people being flexible as they are pushed to do different things-- even things at the edge of our scope. That’s what the pandemic is doing-- stretching us. Have you found this similarly happening to your other pediatric colleagues? What have been their experiences?
Other pediatricians have been redeployed to adult medicine. I was not redeployed. I did volunteer to be redeployed but that did not happen. I prepared for it. I did modules on ventilators, modules on ICU care for adults just in case.
One thing that’s been on the minds of a lot of pediatricians during the pandemic is wondering where the children are and how they are doing. Kids are for the most part not being brought in for their check ups but kids are even not being brought in for illnesses. Usually in the pediatric ER there are kids with chronic illnesses who get fevers or complications based on their chronic medical conditions but they are not coming in. There are also kids who live in unsafe homes that are abusive-- but reports to children services about abuse cases have gone way down-- kids are not in contact with schools, doctors, and other adults. It’s frightening to think of kids not getting medical care that they need or interventions that they might need.
Vaccinations nationally have gone way down. In our office, we are still seeing children to get vaccines but it is hard to convince parents to come in.
If I could change gears-- a big thing I know about you is that you have a website about chronic pain and illnesses and the interplay with that and being a healthcare provider. Can you comment about that and how it compares before and what has happened during the pandemic?
Being a person with a chronic illness has become much harder during the pandemic. Procedures have been concealed, surgeries have been cancelled, appointments have been cancelled. The pain management office where I go is essentially shut down. I would regularly get epidurals, nerve blocks and different things and that hasn’t happened during the pandemic so that’s been challenging. People who need hip replacements or knee replacements aren’t getting those surgeries. It’s really challenging. There’s telehealth if you have a smartphone and know how to use it but not everyone has a smartphone and not everyone can handle video telehealth technically. A lot of people are not getting care.
Some of the restrictions from the department of public health didn’t really consider people with disabilities especially about the rules about no visitors in hospitals and medical care offices. One time I went to the hospital in a wheelchair and my husband was pushing and they tried to not let him in. I had to be really forceful about the fact that he was an exception to the DPH policy and that someone pushing a wheelchair is allowed in. And then they asked if he was my PCA-- which is really an ableist belief-- that people with disabilities don’t have spouses. It was a really negative experience. I did have the disability coordinator contact the medical center and the next time that I went in that didn’t happen and it was much improved. I think they didn’t initially consider people with disabilities.
Then there has been that ”Crisis Standards of Care” that came out which would allocate ventilators if there weren't enough. The first draft for Massachusetts was really not considerate of people with disabilities. People with disabilities were valued less than other people. There was a great outcry from the disability community and they did get it revised to be more equitable. So that was great.
But I think there is a very strong and not unrealistic fear of disabled people that they would not be valued as much as others and would not get the same level of medical care as other people do.
I’m so humbled because you are an advocate for people with disabilities. That’s a population that we don’t consider-- that we overlook especially at the provider side. Unfortunately we assume providers are a certain way or a certain person-- prejudices like that persist.
When I first started in medicine I did not have this level of disability. My illness began probably 15-20 years ago but I could manage it. I wasn’t diagnosed and I just suffered along when I had pain or other issues. It was only in the past two years that it has accelerated to the point I consider myself disabled.
At this point what do you hope or wish for during this pandemic?
I think we have to come to a point where we have to coexist with covid. It’s not going to go away for a very long time. When flu season hits, we will have to deal with the flu and covid. In September, which is when strep throat epidemics pour into pediatric offices, we will have to coexist with strep and covid. It’s going to be really challenging but I think we have to learn how to coexist with it.
Health care workers are stressed and overworked-- we have so many things going on on top of the pandemic. What helps you stay well? What gives you joy?
Different writing projects have been really helpful. I’ve written several essays during the pandemic. I’m working on a cookbook for my church. I’m actually a very avid birdwatcher. From sitting on my bed which is where I spend a lot of time when I’m not working because it’s more comfortable there’s a window-- we have bird feeders and a birdbath. We also have a fox family in the backyard. I’ve been photographing the foxes and the bird with a zoom lens. On facebook everyday I post a backyard safari picture which is really popular. I’m probably going to create a children’s book with different animal facts and teach kids that they can look in their own backyard for different birds and animals.
Photography: H. Del Rosario
You can find more links of works by Dr. Finlay-Morreale here:
Psychology Today Blog: https://www.psychologytoday.com/us/blog/presents-mind