It’s Monday, March 16th and it’s just been announced that all “non-essential” businesses in PA will be closed for the upcoming two weeks in an attempt to slow the spread of COVID-19. However, our outpatient PT clinic will remain open as we are “essential,” I guess. I’m standing in the middle of the clinic floor thinking about writing this blog instead of writing notes like usual because I have no notes to do and there is nothing else on my mind. I’m watching a patient do bridges as we listen to Lauryn Hill’s “Doo Wop” (great song). It’s slower than usual because most people are being strict with their “social distancing.” 

Part of me feels that I shouldn’t be here either. 

But I am, so I’ll do what I can with the circumstances.

I don’t feel sick, but I do feel concerned. 

I wash my hands so many times that the skin feels like it could fall right off. I clean the tables so often that the fabric might disintegrate. I keep distance from others and it feels like a dance. I think about what we’re accomplishing here and I wonder if it’s “essential” or if it’s just “selfish.”

I don’t know the answer, but I wonder. 

The slower pace gives me space to think and I vacillate between feelings. Part of me is comforted. It tells me that everything will be back to normal in due time. However, the other part of me feels worried. It tells me that the world might never be the same. 

I can’t tell which part I trust more. 

The work day drags on as I spend most of it with my hands in my pockets. This week is off to an ominous start and I can’t help but feel unsettled. I don’t know who might be a carrier and who might just have an innocent cough. The clinic is screening patients prior to appointments with a series of questions related to COVID-19 risk factors. The sentiment is nice but it feels inadequate. This virus holds more unknowns than answers and it’s reach is likely wider than we realize. The lack of information scares me but it doesn’t seem to phase some. 

I’m not sure what to do. 

But for now, I guess I’ll do what I know best in the hopes of chartering these new circumstances with grace. I’ll write about how I feel while I control what I know that I can control. I’ll love others and do everything that I can to lift them up in all that I do. I’ll continue to work hard at what I know is right while I attempt to understand what that is. I’ll look up for guidance and trust in God’s plan because I know that He is good. I’ll ask you (yes, you) for your thoughts, because I need help navigating this gray space. In this waiting, I still don’t know…

Should I be here?

___________________________________________________

I’d love to hear your thoughts in the comment section of this blog. 

Before I end this blog, I feel compelled to share a word of encouragement. I don’t write about faith often, however, these circumstances make it impossible to ignore. I believe that everything is happening for a reason and even though these unprecedented circumstances challenge me, it doesn’t change how I feel. I might not be able to understand this virus and its implications, however, I have faith that this is part of His perfect plan. 

“So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal.” 2 Corinthians 4:16-18

If nothing else, I hope that you can find the good in these circumstances, because there is always good to be found if you look through the right lens. I hope that COVID-19 is helping you understand what’s important in your life and what doesn’t matter so much. I wish you the best and I’ll be praying for you and for us. Last, if there is any way that I can help and/or encourage you, please let me know; I would be so happy to do so.  

Go tell someone you love them.

Joe Rinaldi, PT, DPT

IG: @joerinaldi.dpt

46 comments

  1. Hey Joe. Good to know that you’re ok. Due to the fact that I have asthma and COPD my daughters have prohibited me from leaving the house. As for this crisis we’re going through, my personal opinion is that everything will be fine. Just a matter of time.

    1. You aren’t alone. There are many of us out here feeling the same way – some of which are putting our foot down and refusing to work when it is not necessary. I would urge you to consider the same. There is strength in numbers and the powers that be will have to listen to numbers.

  2. Nice post Joe. Thank you for sharing that. I just had the same thing happen to me today here in the Bay Area of California. My outpatient clinic is only open Tuesday, Thursday, Friday. As the news broke at 130 pm I text the office manager if she was watching and if she thought we’d be open tomorrow. She said she’d see what the owner said. Then she replied in a group message 1 hour later that he said we were going to remain open. I sent an attachment from the newspaper article and stating that it states that all medical appointments be cancelled or rescheduled. And I said I wanted further clarification. She said to talk to the boss. So I called him and he said he hadn’t seen the news. So I told him what it said and sent him the link. He said he would go in tomorrow and see how to respond. I told him that if it were ok with him I’m not going to be coming in. At first I was taking this thing less seriously and feeling that there was some overreaction. But after having these “orders” put in place it definitely seems much more serious and something that we all need to take seriously. And yes people need help in the outpatient clinics and it is important. But it is not necessary or life saving procedures and so people who are not compliant at first will be forced to. At least that’s what it seems like her in the Bay Area.

    1. Thank you for the comment Phil and I’m inspired to hear of your decision to lead by example in this time of uncertainty. Stay strong and let me know if there is anything that I can do to help you from the East Coast!

  3. Beautiful post Joe. I wish I had answers for you. I am high risk due to biological meds to control multiple autoimmune diseases. I questioned whether or not to get my infusion last Thursday but my doc recommended I go forward saying it may raise my risk, but with a wonky immune system I was already at increased risk with or without the meds… now, 4 loooong days later I’m not sure he would give me the same advice. All we can do is listen to that still small voice of love. Take care of you. Kim

  4. Super tough times my man. But you gotta follow your heart. If it means take sick days then do it. I just don’t feel comfortable treating in an OP setting right now. And sometimes you gotta stand up in the face of uncertainty and lead by example.

    1. Zak – Lu here, I’m also in an O&P setting and don’t feel it’s 100 necessary to be open. We are seeing patients but it doesn’t feel right.

      I’m thinking to myself- am I a carrier?
      I’m wearing gloves, it should be fine… but at the end of the day I feel like although I’m cooperating with CDC regulations in the office, I’m not cooperating with society.

      Joe- This article resonates with me. I am right here with ya, feeling the same way “should I be here?”
      Thank you for sharing your thoughts with us. 👏👏👏This is necessary- you are not alone in this. Read this, just as I was riding down my rollercoaster of thoughts and absorbing this totally slowed it down.

      Wishing you safety and health- thanks for all you do

      1. Lu, thank you for your comment, thoughts and encouragement. As you could tell from the blog, I’m right there with you. If there’s any way that I can help you, please reach out and in the meantime, stay safe!

  5. Thanks for sharing your thoughts. I am SNF based PT with 40 years of experience.
    Before we knew what HIV was, it was scary. Much harder infection to get but that wasn’t clear in the 1980s.
    My husband of 37 years died 3 weeks ago from metastatic cancer. I took care of him for 11 days in our home. It was an honor but exhausting

    But I am weary and out of PTO. Rehab staff
    is considered essential. We are slammed with admissions as the hospitals attempt to empty out in anticipation of cases of covid-19. I’m sure your local sub acute colleagues are in the same situation.

    The verses you shared helped me remember my husband’s final hours in a wonderful way.

    Thanks.
    Terry Kienle PT GCS

    1. Terry, I am so sorry to hear about the loss of your husband, but I am also so encouraged that you were helped by the verses that I shared at the end of my blog. Just know that God is with you through all circumstances and that he is working all things for your good. I will be praying for you in this time of uncertainty that you will have the energy and wisdom to treat patients the way that they need to be treated and to take care of yourself.❤️

  6. Thanks for sharing your thoughts. I have 40 years of experience as a PT. This situation is far more frightening than HIV before we understood it.

    The scripture you quote gives me comfort as I recently cared for my husband in our home until he died from metastatic cancer. I am weary and out of PTO…. I am in a SNF setting. We are busy getting hospital admissions as they prepare for potential covid-19 admissions. Perhaps you can assist at a subacute facility where your obvious compassion would be of great value.
    Peace,
    Terry Kienle PT GCS

  7. You explained exactly how I feel. We have not yet been stung as much with patient care in my state but it is coming. I feel almost a moral delima between wanting to help my patients and wanting to not be part of any potential thing that could harm them, like being a source for spread of COVID

    1. Kat, thank you for your comment. It’s such a tough situation that I think most physical therapists in the outpatient setting are struggling with right now. Follow your heart and always take care of yourself. Let me know if there’s anything that I can do to help you out!

  8. Hi Joe, I was so encouraged to read this blog post. That may not be the first thing that comes to mind but I can assure you many in healthcare (specifically outpatient PT) have questions. Truthfully, I believe you are doing exactly as you should be doing Lord willing. And that trusting in The Lord to guide you as you make critical decisions for the health and wellbeing of others is the biggest thing you can do right now. As a recent SPTA grad I am grateful to see PTs like you in the community who will say the hard things and be honest. It will not be easy as we all have so much uncertainty, but I encourage you to be willing to speak up and talk to management or whoever is running the clinic if things need to be put on pause for the safety and health of others. PTs/PTAs are the patients biggest advocate, and if something needed to be done to protect them even more we should all be taking those steps (even if that means addressing this with clinic management, etc.) But keep serving the patient the best you know how and trust that unless The Lord directs something else, you are taking the steps of faith to serve others in your work.

    1. Rachael, thank you so much for your comment and your words of encouragement to let my faith guide my decisions. I appreciate your support and I will continue to advocate for our profession and our patients. I hope that all is well with you and if there’s anything that I can do to help you or even just to pray for you, please just let me know!

  9. Joe , I feel your pain and I went through the same debate late last night. Then this morning I cancelled people and left the clinic with a clear mind , I can’t speak for everyone and I don’t criticize anyone for their choice. I agonized over it.

    Below is what I posted on FB under your article :

    We are well beyond the point that this should even be a debate. Science and math and the experience of other countries ahead of us tell us that anything that is not essential ( life sustaining) should be closed.
    It is not brave to put on a tough face and say you are going to face the virus. I would say most are doing it because they know financially it may ruin them. To me , what is truly brave is to say you are going to suffer personally for the good of all humanity.
    We are not being asked to enlist and storm Omaha beach. We are being asked to stay with our families and watch Netflix. Pretty soft generation.
    Yes it will suck. I am likely to be really screwed financially. Very screwed. But I also know the seriousness because my wife is at risk.
    The few visits you do before you are forced closed will not really bring in a ton of income and will serve to put others lives at need. It is hard to understand if you are looking at just your immediate world… you need to zoom out and look at the world at large.

    1. Steve, thank you for your comment and for sharing your situation. I appreciate your honesty and your courage to do what you feel is right even in the face of uncertainty and opposition. I am inspired by your actions and your words hit home for me. I hope that you will be able to use the time away from work to grow closer to your family and to be productive in whatever way means the most to you. If there’s anything that I can do to help you, please don’t hesitate to ask. Stay safe and stay well!

  10. Hi Joe,
    I am a full time PT and work in an outpatient clinic on the east coast. I have seen a few of my friends clinics close but mine as of right now is staying open. I voiced concern this morning and even yesterday via email, but it seemed to have fallen on deaf ears, and my clinic continued to say they were following CDC guidelines, however the recommendation for all “non-urgent outpatient visits to be rescheduled” somehow seems to not apply to PT to our owners. Due to the fact that 1. I feel that for the most part we work with a high risk population, 2. there is research out of South Korea indicating that 30% of cases are asymptomatic 20-29year olds, and 3. my husband works at a hospital and will definitely be treating patients and likely exposed (thus potentially exposing me, and therefore my patients) I decided to take leave. Although I strongly feel PT is important, which is why I went into the profession in the first place, I do not feel that we are above the virus (even if you don’t have symptoms) and at this time need to use our clinical decision making skills and best judgement for our patients. To me this means taking myself out of the equation and helping to shift the movement to responsible social distancing in a setting where telling patients to stay home may be ultimately more helpful and lifesaving than having them come in to clinic.

    1. Hilary, thank you so much for your comment and I couldn’t agree more with you. I commend you for putting other people before yourself and I have to say that hearing how you are handling this situation has inspired me. Thank you so much for taking the time to comment and taking me through your thought process, it was very helpful! I hope that all is well with you and your family and please do your best to take care of yourself and stay safe!

      1. Glad to help – I spent a long time over the past few days wondering, pacing, and refreshing my news apps/websites to try to decide if I was doing the right thing. I am really glad that I found this post (through a former classmate of my own) because it definitely made me feel less alone. Thank you for your writing as it has helped me feel like part of a bigger community and that we really are all in this together even when we feel so far apart right now. Take care and stay safe – wishing you and your family the best!

      2. I’m so glad that my writing could make you feel comforted. You are definitely not in this alone and if there’s anything I can do for you, I’m always here! Stay safe as well and I’m also wishing you and your family the best!

      3. Joe, this past week I have been looking forward to your commenting on our current situation – I knew you would have heartfelt thoughts and feelings and would share them written beautifully and honestly. You have the soul and intellect of a true friend and healer. I appreciate your describing your ambivalence, confusion, and fear – because that’s where we are if we are willing and able to grasp our present reality.
        I have thought a lot about Camus’ The Plague, an existentialist novel about our current situation. The central character is a doctor who, amidst the suffering and the chaos, goes about his work with unrelenting focus and stamina. He doesn’t question; he works. And I think Camus is saying that this is the world we all live in ALL the time, but we keep ourselves busy and create a sense of purpose for what we are doing, doing, doing, thereby ignoring the reality of the suffering and ultimate meaninglessness our lives.
        Most of us, me included, figure out a way to deny reality by imagining a way to create and feel meaning and purpose — through our religious beliefs, our capacity to love, our sense of duty. Doing the work we are called to do caring for others is a noble path to imbuing our lives with value.
        Thank you for inviting us to join with you as we struggle to find ways to live through this plague safely and with our integrity intact.

      4. Richard, thank you so much for taking the time to comment and for your kind words. I truly appreciate your perspective and I enjoyed the reference you made to Camus’ The Plague. You continue to encourage me through your insightfulness and genuine messages. I appreciate your recognition of my attempt to maintain and honor integrity through this challenging situation. I hope that all is well with you and please do your best to stay safe!

  11. This is a great post! Thanks for sharing exactly what I was feeling all day long. I agree you have to put things in proper perspective. I work in occupational health setting and there’s a lot of pressure to get people back to work as quickly as possible, be productive, etc etc. In the grand scheme of things, patients will get better even if they miss a few PT sessions. I’m struggling with how to handle this situation myself. Glad I’m not alone. 🙏

    1. Pete, thank you for sharing your thoughts and just know that you’re definitely not alone. This is something that all outpatient PTs are struggling with on some level. I’m struggling as well and I’ll be praying for God’s guidance and wisdom to be made clear. If there is any way that I can help you, please let me know. Stay safe man!

  12. Joe,

    These are trying times especially as a healthcare professional. And especially one that I wouldn’t consider as “essential” during the COVID-19 crisis. I was at my clinical, which ended a week early and the constant news that seemed to become scarier each day really distracted me. If there’s one thing I know about you it’s that you put people first. And I know you will continue to do so. However, I do understand how it feels “selfish” to be there, though the selfishness is not by your part. As younger, healthier people, our job right now is to protect the elderly and immune compromised. It’s hard to do that when you are told to continue to go into work where these may be the exact patients you are coming in contact with. Wishing you the best and sending you strength in this difficult time. My advice, do what you think is right and talk to the person in charge when you make that decision. I know you’ll find your words and at least get to make your point.

    Best,
    Randi

    1. Randi, I can’t tell you how much I appreciate your words of encouragement and support during this difficult time. I know that in the end, I’ll find the courage to do what I know needs to be done. In the meantime, if there is any way that I can help you, please just let me know. Stay safe and keep in touch!

  13. Thank you for posting this. I’m a PT in the Washington DC area, and I think we’re all in this together. Obviously, we can’t work from home, but we can’t be shut down indefinitely either. There’s no simple solution. My family is concerned about the fact that we’re still treating patients through this outbreak, which I understand, but I’m unsure about what to tell them.

    1. Zeb, it’s a very difficult situation for sure. I don’t think there is one right answer but I do think that we as a profession should take into account the effect (both positive and potentially negative) that staying open would have in our communities and families. If there’s anything that I can do to help you, please let me know.

  14. I’m going to be very blunt. Physical Therapy is very, very rarely an essential service. I don’t mean to downplay our value, but we do not play the same role as doctors and nurses when it comes to sustaining life for critical patients. This dilemma of treating patients during this unprecedented crisis is driven by our industry. Our corporations are fearful of 3 things right now: 1)if “my” organization closes and “their” organization stays open, I will lose clients. 2)if my organization closes, we will lose revenue and still have to pay salaries, and 3)if we close and patients go without visits and DON’T have significant declines, our payor sources will become more skeptical of our need. Please don’t be blinded by rhetoric coming from your employers. I’ve worked in every setting, currently in home health, and I’m being sent to patients home with no sanitizer, no masks of any kind, no disinfectant wipes. Was told today that surgical masks are only being provided when a patient is identified as being symptomatic, and N95 only if they tested positive… Unfortunately, that doesn’t decrease my exposure risk. I also have an immunocompromised spouse who is also a PT and neither of our employers are willing to even provide us with a surgical mask, let alone an N95. This event has truly opened my eyes to how disposable we are as healthcare workers. When the dust finally settles, I may decide to put one of my other degrees to use an opt for a total career change out of the healthcare field.

  15. Hey Joe, this was a wonderful post and could not sum up how I am feeling more. I am currently a student in my final rotation and the clinic I am at just had to cancel all clients that were not in danger of regressing if they did not have PT. I share your thoughts on if the clinic should even stay open at this point. On top of that, my brother has immunodeficiencies which has caused him to start getting anxious. School is urging me to stay as long as I am getting something out of the clinical, but is it really worth the risk? I feel like I have to quarantine myself every night when I get home. Overall, I am just glad that someone else has voiced the concerns I have been thinking all day, so thank you!

    1. Tim, thank you for reading my blog and for taking the time to comment. It sounds like you’re in a tough situation for multiple reasons. To me, and correct me if I’m wrong, it sounds like your current rotation is causing you some anxiety as well because you don’t want to unknowingly expose your brother to COVID-19. I feel like if you explained that to your program, they should be understanding. If there is anything that I can do to help you during this time, please don’t hesitate to reach out!

  16. Joe, thanks for your thoughtful, honest post. I agree that God is trying to tell us something and we darn sure better listen this time! I also think when this is behind us, we shall be all the better for it. The difficulty and challenge is the in-between “now” and “then”. Hang in there, keep doing what you know to be the right things, and may God bless us all.

  17. So relieved to know I’m not the only one who is in a dilemma. I’m a PTA and work with a private clinic in Canada. My partner is a type 1 diabetic and it scares me to imagine that I could be passing it on to him and he would be the one facing more complications considering the co morbidity. I guess it’s time I put my foot down for the safety of my loved one and for others too.

    1. You’re definitely not alone! Thank you for your comment and if there’s anything that I can help you with, please just let me know. I think it’s admirable to look out for your partner like that.

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