The 21st century has already seen many momentous orbits of the Earth around the Sun, but that the current year — 2020 — will remain a singular year in human history is no longer of any doubt. As of the date of this publication, for over 1.44 million people around the world, 2020 was also their final year of life. Millions more and their families have suffered quietly, from being ill, or being hospitalized, or dealing with disabling and prolonged recovery, or being laid off work, or losing their life savings. The litany of loss is nearly endless. While for many this year is a low point in suffering, as a maternal-fetal medicine physician I have confronted the joys and sorrows of humanity on a daily basis, on a granular level: one mother and baby at a time, one family at a time. I have been a physician for twenty years now. Twenty orbits of the Earth around the Sun. Time enough to witness a great deal of human joy, courage, strength, and yes, frailty, failure, and suffering. With every patient encounter over these two decades I have been the bearer of news that has carried much import. No conversation has been, or is ever, trivial. On some days I may converse with thirty or more mothers and their families. Some patients have been referred because of a suspected abnormality seen on an ultrasound of their fetus that was performed elsewhere. Some patients have been referred because the patient herself has a serious medical condition, such as lupus or chronic hypertension or diabetes, that poses significant risk to her pregnancy. All need advice. All need guidance. And all need resolution to their anxieties. Often I am able to soothe their worries, but sometimes I am unable to do so. Sometimes, even with the best of my abilities, I am unable to predict an undesired outcome, for we physicians lack technological capabilities to divine all forms of impending despair. Sometimes I actually contribute
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to a mother’s worries. When I see a fetal abnormality on an ultrasound screen I am inherently aware of the difficult message I will have to convey to a patient. I anticipate the psychic wound I will inflict on her and her family, and I innately know that a profound realization will settle in: the dashed dreams of a life that could have been lived, but because of my words will now no longer be actualized. Alas, as is valid with moving objects in Newtonian space, so too is true with human words and actions: there is always an opposing reaction within the messenger’s psyche. Doctors are not immune from this reality. It’s a lot to bear on one’s own shoulders, the weight of humanity’s trials and tribulations, one individual at a time, one family at a time. This year has been different for me professionally, of course. From restricting all family members from accompanying patients coming to our office for their fetal ultrasounds and genetic evaluations, to testing all patients for a viral plague at the hospitals where I work, to knowing that I am constantly exposed to the public and could acquire this very same deadly virus — one that randomly slays several percent of the infected — I can recall no other year of medicine in recent history bearing such a bleak semblance. Having fallen victim to COVID-19, some of our patients have required prolonged hospitalizations, some requiring ventilators, some requiring premature cesarean sections, some having been near death. As a middle-aged male diagnosed this very same year with chronic hypertension, and already having asthma, hypercholesterolemia, and a strong family history of cardiovascular disease and diabetes, I have been especially wary of my personal risks. My wife and I have three children, each of whom we love immensely. Each in his or her own way has been a blessing for us. Our eldest, conceived accidentally fourteen years ago, out
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