Volume 37 Number 5 | October 2023

Angela D. Darby, MPH, MLS(ASCP)CM, ASCLS Board of Directors

Angela DarbyOn July 24, 2020, Taylor Swift released an unannounced album: folklore. During this time, the pandemic was causing havoc across the globe. But it was also creating chaos in my mind and caused my insomnia and anxiety to worsen. I am no stranger to generalized anxiety disorder and have taken medication since my early 20s. Having educators for parents led to fears of not doing well in school. I vividly remember getting my first “B” in Mrs. McCutchen’s third grade class at Selmer Middle School and promptly having to leave class due to uncontrollable crying over the fear of bringing home a “bad” grade.

As an adult without a dishwasher, dishes would pile up in the sink, which started the anxiety. But it paralyzed me to the point that doing the dishes made me anxious and it became a vicious cycle. Throw in some shame over not being able to keep clean dishes and it became a recipe for disaster. I can always tell that I’m in a rough spot when I come home from work at 5 pm and am asleep on the couch by 6:30 pm because the struggle of keeping it together at work has been so overwhelming. Medications have been tried and tweaked; therapists have been seen. My last day without anxiety is so far back that I can’t remember. Through a lifetime of it all, here came COVID-19.

Since I was already dealing with insomnia and getting up at 4 am, I decided to start tracking our cases in Memphis in an attempt to gain a sense of control in a world that was spinning out. folklore would become the background theme to these early mornings. Each day I played the song, “the last great american dynasty,” on repeat while I crunched the numbers. But even as I let my mind wander into the lyrics about the chaotic life of Rebekah Harkness, the case count grew and with it so did my anxiety.

“Sitting in my car in the garage with pure panic and a heart rate of 120 became the norm. IT WAS EVERYWHERE and there was no end in sight.”

Work was no escape from the anxiety—in fact, it only made it worse. Medical laboratory professionals were hit particularly hard during the pandemic. Each department in my lab sent employees to the COVID-19 testing lab due to the high volume of samples. That in turn pulled them off the bench in the core lab. Due to our patient population, our normal sample load had decreased, but a core lab of 12 suddenly dropped to eight with complex cases to work on each day. Once things settled down and the COVID-19 sample load dropped, we got our employees back and slowly got back to our old work schedule. But now there were new challenges: tests to bring in, instruments to bring up, positions to fill.

On top of all of this, wearing masks—even though important and necessary—reminded me of the ever-present danger. Additionally, my institution began a rigorous screening and testing program for the approximately 2,000 employees who were still on campus. It began with the designation of a central single entrance for employees. Once you walked in, you proceeded to one of five tables, where a security guard behind plexiglass had you scan your badge and asked you screening questions. If you passed the questions, you were handed a green card with the date on it that would serve as your “hall pass.” Once a week you got the yellow card and were sent to the line to be tested by having your nose swabbed.

For me, the worst part of the process was the waiting. Waiting in line to get your hall pass. Waiting in line to get swabbed. Waiting for your results in case you were positive yet asymptomatic. The waiting wore on me and gave more power to my anxiety. All the while the lyrics of “epiphany” would resonate with me on the drive home each day: “… only 20 minutes to sleep but you dream of some epiphany. Just one single glimpse of relief to make some sense of what you’ve seen …”

One of the hardest things was the lack of visibility and awareness of the role of medical laboratory professionals during this crisis. Yes, a patient may come into an ER with symptoms, but who is confirming that diagnosis? Who is dealing with supply chain issues to even have what we need to run those tests? We already were experiencing a lack of visibility, “But we were something don’t you think so?”

Every medical laboratory professional experienced something similar or more intense than what I did. Students had to navigate online classes. Educators had to figure out how to teach blood bank remotely. Retailers and restaurant owners and bank tellers—everyone had their life irrevocably changed. “Normal” doesn’t exist anymore. I don’t like the phrase “the new normal” because this disease is wily, and there are others just waiting to emerge. We have passed normal and are in uncharted territory.

We pushed forward into the fall of that year, and some hope arrived. On November 30 the Moderna vaccine was released. Once the first series of vaccines began going in our arms, an app was created for us to answer the screening questions rather than having to walk the gauntlet. After you answered the questions, the screen changed color. Green=good, yellow=swab that day. At this point we had also decreased testing to every other week and could have it done any time that day.

You would think that switching to the app for screening would have helped with my anxiety. But with everything that continued to happen, from starting Instacart for groceries to making sure my mother stayed safe, my drive to work became more difficult. Sitting in my car in the garage with pure panic and a heart rate of 120 became the norm. IT WAS EVERYWHERE and there was no end in sight.

But as things have calmed down, so has my anxiety. That isn’t to say it is gone, but I learned what worked for me. Lots of reading (I read 184 books last year, just to give you a sense of how much the activity still helps me.) Watching tons of Star Trek. FaceTime with my friends. Getting up early on Sundays to drive to Starbucks and have some me time. And yes, still noting important dates in my calendar and making multiple to-do lists.

I chose to tell my personal story in this article to bring visibility to those of us who struggled during this time, and still do. Mental health issues were not something that only emerged during the pandemic—they simply became worse. As healthcare workers, we are often expected to suck it up, work with less, and not complain because “that’s just how it is.” But we are human beings. Just know that if you are struggling, I empathize, I SEE YOU, and I thank you for everything you do, day in and day out, to keep the healthcare machine running “… for the hope of it all.”

If you or someone you know is experiencing a mental health, suicide, or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.

Mental Health Resources

Angela D. Darby is a Medical Laboratory Scientist at St. Jude Children’s Research Hospital in Memphis, Tennessee.

Photo credit: Ronald Woan from Redmond, WA, USA