Dr. Lauren Jenkins says her medical training has always taught her to think of the worst-case scenario. And one day this past March, that's exactly where her mind went.
It was early into the coronavirus pandemic. Jenkins, a 37-year-old obstetrician-gynecologist who practices at a hospital in Philadelphia, was cooking for her husband and their nearly three-year-old twins, Pierce and Ashton.
That's when she got a call from a colleague. An anesthesiologist she had worked with during a long surgery about one week earlier had tested positive for the coronavirus.
"I'm sitting there thinking, 'OK. I've been exposed. It's very likely that I've been infected. And it's very likely that I've infected my family,'" she says.
For any family navigating the pandemic, that call would be alarming. For hers, it was potentially devastating.
Her husband, Jay Roux, 44, has stage IV lung cancer. Every few weeks, he has a needle inserted into his lungs to drain fluid that builds up. Cancer treatments have weakened his heart. And he eats — or, rather, ingests nutrition — through a gastrostomy tube into his stomach. His body's defenses to the coronavirus are severely compromised.
"For Jay to get COVID, it would be catastrophic," Jenkins says.
After learning of her colleague's positive test, Jenkins immediately stopped cooking and rushed to her bedroom, where she locked herself away from the family. She remembers thinking, "Perhaps I had been responsible for exposing Jay to the very thing that would kill him."
Roux brought food to her room on a tray, she says, "and passed it through the door and ran away." When her family had all gone to bed, she put on a mask, grabbed bleach, and wiped down every surface she could find.
She wasn't upset with her colleague. He had come to work with mild symptoms, and, in general, doctors are taught to come to work even if they have a regular cold, she says. "Calling out sick isn't really a thing," she says. And it was early into the pandemic, before many health care workers were taking much more stringent precautions.
The next day, Jenkins drove to a testing site, endured the long swab pushed into the back of her nose, and got a test result. It was negative.
It was a massive relief. But she decided that as long as the pandemic dragged on, and as long as she was treating patients with the coronavirus, she could not put her family through that experience again. She would have to move out.
"There can never be a next time," she decided. "I can't take this kind of risk."
At first, her husband argued that the family should stay together at their home in New Jersey. His cancer — and the heart problems from the treatment — make it hard to care for two energetic toddlers, even with the help of an au pair.
"I'm not even half the man I used to be," he says.
He eventually came around. After more than a year of fighting cancer, he says, "it would be stupid" to die from a preventable exposure to the virus. Plus, he told Jenkins, if she did inadvertently pass the coronavirus to him, "I think that you would carry that guilt with you for the rest of your life, and it would eat you alive."
So she moved out, landing in an apartment donated for use by health care workers in Philadelphia, about a half-hour drive from home.
Separating helped reduce Roux's potential exposure to the virus. But it forced the couple to confront questions with no clear answers: With an uncertain prognosis, would the separation waste precious time that Roux has with his family? And if the pandemic continues for a year or more, how long would they live like this?
The 'hazmat suit'
It didn't take long to discover just how poor a substitute video calls can be for physical contact — the chance to hug each other, or sit and read to their kids together.
The twins had been born prematurely and had subsequently spent months in the neonatal intensive care unit.
"I never missed a single day by their side," says Jenkins. Even afterwards, she hardly spent much time away from them.
In the first weeks away from home, she started to strategize a way to safely visit her family about once a week. After talking with her colleagues who specialized in infectious diseases, she landed on what they call her "hazmat suit."
It's the same kind of suit that might be seen in a high-tech laboratory: a hooded set of white coveralls, gloves, a mask and goggles.
The first moments she stepped foot in the house in the suit were admittedly "weird," the couple says. Their son Pierce is more timid, and wasn't quite sure what to make of the masked figure in the house.
"He didn't instantly run over to me," says Jenkins.
But Ashton immediately jumped into her lap and started comparing "mommy's glasses" — her safety goggles — with his own.
Once Pierce came around, they all read books and played with blocks together.
"Part of what's so cool about kids is that they don't overthink things," she says. "It's like, 'Oh, mom's been gone. But now she's here.'"
"To even give her a hug and hold her for five minutes, it's amazing," says Roux. "Not the real thing, but it's still amazing."
The hardest part were the goodbyes. They decided to put the boys down to sleep before she leaves. That way, "It's not like a big horrible goodbye," she says. "I don't know if it's more for me or for them."
A way out
At one point, the family was offered a way out of their forced separation.
Leadership at the hospital told Jenkins they could take her off the frontlines, so she wouldn't have to risk exposure to COVID-19.
But she barely considered the offer before turning it down. Other doctors at her hospital, she says, are older and at higher risk. And she felt the need to contribute during a public health emergency.
"I don't think anyone would've begrudged me," Jenkins says. "But it didn't feel right to me."
She remembers calling Roux soon after. "I was actually a little nervous to tell him that I had said no," she says.
But he immediately told her: I hope you turned down the offer.
"You're a doctor," he recalls telling her. "You provide an amazing service to women. That's your calling. It's what you do."
They agree it was the right decision. Still, at times, Jenkins says she feels a creeping sense of "betrayal" by her job. It was hardest that day in March, when she first learned she might have exposed her family. But every now and then it comes back.
"My job is a huge part of who I am. And it's a source of so much of my pride and my joy and my sense of self," she says. "For the first time, I felt like my job was making me choose between my life's work and the wellness of my family."
Roux says his experience with cancer, and their long ordeal with the kids' time in intensive care, has made him a firm believer in the idea that "s*** happens," but you push on.
"I said to Lauren, 'With all the stuff that we've gone through in the last couple of years, this is just a small ripple in the lake,'" he says. "'We just get through it.'"
'Nobody knows when it's going to end'
The day after Mother's Day, the couple decided to switch places. Jenkins was missing the kids, and Roux was struggling to keep up with them.
After talking with experts, they decided that the risk to their kids was low enough that she could return home. But this time, Roux would leave and stay at a family member's spare apartment.
"When she came home, I already had all my stuff packed up in my truck," he says. "She came in through one door and I waved at her and said I loved her and went out the other door."
When the pandemic started, they hadn't really considered that it could go on past the summer. But now they're thinking about what it'll mean to stay apart indefinitely.
"It's a whole lot of questions with no answers, because nobody really knows," says Jenkins. "Nobody knows when it's going to end. We don't even know antibodies actually confer immunity or if it means you can get it the second time. What happens then?"
Roux, in particular, is worried that officials will end lockdown policies too quickly.
"I want to see the numbers come way down below before people start thinking that it's safe," he says. "Not just because of me, but there's the elderly and other people with immune deficiency."
Every day, he still comes by the house to work on the yard, even just to see his family from a safe distance.
"I get to see my kids through the window, but I can't touch them," he says. "It's awful, because I love my boys and they're fun and I'm dad. And, you know, if Lauren comes home and I'm still in the yard, I've got to stay like 10, 12 feet away from her.
"And I just kind of give her one of those air kisses, you know? I tell her I love her. And then we always say, 'this is weird.' You know, it's just so darn weird. But it won't last forever."
MARY LOUISE KELLY, HOST:
Nearly 72,000 health care workers in the United States have been infected with COVID-19. That's according to the Centers for Disease Control and Prevention. Working face-to-face with infected patients has forced many nurses and technicians and doctors to make tough decisions both at the hospital and at home. NPR's Tom Dreisbach has the story of one family that's been forced apart by the virus.
TOM DREISBACH, BYLINE: Dr. Lauren Jenkins was making dinner for her husband and two young kids one night when she got a call with some news from work. Turns out one of her co-workers who had she'd spent hours with during a long surgery hadn't been feeling well lately. So the co-worker took a coronavirus test, and it came up positive. For anyone, it's a scary call. But for Lauren Jenkins, the news was potentially devastating. Her husband, Jay Roux, has stage IV lung cancer, and his body's defenses to the coronavirus are severely compromised.
LAUREN JENKINS: I was sitting there thinking that perhaps I had been responsible for exposing Jay to the very thing that would kill him.
DREISBACH: Being a doctor, specifically an OB-GYN, is at the core of who she is. But in that moment, she says she felt like that very identity had betrayed her.
JENKINS: For the first time, I felt like my job was making me choose between my life's work and the wellness of my family.
DREISBACH: The next day, she got tested. She turned up negative and felt a flood of relief. But she also realized that she had to make a tough choice.
JENKINS: There can never be a next time. If this is OK, I can never do this to my family again.
DREISBACH: She and her husband talked about how maybe she could sleep in one room and him in another, but the chances of making a mistake just seemed too high. Taking a leave from work wasn't really an option because Jay's on her health insurance plan. But it was about more than that.
JENKINS: You know, you don't leave your team behind. It just didn't feel right.
JAY ROUX: I said, don't not work because of this.
DREISBACH: That's Jay.
ROUX: If this is what you want to do and you want to be on the front lines, then by golly, that's what you're going to do.
JENKINS: So in order to keep her family safe while she kept working, she moved out, eventually landing near her hospital in Philadelphia at an apartment that had been donated for use by health care workers. Every day, she could still FaceTime her husband and their twin toddler boys, Pierce and Ashton. But as we all know, it's just not the same.
ROUX: I miss my wife, you know? And I miss my wife with my children. It's not a home without us all there.
DREISBACH: So in the first few weeks away from home, Lauren started to strategize a way to safely visit her family. She came up with what they call her hazmat suit. It's the same kind of suit you might see in a high-tech lab, hooded set of white coveralls plus gloves, mask, goggles. And the idea was, if she had unknowingly contracted the virus at work, the suit would help protect the rest of her family.
JENKINS: Oh (laughter).
DREISBACH: She almost looks like an astronaut, but you get over it.
JENKINS: Part of what's so cool about kids is that they don't overthink things. It was like, oh, mom's been gone, and now she's here.
This is what the tickle monster looks like. Tickle monster comes in a hazmat suit.
UNIDENTIFIED CHILD: (Laughter).
DREISBACH: So about once a week, Lauren would come home in the hazmat suit and see her family. It wasn't like the times before COVID, they say, but it was something.
ROUX: Just when she wears that full suit and I get to even give her a hug and hold her for 5 minutes. It's - oh, it's amazing, you know? Not the real thing, but it's still amazing. I still feel it.
UNIDENTIFIED CHILD: (Laughter).
DREISBACH: And then in May, they decided they needed a change. Taking care of twin toddlers was always going to be hard for Jay, even though they have the help of an au pair. But Jay's cancer and heart complications from treatment make it even harder.
ROUX: I'm not 100%. I'm not even half the man I used to be, you know? And I'm only 44.
DREISBACH: The risk of the kids getting seriously sick from the virus was low, so they decided that this time, Jay would move out and Lauren would move back home. The day they made the switch, Jay went out one door of the house, she came in the other. Now Jay still comes by every day, does yard work, but he stays outside.
ROUX: And it's awful. I got to stay, like, 10, you know, 12 feet away from her. And I just got to give her one of those air kisses, you know? And I tell her I love her and then I - and we always say, this is weird, you know? It's just so darn weird. But it won't last forever.
DREISBACH: Not forever. But it's still not clear for them or for any other family exactly how long the pandemic will last. Lauren and Jay say their greatest fear is that they're losing precious time together as a family. As long as Lauren is working, they know the risk from the coronavirus will never be zero. But before they move back in together, they're still waiting for the number of infections to come down so Lauren isn't exposed to quite as many patients with COVID-19. And if places open up too quickly, they're worried the virus will just continue to spread. And that means their family will have to spend that much more time apart.
Tom Dreisbach, NPR News. Transcript provided by NPR, Copyright NPR.