For This Lesbian Physician Assistant, Being Out at Work Is Essential

The stars twinkle overhead in the clear sky as I open the front door, kiss my fiancee goodnight, and leave for my shift at the hospital. I sit on the porch and put on my work shoes, taking a few seconds to gaze at the nighttime sky and breathe in the crisp evening air. The irony is the stark contrast between this moment and the rest of my night.

The cool air will dissipate into my warm, humid breath trapped under a mask and a faceshield to prevent contracting COVID-19 while caring for patients overnight in the Emergency Department. Stars will be replaced with overhead fluorescent lighting as I make my way from room to room to care for patient after patient.

I enter the room of a patient who just arrived by ambulance. Frightened eyes make contact with mine. By this point, I'm another faceless person with a muffled voice hidden by layers of protective equipment. Sometimes I'm able to ascertain the information I need to have a clear understanding of what brought someone to the ER. Other times I'm not. Prior to COVID-19, this patient would likely be accompanied by family members who could provide much-needed context regarding why the patient was here with me in the middle of the night.

Sometimes I'll hold a patient's hand to calm them. "It's okay to be frightened. Everyone is just here to help you," I say as I brush a hair out of their face. I glance at the cardiac monitor, concerned about the vital signs flashing across the screen. "May I call your family?" "Yes," is the reply. "Call my daughter. You remind me of her. Can you tell her I love her?"

I quickly place some orders in the computer and go back to my workstation to find the patient's emergency contact information. The patient's daughter picks up after the second ring. Her voice cracks as the details of tonight spill out in a run-on sentence. "I'm outside in the parking lot. Do you know what's wrong? Can I come inside?" she pleads. "I wish you could, but it's not permitted. It's for your safety," I try to explain. "We're doing everything we can to keep everyone as safe as possible. I'll call you with another update as soon as I have one. There is a phone in the room that you can reach if you call the main number to the ER. Your dad wanted me to tell you he loves you, and I promised I would."

This scenario or a similar one plays out over and over again, hour after hour, all through the night until rays of sunlight start to peak through the ambulance bay windows shining much more vividly than the stars that guided me to work.

Over the last week and a half, COVID-19 cases have steadily increased in my North Carolina community. To quote Lin-Manuel Miranda: "In the eye of a hurricane there is quiet for just a moment." The eye of our hurricane lasted for weeks as our colleagues in Washington state and New York shared their stories with the medical community and the world. We knew what was coming, but all we could do was wait.

During a recent lecture, I was asked if it really mattered if an LGBTQ+ person was "out" at work. As a gay woman working on the frontlines in health care during a worldwide pandemic, I took this question to heart. Because it is important, now more than ever.

There are brief moments between the constant hustle and bustle of the ER where there is time to take a breath and check in on colleagues. We talk of how we are coping with the current state of the world and of our community. My co-workers ask about my fiancee and how she is doing on month three of working from home. I ask how they are handling homeschooling and being away from their elderly parents. We do our best to keep each other's mental health in check night after night. We are each other's support system because no one else really understands what we are going through right now.

To me, this is why it's important that I'm out at work. It's not about letting patients know that I'm a member of the LGBTQ+ community -- as the patient, it's about them, not about me. But with colleagues, it's important that I can let my faceshield down, remove my mask, and relate to them just as two people sharing our current struggles, hopes, and dreams. We all need that for our own well-being.

And just like that, the moment has passed. A stretcher carrying a new patient who appears to be in distress passes my workstation. Thoughts and conversation of our lives outside of work are pushed aside, and my entire focus shifts to the patient in front of me -- someone's child, parent, or neighbor. A person that likely means the whole world to someone else. It's time to start the process for which I was trained all over again because, first and foremost, I'm a physician assistant. I just also happen to be a lesbian.

Mia McDonald is a physician assistant in the North Carolina-based Cone Health network and board member at GLMA: Health Professionals Advancing LGBTQ Equality, the largest association of LGBTQ health care workers in the nation.