It’s a scary time to be on the front lines of the COVID-19 pandemic — even scarier when you’re a parent worried about bringing home the virus that has sickened at least 631 people in Hawaii and killed 17.
What’s a doctor to do when she’s got a little cuddler waiting there who doesn’t fully comprehend all that’s happened in recent months?
“Most nights we try to have dinner at the table, but my youngest is only 7 and he’s usually in my lap,” said Honolulu emergency room physician Dr. Jaimie Tom. “We’ve been trying to keep as much distance as we can, but he’s very much a hugger and we’re trying to minimize that for now. It’s hard to explain, but he kind of understands why. He goes, ‘You’re not sick.’ And I tell him, ‘I know, but I don’t want you to get sick.’
“He’s beginning to understand, but it’s hard for him, and me, too.”
Tom, 49, is an ER physician with US Acute Care Solutions who works at Pali Momi Medical Center in Pearl City and Kapiolani Medical Center for Women and Children. She has been married for 21 years to surgical oncologist Dr. Shane Morita, and together they have three boys, Josiah, 16, Elijah, 13, and Zechariah, 7.
The close-knit Manoa clan has found a measure of comfort in these uncertain times by engaging in household projects together and continuing a commitment to community service. But Tom admits the first days of the new coronavirus outbreak in Hawaii were unsettling, especially for the medical professionals who didn’t know yet what they were facing.
“It was really scary. In the beginning it was such an unknown and it overlapped with flu season, and at the time most of the screening was based on travel history,” said Tom, who is board certified in emergency medicine. “We didn’t have much testing available here and it had to pass through the Department of Health. At that point we were seeing people with coughs and fevers, but we were lulled into thinking that as long as you didn’t travel the risk was pretty low.”
She said the local health care community started to get an idea of what might lie ahead from news reports and alarming social media posts by doctors and nurses in New York, where more than 21,000 people have died from the disease.
“You read that and your level of anxiety goes up and you prepare for the worst,” Tom said. “In the beginning we were making sure we were being cautious about preserving PPEs and keeping our health care providers safe. And whenever you got a sick person who might be coughing, your level of anxiety goes up and you’re thinking, ‘Am I going to go home and potentially spread it to my family?’”
At that point she considered moving into a condo, away from her family, “until it blows over.”
For many weeks, “staff was torn because all of us who went into health care decided that what we wanted to do is help people when they are most vulnerable. But in the back of my mind was how I was potentially exposing my family and my kids, and how to keep them safe when I come home,” Tom said.
“But that’s our job, that’s what I’m supposed to do — and our kids know that.”
As Hawaii’s public health response ramped up, hospitals throughout the state began setting up temporary screening and triage tents that diverted COVID-19 patients away from ERs. Drive-thru testing at various community sites helped keep the public from overwhelming medical centers, “allowing hospitals to take care of ones who were sick enough and limiting exposure” to other patients and employees, Tom said.
Elective surgical procedures were postponed and health care providers and patients quickly transitioned to “telehealth” to further minimize infection risks. “Everyone was on the same page and that really helped,” she said.
“But we were still so anxious and everyone was very stressed out about being properly covered and protected. Once we got into it you started to have more faith in the process of screening and we had protocols to divert these people who are not immediately sick and keep those outpatient cases out of the hospital.”
Because of the relatively low coronavirus numbers in Hawaii and effective screening protocols, Tom estimates she’s treated only a handful of active COVID-19 cases in the ER. When cases have come in, “we work as a team and it was almost like controlled chaos. Everybody knows what to do,” she said. “It’s not like TV, where people are hacking and collapsing to the ground.”
Intubating any patient in respiratory distress is tricky enough, Tom said, but conducting the procedure on someone infected with COVID-19 upped the ante. “Now you have to worry about doing the procedure in a manner less likely to spread the virus.”
Her strong Christian faith and sense of working for a greater purpose helped overcome some of her worries during the crisis, she said, and as a mom, Tom also felt challenged to be an example for her children.
“It’s easy to be an example when everything is smooth sailing, but to have your children see you struggle, see your fear and then witness how you deal with those situations, I believe, is one of the most valuable gifts you can give to them.”
Call to medicine
Tom said she found her calling during a required rotation in emergency medicine while studying at the University of Hawaii’s John A. Burns School of Medicine. “I just loved it. I thought, ‘Oh, my gosh — this is where I need to be.’”
Reflecting further on her career choice, she explained: “It’s the fact that you get to see people at their worst, when they are very, very sick or very, very scared and you have to help someone almost immediately, and if this whole team wasn’t here at this very moment, the outcome would be very different. Every day you go to work it’s exciting and scary. You don’t know what is going to walk through that door. And it’s being able to get people to trust you right away versus having to build a rapport over a long period of time (in an office practice).”
Tom said she didn’t aspire to become a physician while growing up in Kahaluu the eldest of three children. She attended Maryknoll School in town, and because of the long commute, Tom often stayed with her grandparents in Manoa.
“I never really thought about it during high school. I didn’t have anyone else in my family in the medical profession and I always had a little bit of doubt whether I was strong enough to do it. It never crossed my mind until my grandpa got sick,” she said.
Tom was attending UH as an undergraduate at the time, catching the bus after classes to her grandparents’ home.
“I really was close to him and saw how scared he was when he got sick,” she said. Shortly before he died of cancer, “I was talking to him on the phone, and all of a sudden it dawned on me that he actually got to live a couple of years more than what we thought. And it struck me how these doctors who didn’t even know us, that they would go out of their way to help him and help our family — even just the guidance and information they gave us on what to expect. That’s amazing. You don’t only change one person’s life, but the whole family. That part really left an impression on me.”
She went on to transfer to the University of California at Irvine, where she earned a bachelor’s degree in biology before enrolling at the UH medical school.
Morita, who grew up in Hilo, said he “hit the lottery” when they married after both graduated from the JABSOM in 1998. “She was there for me when my dad was fighting cancer and my mom was battling dementia,” he recalled. “We have been together for 25 years and she never ceases to amaze me.”
The couple lived on the mainland in the early years of their medical careers, with Tom serving stints in ER departments at hospitals in Long Beach and Orange County, Calif., and Alexandria, Va. The couple’s older two sons were born on the mainland, and the family returned to Hawaii for good in 2007.
Early on, to build some consistency into her schedule to accommodate their growing family, Tom volunteered to work nights in exchange for choosing her days off. Morita sees patients and performs surgery at The Queen’s Medical Center during the day, and like many working couples, they’ve found success with tag-team parenting, with an assist from family members when needed.
“It’s worked, we’ve managed,” she said. “I’m one of the lucky ones: I can sleep in the day.
“My bosses have been very supportive because I was able to have a set schedule. I’ve been able to be around for a lot of the kids’ activities, field trips and sports and then go to work. A lot of the kids’ classmates thought I was a housewife because I’m around a lot in the day and I could volunteer.”
But there are times when the urgent needs of their patients have taken priority, and their three sons have grown to accept that.
“This is how our life has been since they were little. We may not celebrate Christmas on Christmas or your birthday on your actual birthday, but that’s just the norm for our family,” Tom said. “They realize that if it’s possible for us to be at the game, we’ll be there. They understand that. And at least one of us always tries to be there.”
The small moments
Stay-at-home orders have afforded the family time to enjoy movie nights, start a vegetable garden and compost heap, and engage in other activities around the house. Tom said she especially cherishes the time spent with her oldest son, Josiah, before he heads off to college in a couple of years.
“You’d think that we would all be crazy being all cooped up together, but I feel like it’s made us appreciate how precious the time that you have together is. I’m almost going to miss it,” she said.
The pandemic hasn’t interrupted the family’s community service effort, dubbed Keiki-Ade, which gets its name from the lemonade slushies the boys sell at craft fairs and other community events to raise money for charities. Other projects have included sponsoring monthly birthday parties for children at the Next Step Shelter in Kakaako and donating 200 Easter baskets last month to families at the Kahauiki Village affordable-housing project in Kalihi.
“Shane’s parents were active in the community, and one of Maryknoll’s missions is ‘noblesse oblige,’ (a responsibility to act with generosity and nobility toward those less privileged), so it’s always sort of just been what you do,” Tom said. “It’s nice because our kids get the benefit of seeing how something so small and simple can make other people so happy.”
While treasuring the smaller moments at home that have come during the COVID-19 crisis, Tom is ever aware of its historic scope.
“It’s been crazy. It almost seems surreal,” she said. “As we’re going through it in real time, you are realizing we are living through a major part of history. People will look back 20 or 30 years from now on this huge pandemic that touched the entire world. It makes you realize what a small world this is; everything is so global and interconnected.”
As an ER physician for two decades, Tom said she is also well aware of “the realization that life is precious and very short and could be taken away at any moment.” COVID-19 has forced the public to confront these realities, while highlighting the dedication of health care workers and first responders, who likewise have had to reflect on their professional and personal responsibilities in trying times.
“This current state has really illustrated to me that although there are situations that are out of my control, I do have control over how I will respond to those situations. Am I going to focus on all the negatives? Or will I choose to focus on the upside?”
The answer, for Tom, is obvious.