Melissa Gilmer Scott is a family health physician and lead provider at a community health center in Moncure, NC where she leads a team of nurse practitioners and doctors. When we spoke with Melissa, she shared details on how she navigates the pandemic as a frontline worker while balancing her responsibilities as a mother and a wife. This conversation took place in May and has been edited for length and clarity. To learn more about Her Testimony and participate in our survey, visit here. The survey can be completed by anyone who identifies as a Black woman residing in North Carolina who wants to share their experiences during the COVID-19 pandemic.
Here is Melissa’s testimony.
Reflecting on what this experience has been like so far, what are a few words or images that come to mind?
Chaotic. Very chaotic. Adaptive, I would say. It’s been a lot of adaptations that had to be made. Very emotional. Just a lot of emotional roller coasters between roles.
How has it been chaotic between your roles?
Just having to be in different emotional states depending on where I am or what I have to do. I have a leadership role at the clinic. I’m actually the lead provider. So I’m in charge of all of the PAs, the nurse practitioners and all of the other medical doctors that work at my clinic. So I had to help to organize and give input in meetings in having to adjust and drastically alter the way that we do our job for the first time ever. And to make sure that things are happening when they need to happen to get to the other side of this without contracting this ailment has been less than fun.
How have you been adapting under these conditions at work and at home?
The adaptations at work have been more difficult than the adaptations at home. Previously, my work was always very predictable. I’ve just been there for so long that work was kind of comforting at times because this is what I’ve been doing for 20 years. And home was more chaotic with all of the things that have to be done at home and the places that people have to be. The events, all of those sorts of things. And now it has sort of flipped flopped a bit. My youngest is still going to his daycare. My daughter has always been amazingly independent and responsible. So she’s here, doing her thing, keeping up with her work. My husband is with outside sales so he is an essential employee and is continuing to work. He comes in and out of the house throughout the day. So when I’m at the clinic I know that my daughter will be able to see him a couple of times today and not really here alone.
So life at home is pretty calm. I go to the grocery store, cook dinner, we take the dogs for walks, go out and play, sit out on the porch. Things have flipped flopped. Work is crazy and home is very peaceful.
How has this experience impacted your daily life?
I think the biggest thing is that my in-laws live seven minutes away. They used to keep the kids overnight. That part has been hard to get used to and not knowing, well there will be an end to this, but not knowing when that will be. It might be next year where we will have to continue to distance ourselves from them and not have interactions with our children that they have moved to NC for, so it’s been difficult.
What has been a low point for you?
Being in health care, we started to prepare in the first week of February because we just knew. Okay, it’s in Washington state so it may as well be here. We just started the preparations for asking screening questions and got ready to be here. Even with all of that preparation, when it actually came here when they closed the schools, everything started to happen, it was go time.
We were talking about masks and how many we have and how many people we can have in the building. How many employees can we have in the building? How long can masks last? So those sorts of things.
I think around mid March, things really became very clear that we were diving into this. We have an affiliation with UNC and in my head I had this theory that UNC was going to have this respiratory clinic in our county and they were going to be testing. It turned out if you work in a community health center and there is a public health crisis, you get thrown into the middle of it. So we had a tent. When they put a tent outside of our clinic, that may have been the breaking point for me. Knowing that our employees will be doing the drive in testing, the evaluations, and that kind of thing.
I have been able to stay in a leadership role with that and not actually do any. There are younger people than me at my clinic. So I have recognized that being almost forty-six is not young when it comes to COVID. So I have been able to do a lot of telehealth and see very few patients in the clinic. I think that realization was like, “oh my god, we are really going to do this.”
How frequently do you go to the clinic?
I go on Mondays and Fridays and that’s when I actually touch patients. Friday is a half day. I really have about ten hours a week of touching patients. And then Wednesdays and Thursdays are telehealth only. I stay at home on Wednesdays.
About a month ago, we all started wearing masks, all of the clinic staff. Pretty much as soon as you go into the building, we get our temperatures checked. We wear our masks all of the time. I have an office and I go to my office to eat or to just take my mask off for a second. And then we are staying 6 feet apart from each other while we are at work. Mostly I’m staying 6 feet away from the patients also. I put gloves on and examine them really quickly and then we just go to the opposite ends of the room. Both with masks on. All of the patients are getting masks as soon as they walk in if they don’t have one already. We have gotten used to that. The new reality that is going to be happening for quite a while.
Are there people coming in checking for symptoms of COVID or are they coming in for other health issues and normal check ins?
That was our main concern.
How do we keep the sick people away from the well people? How do we create an environment where people can come and get care without getting worried that they will come and get something else to take home?
We have screeners at the door asking patients if they are sick in any way. Cough, fever, runny nose, short windedness. If they have been in contact with anyone who has been sick? If they work at a factory of any kind? We ask a million questions on their way in. A lot of people blaze through the questions, we found. So we had to get really specific to make sure we know if they are sick in any way, they cannot come into the clinic. You are going to get in your car. Drive to the tent. And they will talk to you.
For our elderly population, we pretty much changed 95% of visits into telehealth or video calls. We tell them to come in between the hours of 8:30-9:30a. Sometime in the next couple of weeks, you’ll get your lab work done. You’re in and out. We’re trying really hard to do what we normally do. Or at least to continue to provide that care.
There are some people that we need to see in person. Mostly prenatal and pregnant people. And then if someone needs a procedure done, mostly contraception like IUD, then we’re still doing that. That was what we were doing in February to figure out who we really need to see and who can delay coming into the clinic. We are still figuring out the pediatric situation, which is why the schools are closing. They are the germ carriers of the world. They are just spreading stuff all over the place.
We are doing a lot of telehealth there. But several times a week we are having conversations amongst ourselves in leadership trying to figure out how to give vaccines and keep them current on stuff without affecting our staff. We do have enough PPE. We actually got donations and the state has provided more. UNC has provided more. So gowns, gloves, masks and face shields that can be used if someone needs to evaluate someone who is ill in any way.
What’s a high point for you?
I think the high point has been in two areas. At work, it’s really been seeing the team come together. We have a good team with everyone’s goal is the same. Everyone wants to help the patient. Everyone wants to do what they need to do in order to serve our population and that has been really refreshing. All of the staff have been willing to adjust their jobs and do things that they would not normally do, like run medications out to people’s cars to help out.
Spending more time with my family has been great. Being able to sit down with more meals. The weekends have been really nice to have that downtime. We worked a few puzzles.
What have you been learning about yourself and what you need in this time?
I definitely learned that I probably do need more downtime that I have been having previously. It’s very energizing. Even if it’s 30 minutes a day of just down time. For a while when things were really crazy, in the post COVID super craziness, I found myself watching jeopardy every night. And that’s just a comfort thing. I watched Jeopardy with my mom when I was a kid. She watches jeopardy every day. My dad died a couple of years ago and when he was in the hospital, she would be home, every day at 7 o’clock watching it. I think I defaulted to just having that kind of consistent comfort. Alex is always there. I did find myself doing that and that was really helpful.
You talked about March, and how you were preparing in February. Now we’re in May. Did anything shift at all in regards to what you’re seeing? I know cases are continuing to rise. And I know a lot of people believe that we should not be opening up.
I think we are just starting to get into a routine. When we started telehealth, it was just telephones because they had to figure out zoom licenses to pay for the HIPPA protection. We just started televideo a couple of weeks ago. We are still figuring that out, especially in a rural population.
We have a super underserved population. Forty percent hispanic and thirty percent African American. And then just rural. Between connectivity and flip phones and all kinds of things. And the fact that grandchildren are not around their grandparents to help them figure this out. It’s still a learning curve with that.
In our community, because of the prevalence of essential workers, tons of essential workers go to community health centers because it’s affordable and we take the uninsured. So we have a lot of fast food workers, grocery stores workers, meat packing plants workers. Other factory workers in Lee and Chatham, county.
We know that COVID is going to be with us for a while.
We just know that because we don’t have people who can social distance at home or work. At work they are working it out and being receptive at the plants to figure it out so that they will not have the same kind of outbreaks that they had. But at home, we’ve dealt with families of twelve people in one home. And they all had COVID. Nobody can isolate.
But we have been working with people to try to help meet their needs. Even their community needs. Helping procure food. Our pharmacy started delivering medications. Anything that we could do to help them get the services that they need, which can be difficult sometimes. We’re also dealing with undocumented people at times. So there are some services that they can’t really get. We got a lot of folks working on it and it’s all hands on deck. We really try to get healthcare in the community, especially with COVID positive patients. To make sure that they have what they need to isolate has been really important.
What have you learned about the needs of your community?
I’m part of a facebook physician doctor mom community. It’s actually international. I think 100k. That’s been really helpful during this time because you are in your own world. There are not a whole lot of people that have the same circumstance of a female minority doctor mother. So it’s good to be able to see how other people are doing this and what they are going through. What’s taking place in other towns and cities around the world during this time. It gives me a few more tools in my toolbox to navigate and to help make informed decisions.
What have you learned about your fellow coworkers or just healthcare workers in general, around their needs?
There have been discussions on the facebook page. People would throw out questions about “what are you guys doing about this” or “have anyone seen their parents lately?” Just trying to figure out how people are navigating. I know when all of this started, people were figuring out if they needed to be on the frontline in New York, and keep their families safe by isolating themselves. With my more close knit community at work, I’ve been checking in on people more often. We had a zoom meeting which was nice because we are trying not to have too many people at the clinic at a time so we can go weeks without seeing certain providers and doctors. It was really nice to see everybody.
I definitely found that having support from your fellow comrades, knowing that other people’s hairs are on fire too, is really helpful because sometimes you get the thought that you can handle anything because you’ve done so much already, as a physician. You just feel like you can pile on as much as the world has given you and you keep trudging on. Just knowing that other people, you may think should be doing well, but aren’t, is really helpful to put it in perspective.
I had a talk with one of the younger providers who is out doing the testing. He’s newer, only been practicing for a couple of years. This was mid March and he was starting to feel like he was coming down with something. But it was Friday, he’s been doing testing all week. He took his temperature. I told him, “this is super hard. I’ve been doing this for a really long time. This is not normal. There is nothing normal about this. It’s really really hard. You really need rest. Go home, drink water, go for a run. Do whatever you need to do to recharge because this is really really hard.”
So I think that just a way to acknowledge that this is not normal. There is nothing normal about this. You have nothing in your toolbox in order to take care of this. So whatever you do in order to get through difficult times, do that. You need to just put as much as that in your life as you can find. This is not going anywhere and we are going to be here for a while. You really have to remind yourself, okay, I think I used to like to do this. Let me do it. My kids brought out the puzzles and I was like, yeah lets do puzzles. That sounds like a great idea. We are going to sit at this table and work some puzzles.
Where are the places that you are finding joy?
I am really finding it in a lot of different places. I’m finding a lot of joy in nature.
I’m finding a lot of happiness just sitting at my desk and listening to the birds and let the sun hit my face.
Taking deep breaths. We have two puppies. That’s been fun. And then just watching my daughter grow has been really cool. She’s just at this really cool age. She’s this tween. She’s been really inspirational for me. She completed 30 days of yoga when this first started. Now she’s on 30 days of mediations. She’s working on different crafts and projects. She’s really taking this time and making the most of it. Showing me that if you have time you should do what you want to do as long as it doesn’t involve being around a lot of people. Those things created a lot of joy for me.
What are your hopes for the future?
For myself, I hope I can remember this time. If things get too hectic, I could just continue to remember and take time for myself. And to live a realistic life would be the most important thing. To figure out if I’m doing too much, how can I do less? Who could I ask for help and what can I say no to? All of those sorts of questions. Hopefully I will be able to continue to remember priorities and how to prioritize in life and continue to interact with people and circumstances that do revitalize me and give me joy.
I really hope that society comes out of this way different than before.
I definitely find myself interacting less with social media because I couldn’t relate to all of the materialism, selfishness. I really hope that we come out of this being a better community, more of a global community, more of a brother’s keeper type of community. Now that everyone has seen all of the problems of the United States, I feel like we have seen the problems for a long time. Now that people have time to really see and share, hopefully a large number of people are waking up to understanding that there are a lot of problems here. Hopefully, they will continue to do whatever they started doing during this time to be able to fill some of those gaps that they found.