Ob/Gyn Dispatches During COVID-19: Catherine Monk, PhD

Each day during the COVID-19 crisis, we'll share an update from a member of our team in the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center. Today's note is from Catherine Monk, PhD, Professor of Medical Psychology in the Departments of Obstetrics & Gynecology and Psychiatry, and Director of the Women’s Mental Health @Ob/Gyn initiative.

What comes to mind about this period, the pandemic, is the relative silence of our raucous city. Silence and then sirens, too many sirens. Then two sirens simultaneously, one on my end of the telehealth mental health session, and one coming from the patient’s neighborhood, as if orchestrated to blare together.

There is of course an emotional toll of the pandemic — destabilizing anxiety and fear, a constant “What if?” of worries and disrupted sleep; sadness and grief for people lost, or the life lived or longed for on hold; and tremendous isolation. The pandemic can severely undermine a sense of reliability and control. At times these difficulties are on top of existing problems, like postpartum depression, cancer, an abusive relationship, or a pregnancy loss. I am grateful to the five other clinicians on the women’s mental health team who provide patients with tools to manage the distress and make connections to the patient’s past, which reveals solutions for managing upset now. We hold telemedicine therapy sessions, over and over again, for each woman, each group, and in doing so, contain the disregulated emotion, and model that the distress can be tolerated and alleviated. 

We also hear from patients about other experiences, what Camus called “a happiness that forgot nothing” and our governor terms “the silver lining”: Women with newborns and infants feeling they and their partners now are having the kind of long-term family leave (albeit with full work demands) that is common in many other countries. Also, a slightly slower pace to life, more cooking, healthier eating. In psychotherapy, we call this a reframe: What else can we see in this situation? How else can we look at it to make it manageable?   

I am aware of other changed sounds in our city. The lovely bells at Riverside Church are louder, and likely blanket the area as they did when the church was built in 1930 and there was less traffic, and no construction sites active on Sundays. Birds singing, a lot: who knew there were so many in Manhattan? And the 7 pm joyous, exuberant noisemaking from windows and balconies, thanking frontline providers.

In the inspiring reflections so far, people have quoted leading thinkers, while Dr. Wapner referenced that star athlete from Philadelphia, Rocky Balboa. Similarly, I will cite the great poet from Ashbury Park, Bruce Springsteen: “The road is dark, and it’s a thin, thin line, but I want you to know I’ll walk it for you anytime.” Those words are the sound I hear on this call every day and during all interactions with people from this department in dealing with the pandemic. I am in awe of the sense of communal purpose and selfless commitment to patients and each other, from every person playing a different role that adds up to the care we provide. The support and sense of shared purpose is wonderfully uplifting and will go a long way to getting us through this health crisis.

Catherine Monk, PhD