My Uncertain Journey

In March, when COVID-19 became a genuine concern at the state level, I felt that although I had not anticipated a global pandemic specifically, my small firm was set up to work from home, and I made that call a day before the chief justice of North Carolina’s supreme court began to issue orders limiting access to the courts.

Attending to my eight-year-old daughter’s schooling was a lot less straightforward. When in-person classes were initially suspended in our school district, she was on spring break; traditional classes never resumed. My husband and I had to learn how to teach and support our daughter as we became increasingly certain that she may have a learning disability.

My husband’s work switched to a rotation schedule even though, as management in corporate dining, his work is very much on site. We traded off work, home, and now teaching responsibilities.

We fully recognize how extremely fortunate we are in regard to our ability to continue to work from home and keep our benefits. In our minds, we really had no right to feel a sense of impending doom and dread as we watched the numbers of COVID-19 infections and deaths escalate throughout the spring. And those feelings were not productive to “solving” any of the problems we still faced.

As my husband and I made lists and divided tasks, trying to stay one step ahead of, well, everything, I researched increasing our life insurance, including a separate policy for my firm to insure me to pay someone to wind up my practice if I passed away. I compiled options for short-term and long-term disability insurance policies. The research was “in progress.”

But as March turned to April, and April began sliding into May, I stopped sleeping. My billable hours plummeted, the phones stopped ringing, and emails crawled in as the courts shuttered for the foreseeable future.

I would get so depressed that I would sit and stare, unable to move, feeling literally stuck in place. Then I had an anxiety attack—heart pounding, sobbing until I could not draw air. I was a mess. And I felt guilty for struggling; I am competent, resourceful, and powerful. My mind was spinning through each worst-case scenario, just as it would be in preparing for court. But here, in our reality, I had no clinical distance, and there were far too many variables that I could not argue or rationalize my way through or around. There was no case on point to tell me how my choices would keep my family safe and my business viable; no statutes to guide me on best practices to navigate my way through what was becoming dire daily news reports of illness, fatalities, and long-term effects for those who survived COVID-19. My lists were not helping, not here, not with this. I put my pen down.

I reached out to my primary care physician. As I discussed my symptoms and concerns, there was no insinuation that I was being histrionic (a pejorative term on its face). Although I wanted to believe I could just “work through” whatever was causing my anxiety (life), I took her advice and started a low-dose selective serotonin reuptake inhibitor—an antidepressant—and scheduled a virtual follow-up visit. Unfortunately, my sleep was still almost nonexistent, and I experienced another anxiety attack before my next appointment. I agreed with her recommendation to increase my dosage. My sleep has improved somewhat, and my anxiety was shoved back down into its dark little corner.

In my virtual follow-up visit with my primary care physician, we decided to take some x-rays of my hands to look for arthritis markers to try to explain the intense pain I feel in nearly all of my joints. On May 20, 2020, having been home from my x-ray appointment for less than an hour, my primary care physician called to tell me that I have a bone tumor in my right index finger. She was optimistic it was something called an enchondroma, a typically benign tumor. But, due to some past blood work and the tumor’s proximity to my proximal joint (where the finger attaches to my hand) she wanted it removed right away. She wanted the pathology report to be sure that the tumor was not malignant.

I put my pen down and, honestly, I laughed out loud for what felt like an eternity. This could not be happening. It seemed grotesque that other calamities were allowed to occur while COVID-19 still ravaged the country. Some things should just have to be held in abeyance while it seemed the world was literally on fire. No cancer; no tumors. Heck, if I had a say, menstruation would even be paused until life seems a little more manageable. But as was the problem with most things, from my perspective, I did not get a say.

My primary care physician referred me to a very reputable surgeon. I asked my sister-in-law, who is a nurse, and my mom, who was a volunteer first responder and firefighter and has experienced her own bouts with cancers, to help me generate a list of questions to ask at my surgical consultation. If this were for a client, I would have been all over it—researching articles, surgical techniques, mortality rates, etc. But when I am the patient, Google is dangerous, and my brain just sort of shuts down. And this time, because of COVID-19, no one could go to the appointment with me.

I can tell you that my initial conversations with doctors are always pleasant. Until they ask what I do for a living. Over the years, I have made up occupations: taxidermist, garbage collector, anything other than telling them that I am an attorney (I am now too old to go with amateur wrestler). Invariably, the tenor of the conversation changes; the quality of the information degrades to opacity. Sometimes I just want to be a patient! And this time was no different. The surgeon would not commit to a likelihood of my keeping the proximal joint. If I could not keep the joint, I would lose dexterity in my finger. It seems we can replace hips, and the patient is, generally, much improved. Not so with finger joints, apparently.

Thanks to my white privilege and persistence, I secured a second opinion with a bone cancer surgical specialist. Based on my prior “blood issues,” I was also able to convince my primary care physician to schedule more x-rays to see if there were tumors elsewhere that were causing me pain. Forty-five x-rays later, my primary care physician found bone spurs, compressed discs in my spine, and a mass in the soft tissue of my right leg. I needed an MRI to see whether it was benign; it was and it will just be monitored at this point.

The second surgeon was very kind and helpful, even after I told him I was a lawyer. He was optimistic about my likelihood of keeping my joint—a chunk of bone was already eaten away by the tumor and would have to be replaced—and had a good professional opinion about the first surgeon. That was comforting.

My finger surgery was scheduled for June 26, 2020. My husband and I had to try to find a way to tell my daughter and at the right time: not so close to the date that she would not have time to process and ask questions, but not so far in advance that she had time to just “spin out” in her anxiety.

And now I had to make an equally difficult set of decisions: How much do I share with my colleagues, clients, and the court about what I was facing? Contrary to the impression this article may give, I am a fairly private person. I certainly did not want to appear as if I was unable to handle my business, that my issues were more important than whatever they may have going on. But I did not want to go to court or meet anyone in person if it could be avoided; I did not want my surgery to be delayed due to a COVID-19 diagnosis, even if I wanted to believe I was young and robust enough to survive.

The research I had done for additional life and ancillary insurances were useless while this tumor diagnosis waited in the wings. I kicked myself for not moving forward sooner. But hindsight is always 20/20. All I could do was pick up my pen and make what arrangements I could.

While I still have not drafted a formal “succession plan,” I did contact a colleague to see if he would act as my emergency contact, someone my paralegal and husband could contact if something happened to me, to triage cases and wind up my practice. He immediately agreed. I told him that before he agreed, he should know about the tumor and that I had not been able to procure a separate firm life insurance policy for me prior to the tumor being found to definitely pay him for his time, because although he is a few years older than I am, there is the potential for something on the horizon that may make this a little more “real.” He still agreed. I could check that off of my task list, put my pen down, and focus on getting ready for the surgery, recovery, and waiting on the pathology report

I had my COVID-19 test June 24, 2020—negative.

I was allowed only one person, someone to drive me home, to come with me for the surgery. My husband and I made the calculated decision to send our daughter to my mom’s house the night before my surgery, to stay for the weekend. When I saw my mom, we hugged, even though I knew it was the wrong thing to do. It was the first time I had seen her in person since the end of February. As grown as I am, I needed my mom. I was scared.

My husband and I showed up at the surgical facility a little early. He shuffled off to a completely different part of the building while I was processed in for surgery. I was lying on the gurney in my surgical gown, hair up in a hair net, glasses stowed away.

The surgeon came in and sat down in the chair next to me. Rubbing his hands together, he told me that they were going to have to postpone my surgery. I thought this was a scheduling or insurance issue—something that should have been identified and resolved prior to my shipping my daughter across the state and mentally preparing myself, my paralegal, and my family for the recovery and impending pathology report. I had not taken my medications in two days nor eaten since the day before. I was annoyed.

The surgeon snickered. Bold. He said, “No. Your last pre-op test came back positive.” I proceeded to tell him he was mistaken because I had my COVID-19 test two days prior, and it was negative; it was in my chart. He smiled bigger—now I was about to blow my top.

“You are misunderstanding. You gave a urine sample when you came in this morning. The last test is a pregnancy test. You are pregnant.”

“I am 40 years old.”

“We checked it twice.”

Again I laughed. I laughed long and loud with a hand over my stomach. After I wiped the tears from my eyes, he said what would become a recurring refrain, “Congratulations”—as much a question as a statement, under the circumstances.

In my mind, I picked up my pen and started asking questions about when we could safely reschedule the tumor removal and what I needed to do next (after I got something to eat).

I got dressed again and immediately texted my husband that my surgery needed to be postponed; it was not an emergency, but we needed to talk. The administrators and in-take processors looked at me as if I was escaping—people typically did not walk out the same door through which they entered.

My husband says he could tell I was pregnant by the utterly stupefied look on my face, even with my mask on.

I am 40 years old . . . pregnant . . . with a bone tumor . . . during a plague.

Instead of giving surgical updates, we were telling people the news. “Congratulations?”

Our daughter was ecstatic; I thought my mom would explode with joy. But within a 24-hour time span, my daughter went from elation to terror that the baby would catch COVID-19. We talked through all of the facts as we understand them and what we could and could not control. Her fear is managed but in no way gone.

And, sincerely, neither is mine. My finger joint is hurting. I want this baby to be safe and healthy. I want my business to thrive. I need the authoritarian turn of our government to stop—or be stopped—in its tracks. The world is still on fire. The pandemic is still burning its way through the country. And I am trying to incubate a whole new human.

On any other day, at any other time, I would state without hesitation that my highest obligation is to my clients. Is that still true now that I have a tiny human inside of me, counting on me to always make the decision that will provide protection? If it is still true, what does that look like now with COVID-19, with protests, with unidentified militarized forces purporting to act on behalf of the government silencing dissent, gassing, maiming, beating, and kidnapping nonviolent protestors?

I do what I know how to do: I pick up my pen and make lists of financial moves I need to make, things we will need for a new baby, how to prepare to acclimate my daughter to the new addition to our family. And I wait. And I worry. And I continue to put pen to paper, furiously scribbling, plotting to try to make sense of it all.

I do not ever have all of the answers. But I do have plans, whatever they are worth. I am reminded of playwright Edward Bulwer-Lytton’s words from 1839: “The pen is mightier than the sword.” I hope it may just be.

Erika Bales is the founder of the Law Office of Erika R. Bales, PLLC, in the Raleigh-Durham area of North Carolina. 

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