The GP couple balancing family life and work during the pandemic

"Give your kids a hug, a really big one, every chance you can. All the rest is optional," says husband and wife, Dr Knut Moe and Dr Hana Maka, when I ask their advice for other general practitioners attempting to balance working through the pandemic and caring for their children. Knut and Hana manage their busy GP practice in Churchtown, Dublin, while Knut also manages his father's practice in Clonskeagh.

The overwhelming pace of the pandemic has had a significant effect on their workload, which inevitably impacts on upholding a stable family environment. As we have faced intense closures, Hana and Knut are conscious of how the pandemic has affected their two boys, Harvey (4) and Freddie (7), from the beginning, and how family life has altered.

"The first lockdown was really hard on the kids. We were both working so hard," says Hana. "While Knut was focused on working on pandemic projects, such as the screeningform.com tool for patients to submit Covid-19 queries, we were also making changes to practice operations, and the kids really suffered during the week from lack of stimulation."

While many of us can appreciate how unbalanced these pandemic days are, Knut and Hana are two doctors working, living and raising a family together. The boundaries between work and home life, which can ordinarily be maintained, are often knocked down as we find ourselves in unchartered territory. Finding a way through the difficulties of a fraught workload has been an important factor for Knut and Hana as parents.

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Tough

“We’ve been doing our best to make sure we don’t project our stresses on to the boys, although I’m not sure how well we managed in the first lockdown – there was lots of screen time,” says Knut.

“It’s hard not to take the work home with you and it’s certainly hard to delineate work time and home time. We’ve seen a huge increase in mental health presentations to us and these take their toll on us too. It’s hard to be unaffected by the difficulties people open up to us with and the increase in volume of these has been tough.”

As childcare became a substantial issue for Knut and Hana due to losing their childminder when the virus arrived in March, working from home became a viable but difficult option. But being without a childminder for six months until schools returned in September was a distinct challenge met with the kindness of friends and family, while, when possible, one or the other stayed at home with the boys. “We had a new childminder when the schools reopened but unfortunately that fell through again in January,” says Hana.

“We’re currently back with the kids home full time. We could send Harvey into creche and they’ve been great about it, but with the risk of community transmission so high, we’ve decided to hold off for now. On top of that, the two of them are good company for each other. Our family, friends and patients have been incredible. The kindness that has come out of this in relation to work and childcare has been amazing, and we are grateful to all who have offered to help.”

Having watched family members struggle with options for childcare and relying on family and friends to help with childminding, Knut says, “we’re really mindful of those couples working in hospitals or on shift work where working from home is just not an option. There’s no easy answer to how to solve the childcare issue for these families as any measure needs to be balanced by the increased risk of transmission of Covid-19 in childcare settings.”

Working from home comes with its own troubles, however, as Hana says, “those lines have become even more blurred. We’d often both be at the laptop going over blood results and paperwork late into the evening once the kids have gone to bed. Both of us would normally be scheduled a day off in our week, but this has pretty much disappeared since March too.”

Over the past year, lessons have been learned, and for many of us how we have managed in the first lockdown has altered between the second and this current third lockdown. “Since the summer,” says Hana, “we have focused on making sure the boys had lots of activities, and a great summer holiday in Connemara and Kerry. Then when schools reopened last September, they’ve really come along and are much more enthusiastically engaging in work at home during this lockdown. We’re conscious to take it easy on them.

“It’s hard on them not to see their friends or do all the things they would normally do after school or at the weekends. The main thing we’ve been trying to focus on is how they interact with each other. There have been a few screaming matches but generally they’ve been great at playing together.”

On top of refereeing the ordinary squabbles and intentionally indulging in quality family time, they are also managing the needs of their community, being conscious of their staff, and overcoming their own concerns and stresses of working through a pandemic. Being close to potential transmission is an unnerving worry dealt with daily, with genuine fears about what may happen if Knut’s dad or Hana were to get sick, as both of them are in at-risk groups.

Restrictions

“We have been waiting for the moment over the last six months where one of us or the kids get a fever, or a cough and we would all have to self-isolate,” says Knut. “Whilst we can do remote consultations and have been set up to do that even before the pandemic, these are obviously not suitable for every consultation type.

It was clear, due to self-isolation restrictions, that if one of us had to isolate, we both would. This would have significant knock-on effects on our ability to run our practice. Thankfully this hasn’t happened yet.”

Knut and Hana appreciate the support they have received from their family and community but recognise their difficulties working along the front line have been experienced by so many other parents juggling working from home. “In some respects, given that we work for ourselves and with each other,” says Knut, “we’ve been more fortunate as we’ve been able to divide and conquer. Others working in two full-time jobs, remotely, both with deadlines and commitments for different companies, we can only imagine how difficult that has been”.

Mindful of caring for themselves as well as their children, Knut has taken on the challenge of #100DaysOfWalking and happily has stuck with it so far. Hana has "found use for the €6 pack of 10 paint brushes" she knew would come in handy one day and started acrylic painting friend's isolation spaces which has kept her calm and entertained. Her favourite painting being the Bring Centre bottle bank in Milltown. But life has not been without spontaneous stresses this past year.

“There’s definitely been a few tetchy moments,” says Hana, “where we’ve bitten our tongues, or where there’s been a few arguments, but overall we’ve tried to keep our spirits up. I think there’s been a lot of subconscious stress where we just get on with it and maybe don’t realise how much the past year has affected us mentally”.

The pandemic has made Knut and Hana realise the way they were working pre-pandemic was “quite toxic”.

“It has helped us slow down,” says Hana, “spend more time with our kids, and make more of an effort all round in trying new things and trying to be better. Change is good. Unfortunately for a lot of people, including ourselves, it took a pandemic to make these changes. We appreciate now more than ever what we have and how we need to protect it and each other.”

[ Being a single mother and frontline worker is no easy task ]