As a palliative care physician, I recognized quickly that the pandemic would present unique challenges for our work in the hospital.  I knew we’d be treating patients with a new disease process, there would be a steep learning curve with rapid changes, and that our volume of dying patients would increase.  What I did not anticipate was the very great loss I would experience with the inability to empathize and connect with my patients.  Because our patients are some of the most medically fragile patients, we have socially distanced ourselves from our patients to keep them from contracting COVID.  Visitors are not allowed in the hospital so all of our conversations, including about end-of-life decision-making occur with families by phone.  We wear masks in the hospital and only touch our patients to examine them when it is absolutely necessary.  So much of my work involves the “art” of medicine.  When discussing complex decisions, the nuances of facial expressions, body language, and the use of silence are all key tools in developing a trusting therapeutic relationship.  I have come to realize this on a much different level now that those tools are not able to be employed.  How can I connect when I hear a daughter sobbing on the other end of the phone without being able to span the distance with a hug?  How can I reassure my patient in their last days that I will be with them until the end without a hand on their arm, and only my eyes above my mask to show my care and commitment to them?  In some sense I am even more aware of my words and my physical presence than I have been before.  I feel like an actor on stage trying to express boldly with my eyes my emotions so that the audience member in the last row can see it.   But the strain of this conscientious and new “performance” leaves me drained by the end of the day, and with an ache for human connection without these barriers.  I have felt angry and sad by these losses, for me and for my patients and families.  I have not yet found the answer to “fill my cup.”  Certainly there are many positive things that I try to focus on like going on a run, snuggling with my kids, and being thankful for a steady income.  But perhaps the answer is grace, especially for myself.  Grace that it is okay to have lots of days where it feels too hard to get out of bed and put the mask on.  Grace that it is okay to not pull off the “performance” because I have never been trained as an actress.  Grace that it is okay to binge watch a Netflix show because I just need to forget about the tough stuff for a bit.  And grace that it is okay to see this COVID time, not as an opportunity to better myself, but as something I just have to get through one day at a time.