CounterBalance the COVID Chaos

When you think of “balance” do you think of a perfectly still scale or a yogi standing on one leg with appendages gracefully, equally extended? Certainly, those do represent balance, but those mostly reflect balance in a “quiet system.” The systems in which we work are never quiet and we often are challenged to find that professional and personally balance. Currently, amidst the COVID-19 pandemic, all of our foundations are seem to be no longer solid. This has lead to a lot of additional angst and anxiety – naturally. How to we keep ourselves, our families, and our patients safe while also maintaining our collective and individual sanity? While I do not have a specific answer that solves this complex calculus, I do offer the following illustration that I described to our residents at Carolinas Medical Center Emergency Medicine Residency. I know that with our talents, continued effort, and focus on caring for all, we will be able to Counterbalance the COVID Chaos.

Courageous Colleagues,

I admire people with talent. People with physical talent, musical talent, scholastic talent, artistic talent all fascinate me (mostly, because I lack talent… aside from ability to fall asleep in a matter of seconds). Several years ago, while in Key West, I was awestruck by a street performer who had a talent may be the most useful of all… and one that you all also possess.

Standing on a single plank atop a simple cylinder may not seem like an inspiring talent, but it certainly is. This person was not a superhuman and had the same nervous and musculoskeletal systems that we all have yet was able to manage the undulations of the unstable foundation. Even as more chaos was purposefully added into the system, with more planks atop more cylinders, the street performed did not fall. Balance was maintained. When my neck was craning skyward to watch, it was clear that balance in a chaotic system takes strenuous effort. You could see micro-contractions of muscles aimed to counterbalance swinging appendages. Every muscle was active. Breathing effort, preventing erratic respirations, was just as important as was the position of the head – it may have been even more important as the levels grew higher and risk increased. Then when the chaotic foundation seemed to be too much for any person to manage, the street performer inverted and stayed atop the precarious tower upside down.

I have similar admiration for you all. Our balance is being challenged, but our ability to maintain it is not questioned. Balance, it turns out, is not about staying still. It can be unsettling… actually terrifying at times… to be atop such a chaotic system; however, we in Emergency Medicine manage chaos well, know how to manage our own respirations, and make appropriate adjustments to maintain our balance

Unlike the street performer, we have the advantage of being able to rely on each other. Being amongst such amazing, altruistic, courageous, and magnanimous people who work tirelessly is inspiring. Emergency Medicine, is a team effort and we have THE BEST TEAM.

Sean M. Fox, MD

I hope that this illustration resonates with you and may add to your internal confidence in yourself and our teams. We will all meet this challenge and and grow from it… and will be ready for the next undulation and alteration of our foundations.

I know that this current pandemic has created many additional questions and I purposefully have avoided trying to produce a Morsel on COVID-19 right now, as I believe the information is changing so rapidly, that whatever we “know” today is understandably going to be different tomorrow. That being said, if you have a specific clinical questions pertaining to COVID and children, please add it as a comment below or send that question directly to

Thank you,


Sean M. Fox
Sean M. Fox

I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renowned educators and clinicians. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. I strive every day to inspire my residents as much as they inspire me.

Articles: 583