Some things can't be canceled: One woman's life as a doctor and runner during COVID-19

This race was different than the others.

It was March 21. Four days after all North Carolina restaurants and bars were ordered to suspend dine-in services to contain the spread of the coronavirus. Six days after the Centers for Disease Control and Protection advised canceling events with more than 50 people for eight weeks. Eleven days after Gov. Roy Cooper declared a state of emergency.

The race — COVID-19 Miler — was organized by Ruff and some running friends when, one by one, the Spring races they’d been training for were canceled.

The 38 runners that morning raised money and collected food donations for local schools and food pantries. The race was free, but as a group, the runners collected $130, plus several direct online donations to Orange Congregations in Mission.

The 38 runners at the COVID-19 Miler raised a total of $130 and collected food donations for local schools and food pantries.

“Well that’s a wrap,” an email from the race’s organizers said. “That may be the last the medal you’ll receive for a while. Keep on running. Stay healthy in body and mind, keep your distance and stay virus free.”

For Ruff, the race served as a reminder that in the midst of so much upheaval, not everything has to change.

“During this time it’s important to do those things that bring you joy and help ground you and help calm your anxiety — running for me is definitely that,” she said. “It was nice to realize we can still do these things, it’s just going to look a bit different.”

***

So, this is a coronavirus story. Not that kind of coronavirus story, though. Yes, it is a story about forced adaptation and change. It is also a story about helping others and giving back when you can — about one woman, who, during a time of global adversity, is doing her best to make the world better.

That woman, Ruff, 41, is a marathoner. She has run 13 marathons and 13 half marathons. Her 14th half marathon was supposed to be the day she ran the COVID-19 Miler.

She is also a doctor. She works full-time as a family physician at UNC Family Medicine at Southpoint and takes calls for the clinic’s maternal-child health services at UNC Hospitals.

In the age of the coronavirus, Ruff’s life as a doctor looks different. Due to a push for telemedicine to preserve social distancing, she now sees many of her patients through video visits and phone calls. A lot of her days are spent talking to people with questions about the symptoms of the virus.

Some changes have been positive. Last week, a patient video-chatted Ruff from her daughter’s pink, frilly bedroom because that was the most private place in the patient’s house. Another patient gave Ruff a tour of her house over her phone.

“It made them feel like a normal person and not just a patient,” she said.

Other changes have been frustrating. The constantly shifting protocol on whether her clinic can see or test patients with respiratory symptoms. The scarcity of PPE, personal protective equipment. The requirement to tell patients with respiratory symptoms over the phone where to be treated without being able to see them or listen to their lungs like she usually would.

And still, some people are not taking social distancing seriously. For Ruff, who is unable to stay home in order to treat patients, this is disheartening.

***

“The only the way that we’re going to slow this down is by staying at home,” she said. “Yes, it’s an inconvenience but it could be so much worse. If you’re healthy and you can isolate yourself to protect yourself and others, then there’s nothing else – you can totally do that.”

At the starting line of the COVID-19 Miler, Ruff wasn’t surrounded by hundreds of people or given the starting command through a loud radio. It was quiet.

Everyone ran in pairs and staggered their starting times so that no one was running in groups.

Ruff ran the race with one of her close friends, Katie Dinsmore, separated by six feet of the American Tobacco Trail — positions they maintained the entirety of their nineteen-mile race.

Dinsmore, who hadn’t run 19 miles since 2015 when she was training for a marathon, said the race helped give her perspective. At the end, when it was getting harder to breathe and their legs were tired, Dinsmore and Ruff were praying about having the strength to do hard things.

“If I can run 19 miles after not running 19 miles for five years basically — that just gives me confidence to say I can do hard things. I can work at home and help my three kids do school and not go see my parents,” Dinsmore said. “We can do hard things. And I think a lot of times we come out better on the other side for it, if we keep the right perspective.”

They hadn’t trained to run 19 miles, and the weather was not ideal for racing — it was a humid, warm morning with lots pollen. But, along the trail, the blooming flowers and chirping birds made for pleasant company. Spring would not be canceled by the virus.

***

Normally, Ruff sees 13 patients in person during a half day, but now she sees about 13 in an entire work day. Her clinic calls patients to make sure anyone with respiratory symptoms does not come in, as the state is recommending people who believe they have coronavirus to go to specific testing centers.

Though she sees fewer patients in person, Ruff is talking with many more by phone — during her shifts and at home, where she volunteers to answer UNC’s Coronavirus Helpline.

“There’s this huge pool of people that need to be called back and they need advice,” she said of the hotline, which more than 300 people call every day. “They need to know where they should go, if they’re OK to stay home, that kind of thing.”

Ruff strives to answer their questions directly.

She says: It will probably get worse; this is only the beginning. You might have the coronavirus — I can’t tell you that you don’t. Your symptoms are mild and, I know it’s frustrating, but we need to save the tests for people who really need them. This is what we know now. Today, this is how it is. If anything changes and you start to feel worse, let me know. I am here for you. We will talk you through this. I am here.

“There just a lot of fear,” she said.

***

Even as Ruff’s clinic adapted to major shifts in protocol and discussed potentially changing roles to meet future coronavirus needs, the staff threw a birthday party.

Celebrating one of the nurses at the clinic, the office was decorated with streamers and balloons, and birthday cake was served.

Laura Gay, another family physician who works with Ruff, said the clinic throws a birthday party for everyone on staff — a tradition that was not going to be deterred by the coronavirus. “We’re still trying to maintain some level of normalcy here,” she said. “We’re trying to hold onto the things that kind of keep your normal day-to-day, the fun parts of life that we used to have — we’re still doing those things.”

Some of the doctors and nurses at the clinic are preparing to take on different roles in response to the virus — they’ve discussed the possibility of being pulled to the hospital if there is a local surge. Gay said Ruff’s positivity helps maintain perspective and normalcy, even as these changes take place.

“She’s just an amazing person,” she said. “The amount of energy that she has — her ability to make everything have a positive outlook, I mean that’s just who she is. I think that’s what everybody loves about her.”

***

Even after UNC Family Medicine put procedures in place to redirect anyone with coronavirus symptoms to another location, one woman “made it through the cracks.”

Her first day at work with the ramped up protection policies, a woman with a fever and a cough walked into the office. As a hotel receptionist, she’d been exposed to multiple travelers from all over the world.

Once the clinic realized the patient was “at-risk,” they gave her a mask and put her in to a separate room. At this point in time, the clinic was testing for the coronavirus. Ruff would be the doctor to test her.

Before going in, she geared up: putting on a neon yellow gown over her scrubs, gloves, a mask over her mouth, goggles over her eyes and a face shield over the mask and goggles.

So far, she’s felt protected at work. But her clinic only has enough personal protective equipment for the occasional walk-in patient, so they’re trying to limit their use of it. Each employee is given one mask to wear — all the time — for five days straight, in a conservation effort.

Last week, she learned a different patient she’d seen the week before had symptoms and was tested for the coronavirus.

“When Sarah told me that, I had my first emotional gut reaction that I would liken to being mama bear, like I am with my kids,” Dinsmore said. “Which is my instinct to say, ‘Stop, quit your job, like this is not worth it.’ Because I love her and I want her to be protected. Now, if I zoom out to bird’s eye view, of course I don’t want her to quit. Of course, she has to do her job, but that was a very gut response for me.”

For Ruff, the risk of getting sick is scary, but it will not keep her from caring for patients.

Out of her family of four — her husband, J.W., 12-year-old son Jackson and 9-year-old daughter Savannah — she is the only person leaving their house, as her family is taking social distancing very seriously.

To help protect them from getting sick, she wears scrubs every day to work and changes out of them and showers before driving home. She also avoids hugging or standing close to coworkers and doesn’t hang out with friends — not “breaking her own rules.” She tries to do the things she tells her patients to do, being smart in the rest of her life, to minimize her exposure to her family and others.

There is fear that Ruff with contract the virus from doing her job, her husband said. In the beginning, he had a lot of anxiety for her safety, but that has lessened with time — focusing on how she is helping others reminds him that the risk is worth it.

As a Christian, he thinks Ruff has a great opportunity to share hope with others.

“I don’t have the options of not seeing patients, or not going into work,” Ruff said. “But overall, I’ve felt more of a sense of purpose. I’m thankful that I have something to do during this time, that I can help people.”

***

Following the cancelation of their Spring races due to COVID-19, friends (shown left to right) Katie Dinsmore, Martin Wileman, Sarah Ruff and Randy Mullis organized the COVID-19 Miler as a safe way to still run with friends and raise money for local food pantries. “It was nice to realize we can still do these things,” Ruff said regarding running. “It’s just going to look a bit different.” (Photo courtesy of Sarah Ruff)

Running the 19 miles, Ruff and Dinsmore — who are in a Christian work program called Triangle Fellows at Chapel Hill Bible Church together — took turns praying for something different at every mile. They prayed for employees and the recently unemployed, sick people and healthcare workers, students and teachers. During the last two miles, they prayed for every person in their Triangle Fellows program by name.

The prayers distracted her from the pain, Ruff said, and helped give purpose to all the miles they were running when they didn’t need to.

When they finally crossed the 19-mile threshold, there were no flashing cameras or cheering crowds. They simply smiled at each, from the six-foot distance between them.

Her entire body ached, but she was happy. Driving back from the race, the homemade COVID-19 medal swung from her rearview mirror. Reminding her that some things — running, friendship and generosity, to name a few— cannot be canceled.