When the pandemic first arrived in the U.S., I felt a familiar pull. Public health emergency? Epidemiology? I’d worked for decades as an infectious diseases doctor. This was right up my alley: Sign me up!
I work as an ambulance paramedic. Nowadays, on every call that meets the criteria for COVID-19, my colleagues and I wear masks, gloves, eye shields and gowns. We stand six feet away from our patients as we interrogate them about the presence of fever, cough, body aches, or breathing problems.
Our overall 9-1-1 volume is down, as people stay home instead of driving drunk, as they decide to stay away from hospitals, as most of them (minus the over-advertised outliers) shelter in place. But I notice more secondary symptoms: domestic abuse, assault, anxiety, mental illness, loss of sobriety.
"Don't you even think of going out in this," my former colleagues warn me. They're on the front lines, truly seeing the effects of COVID. I retired from my medical practice five years ago when I developed some serious illnesses.
“Honestly, Keerthi, I wish I wasn’t a physician right now. I feel terrible for saying it, but I wish I could isolate with you,” my mother, a sixty-year old physician, admitted to me late one night as she slightly sobbed into her blanket. As a daughter, I rarely see my parents cry. The last time was when my grandfather passed away twelve years ago.
It had been four weeks since the first COVID-19 patient had arrived at our community hospital, and my mother was exhausted. It had also been three days since I’d seen her in-person, as she would leave early and return around midnight in the hopes of minimizing her interactions with me. I looked forward to “Good morning” texts or “I love you” post-it notes on the fridge, telling me that she was still alive and doing well.
I got home this morning after my third 24-hour shift this week covering labor and delivery and newborns for our family medicine service, tired from only three to four hours of sleep. I put on my face mask in the car, came through the front door, where my husband had left a thermos of coffee, ignored the whines of our puppy who wanted to greet me, and went directly to our bedroom, where I have been self-isolating at home for six days now.
I had changed out of my scrubs at the hospital, but I now threw all my clothes straight into the wash and took an immediate shower. My husband left breakfast for me by the bedroom door. We texted our check-ins about work (from me) and the kids (from him) and about how much we miss physical contact.
I’m a rising fourth-year medical student and currently in limbo. Clinical rotations have suspended until further notice. But I want to help, even if only in small ways.
In the midst of this pandemic, I've been thinking a lot about breathing. In the yoga that I practice, breath is important. It's a way to focus attention and connect to the spirit. It brings calm to an anxious mind.
You don't think about breathing, you just do it. My career as a family doctor has been like that to me for over thirty years. I work at a clinic in the Bronx, and I know most of my patients well. We work together to manage their diabetes and hypertension, the personal crises in their lives and acute problems like colds and back pain. It's hard work, but it feels good to help people and to have them know me as “Dr. B.”
There were happy tears in the clinic that day. Our patient, Jane Doe, was finally approved to take the new cystic fibrosis medication. As the air went in through her nose, the stark realization set in that she had never until this point been able to take a truly deep breath.
But just when she thought her days of lung problems were behind her, a public health emergency for COVID-19 was declared.
You don’t know me. I’m the sixty-plus woman who was behind you in line at the grocery store today. I watched as you ignored the taped lines on the floor that designated the requested six feet of distance between shoppers. I noticed as you crowded the elderly woman in front of you. You looked back at me, glanced down at my feet on the taped “X” behind you, glanced at my grey hair, and then turned to the young checker and said, “I don’t know if old people are worth saving from that virus.”
Life turned upside down in a matter of days. On March 13, the governor closed schools. My husband and I met friends for dinner that night. We were nervous and opened the restaurant’s door with a Lysol wipe and carried hand sanitizer inside. On March 16, restaurants and gyms shut down. It was my son’s 15th birthday and he almost cried when I didn’t let him go to a friend’s house. We’d promised him dinner at a steakhouse. Instead, we got takeout, and he was too sad to eat cake.
My mom is ninety-six years old. She lives in a wonderful assisted living facility, and is mostly blind and incontinent. She has lost most of her motor skills, uses a wheelchair and suffers from dementia.
Mom was once as sharp as a tack and a force to be reckoned with. Despite her dementia, she is still that. Each day in my heart, I bow down to the wonderful aides who treat her with infinite patience, humor and gentle kindness.
Two nights ago I received an email telling all residents and families that four residents had tested positive for COVID-19.
Because of COVID-19, the rec center in Dad’s retirement community was closed. Determined to continue exercising, my vigorous 89-year-old father went for a walk. We don't know what happened, but passers-by found him on the ground. Paramedics were called; flat-line ECG. He was resuscitated and placed on a ventilator. Unfortunately, his brain appeared damaged.
Despite the emerging pandemic, my sister and I traveled to Arizona. We sat by his side and held his hand.
Then, the rules changed: No visitors allowed.
“Did they finally pull you out of the hospitals and clinics?” My father’s voice resonated through the receiver.
“Yeah,” I replied with my eyes fixed on my whirling ceiling fan. “I figured it was inevitable after the AAMC issued its recommendation for students to be pulled from direct patient care, given the uncertainties surrounding the supply of PPE and the potential harms of having more people than necessary in clinical environments.” My father knew those abbreviations referred to the Association of American Medical Colleges, which governs the education of medical students, and to personal protective equipment, like surgical masks and gloves.
People don’t die like they do in the movies--alive one minute, saying something profound, and dead the next. There is a way the body is programed to die. Most of us don’t think about that, don’t know about it, and generally don’t want to know about it. We live in a death-denying society.
But as a nurse, I have spent most of my life talking about death, and now more than ever I want to explain the normal way the body dies.
The fear is palpable as I walk through the near-empty maze-like hallways of the hospital. Having no visitors makes things eerily quiet. It is the same as the quiet throughout my small city--in empty shopping center parking lots, down neighborhood roads.
Even as a little girl, I needed a routine to keep me focused and sane. Now, I like knowing that from 9 a.m. to noon, I will be working at the university with my writing students; that after I get home, I will either read or take a nap; that I might take a before-dinner walk or muster my energy to clean the bathroom or kitchen; that I will watch the news—news that does not inundate me with warnings and dire statistics—and then challenge myself on Jeopardy; and that I will end the day with a book, feeling satisfied and comfortable.
April's More Voices theme is COVID-19.
Here's how it's changed my workplace: As of yesterday, my hospital in the Bronx had about 500 patients admitted with the COVID-19 diagnosis. Over sixty of those were in the ICU.