Category Archives: COVID

COVIDY

My speech community has a new word to describe being extra sensitive, teary, emotional, sad, scared, and reacting more strongly than would be considered reasonable under reasonable circumstances. It includes being vaguely uneasy, on edge, even being on high alert and hyper-vigilant, and worrying beyond repair. It covers wanting control over things like the neighbor’s dog – and a global pandemic. It also encompasses brief moments of flooding joy that wash away as quickly as they come. It does NOT include anything close to letting things slide like water off a duck’s back. It DOES include being thin-skinned and feeling unsteady, like the ground under our feet is about to give way. The word is “covidy”. It may disappear from our vocabulary along with this pandemic, but for now, I find myself being – and apologizing for – and forgiving myself for – being, well, covidy.

My hospital just announced they are changing their policy for visitors to loosen up after a very strict period of virtually no one allowed at bedside, and I almost started crying with relief. Women in labor can have a partner AND another labor support person, who can stay up to two hours after the baby is born. The partner can stay on for the duration. Dying patients can have someone at their bedside again, even two visitors at a time, and older children can see their hospitalized parents (one at a time with an adult accompanying). Patients having surgery can have their support person during the long waiting time, and in-patients can have a loved one in their room during hospitalization.

Patients can even bring a friend to a routine clinic visit! All the usual precautions remain in place. Temperature taken at the door. If you leave the room, you leave the hospital. Mask on at all times. Still protective, but less restrictive, because we are having less cases, and it seems our isolation is paying off. When I read through all the new rules, I got trembly and joyful with the kind of relief I felt at age 4, when my Mom found me in next aisle at the grocery store after I was convinced she was gone forever. Safe again! We are safe again, because we are back together.

So why did I tear up with relief, why did my face beam with joy, at such a simple thing as loosened visitation rules at my hospital? Mostly, because I am covidy. I am carrying my share of the weight of our collective burden of concern and sadness. I am a health worker and I care deeply about how vulnerable people are feeling, and at the same time, I have been feeling quite vulnerable myself. Quite like a bird in a storm-shaken tree, watching as twigs and moss and other bits of my carefully placed nest fly away in the screaming wind.

As I sit and translate the new visiting rules for one of my speech communities, I feel momentarily happy and relieved – like the storm clouds have parted just a bit and those ephemeral beams of light are shining upon the waters. There is a feeling of cautious hope and coming renewal. People are able to be with their loved ones again in their hour of need. People are getting support. Visitors are able to show their love and share it, and we can lean on each other again. Especially in those communities where independence isn’t even a core value – where interdependence is the mainstay of the social structure. Being together is the way.

I think back to my beloved dying parents, when each of their turns came, and how grateful they were, how safe they felt, when they knew I would never leave them. They had me and my siblings, along their grandchildren, and they were never alone. No matter how scary it got, or how long it lasted, or how many unknown variables were in play, they knew that whatever they faced, they had the comfort of family right alongside them. Asking questions, getting that warm blanket, arranging a visiting nurse, showing them how to do the home injections, setting up a hospital bed, arranging for hospice and pain control, talking to their doctors, or just being in the room. Just being nearby. Within reach. The immeasurable, unspeakable comfort. They were not alone. They had us.

I am unutterably happy for my dear patients, that they no longer have to face the hospital alone. Happy that they once again have the deep comfort and relief that comes with having a loved one nearby. Because in spite of the fierce independence that a few of our cultures like to pride ourselves on, underneath it all, not so very far beneath the surface, we are completely and irremediably interwoven and connected, interdependent in every way possible.

If any of you out there are feeling as covidy as I am, I totally understand and relate. And I hope we can all be as patient with each other as my loved ones have been with me. This, too, shall pass. But the web of interconnectedness will remain as always, vibrating and humming just below our conscious awareness. And even if we lose sight of it as we slowly and carefully hunker back down into our usual daily routines, let’s remember to look for it, and appreciate it, and revel in our glimpses of it, just like the sun through the clouds over shimmering over the water. As covidy as we may be feeling, we are not alone. We are in this together.

DAY WITHOUT A DEATH

We just had a strange and quiet celebration in my state – our first day without a registered COVID death in over two months. People have been dying every single day for the last eleven weeks without cease. With this one-day respite, we are invited once again to make meaning out of numbers and statistics, and decide what we think is happening, and come to our conclusions. No doubt, competing essays will emerge over the coming days, parsing out what this break in our death count means, and how we should understand it. Folks will use it to prove their foregone conclusions of hope and despair, blame and praise.

Does anyone else feel bombarded? Even as we practice mindfulness, avoid the news overload, try to spend time out in nature, and appreciate the life and health that we have at this moment? Does anyone else feel like we are constantly having more pieces of the puzzle thrown at us until our psyches are bruised and avoidant? More shards of colorful facts shooting out from the broken kaleidoscope of our media system, leaving us with cuts and scrapes and an overall feeling that we have been knocked off our feet, and have tender wounds to protect?

I think back to everything I have read, mostly literature, about the various plague times and pandemics, and how people dealt with it in those distant times. The information traveling at that time was of course slow and limited, and rumors and religion stood more strongly than any science and statistical analysis. But from the perspective of the individual human, I wonder if it was easier in the past. Forgive my nostalgia.

Imagine a community where you know all your neighbors, and live where you were born, among kinspeople with ties going back through generations. Your world is small yet complete unto itself. You eat locally, shop locally, and support each other very naturally. And in most places, you have a collective way of processing changes in weather, harvests, and health. Things sweep through. You don’t have to “figure it out”. You just accept it. You don’t have to become an expert. Of course you are scared. But I would guess that you accept the mystery. You don’t have this modern need to grasp it, make sense of it, read about it, study it, watch videos and podcasts, attend zoom meetings and share scientific and pseudo-scientific information and misinformation ad nauseum. You don’t have this need to become an expert, or make yourself safe by presuming others are wrong. You wouldn’t feel called to “have an opinion” about it at all.

I work in a major research hospital that is a global center for pandemic studies. We have had a rolling roster of 70 to 125 hospitalized COVID patients each day since the pandemic hit our area. I have personally had COVID patients among my cases most days at work, and along with my colleagues, I am constantly trained, informed and updated at work. Enough is enough! I really don’t need or want to give this disease any more of my time or attention. But I cannot go online or walk around the block without someone telling me in the strongest of terms what COVID is, what it does, and how it works, citing everything from scientific research to their old Uncle Harry.

They know! And they feel strongly about it! They speak and write with such grave certainty, and they forward studies and videos, or cite something from the newspaper, as seriously as if they knew that what they read was accurate, complete, and unbiased. My friends and acquaintances have heated online arguments about wild edible bats versus nefarious biochemical labs, the clear perils of sheltering in place, vaccinations, herd immunity, and more. They “know” their facts and relentlessly cite their sources and cannot understand how others can doubt this or that study proving this, that, or the other.

I sympathize, as a need for certainty is one of my core personality traits. But perhaps because I work closely with COVID patients, and have easy access to grand rounds, meetings, and research results, I feel strangely distant from any further need to seek out and ponder the typical mass media editorials and internet theories, like how far a cough carries biohazard in a cyclist versus a runner, or how long COVID may survive on wood, metal or cloth, and at what temperatures. Or how essential businesses are coping, and whether the economy will recover to the satisfaction of the stockholders. Or what plots the various interested parties are hatching to use or misuse COVID, and how the disinterested parties are interested in having us get involved on their side.

I think I may have done better in the middle ages in a more collective community. Accepting the mystery of it, infusing it with my own personal meaning within an unknowable cosmos, recognizing myself and my loved ones as miniscule sparks of life destined to be here for the mere blink of heaven’s eye. To the degree I can replicate that simpler life in the face of so much bombardment, I will do so. And one important step will be to put myself on a very intentional COVID diet, which may include covering my ears and closing my eyes while humming or singing, which is what we did as children to effectively block out what we instinctively knew would be too overwhelming. I hope my neighbors and friends understand.

BACK BURNER

I remember years ago, talking to a patient who had a very rare form of stomach cancer, and a tentative and uncertain treatment plan. She was lying in bed, very ill, playing with the edge of her gown. “I kind of wish I had something like breast cancer,” she said softly. “People know more about it and they march and everything.” She felt ignored, placed on a back burner, in her treatment and care. Likewise, some of the press around COVID may leave us forgetting that while we put all our attention and all our efforts on COVID, and for good cause, everything that was happening the day before COVID hit our shores is still happening. People have cancer. People have other diseases. They are just facing it in a much altered and limited landscape, with skeleton staff and few live appointments. Things are delayed, and there will be consequences. Some people without COVID may die from COVID.

So many people are involved behind the scenes in any service or product we use. I remember seeing a video where a person held a cup of coffee, and gave a monologue about where each item involved had been harvested, processed, warehoused, fabricated, and transported. From the paper cup to the plastic lid, the coffee, cream and sugar, the coffee machine that produced it, the water source, the little wooden stir stick, the story spread across the globe to metal mines and forests, sugar plantations and dairy farms, hillsides covered with coffee trees, urban plastics factories using petroleum products and more. Hundreds, perhaps even thousands of human hands and human minds had been involved. Each item involved had been processed and loaded onto trucks and ships, reloaded for delivery, bought, sold, and handled in countless ways before eventually ending up in the hands of the consumer. It was eye-opening to contemplate the vast resources and numbers of people it takes to accomplish the smallest and most ordinary of things – a single cup of coffee.

This week, I was with someone who was not looking for a simple cup of coffee, although he may have enjoyed it back when he was healthy. He needed something way more expensive, way more technological, involving many more expert hands and partners, something difficult to coordinate and carry out even in the best of times. He needed cancer treatment. Like many laborers, this patient suffered from symptoms for quite a long time, but not having a job that provided health insurance, and not being eligible for a government plan, he labored on in the hopes that his increasing symptoms would simply go away on their own, or with home remedies. They did not, and when he began spitting blood, he finally made it through the bureaucracy to a medical center and was diagnosed as needing urgent care for a very aggressive cancer. That was in February, just days before COVID hit our area. Now it is April.

His cancer is treatable, according to the doctors he saw in February. They started the usual steps in arranging his care. They did some scans and blood work and started to plan out what would be best as to chemotherapy and radiation. They even referred him to our cancer center for some of his treatment. But here is the thing. Because he was just getting set up for care right as the COVID crisis hit our area, many things have been put on the back burner. Not things, actually, but people. He is one of them. In the two months he has been waiting without treatment since his diagnosis, his health has declined dramatically. He has lost the ability to eat any food, even baby food, and is surviving on protein shakes alone. A strong and healthy 160 pound laborer is now a very weak 120-pound patient, who talks in a whisper and spits into a handkerchief. As COVID patients tragically die or heroically recover, he is still quietly waiting to start his cancer treatment.

The hospital is doing their best under the circumstances. They expect to get him in next week (on the severely reduced surgery schedule) and place a feeding tube into his stomach, so he can hopefully gain some weight while he continues to wait for treatment. They didn’t talk about when the chemo or radiation might start, or how much longer it might be delayed. I can only presume that they are not fully staffed, with people being moved around in response to COVID, and of course priority must be given to those already mid-course in their cancer treatment. One of the downsides of interpreting is that we don’t get to ask questions. We don’t get any backstory upon demand. And we don’t know outcomes, unless that information just falls in our lap in a future appointment. So I may never know what happens in this case. And by case, as always, I mean an actual person with their subjective experience taking place under these very harsh and scary circumstances.

Although I may never see this particular person again, I will continue to hold him in my thoughts. And I will continue to ponder how many people, what equipment, which factories and biotech companies, which truck drivers, and how many staff within the hospital, doctors, physicists, techs, nurses, schedulers and more, must all coordinate seamlessly without anyone dropping the ball or being absent in order for this patient to get the care he needs. And how many of these many people, human beings all, have had to step out of place due to illness, reassignment, closed schools, reduced hours, lack of equipment or other reasons. What pieces of the puzzle are missing, what has unraveled, that inhibits this patient from getting his care in a timely manner, and maximizing his odds for survival? Because he is literally losing himself as I write these words. He whispered to us that even his dear old dog doesn’t recognize him now, because the cancer has altered him so profoundly: “I am not myself anymore”.

To the people with COVID, my heart goes out. To the patients whose care is severely impacted by COVID, my heart goes out. To the workers trying to run faster, do more, track down the missing equipment that others are also trying to obtain, my heart goes out. To those in the fields and the factories, those waiting in isolation with no pay, to every member, every family, every thread of this precarious patchwork society, my heart goes out. We are truly interdependent, relying on uncountable visible and invisible people, places, and resources. Beyond what we can know, in infinitely expanding circles. Our healthcare, our food supply, even our cup of coffee, are in each other’s hands. Most vitally and fundamentally, our very lives are resting delicately in the overwhelming immensity of our collective hands. Let us keep them steady, as best we can.

SERVING COVID

With any overwhelming event, people naturally try to make sense of it. Knowing that people I truly care about are simply trying to process what they are seeing at a distance, I do understand. And I have had some very thoughtful and respectful dialogue with friends about this. But I remain struck by how many people known and unknown have posted a veritable flood of how they personally know why COVID is happening. It is here to serve the needs of (their favorite religious, spiritual or even political persuasion). Because it is high time for (whatever their vision is of a better world) to come to fruition. Finally! All hail this blessing in disguise. It’s all over the media. Some say we are being punished for our sins. And they have a strong, specific vision of what the sins are, and feel delighted at the coming punishment. Other promise future delights, for the survivors, of course. Almost a Second Coming or Age of Aquarius feel.

Ironies abound. A southern minister famously claimed that COVID was a liberal hoax and then died of it himself only days later. Others claim that COVID is here to serve our purpose to become more enlightened while lighting the path for lost and wandering souls, and those folks have a strong abiding belief about what enlightened people will look like (hint – quite similar to the person posting). I myself acknowledge that I hope more people will share my views about the importance of healthcare and social equity after this crisis. But here is the important difference, in my mind. Because I am dealing with it at very close quarters, I am careful not to hail it as a phenomenon brought for my benefit, much less to further my personal agenda. That would be a serious case of having the tail wag the dog. And I would find it disrespectful of those fighting the disease and mourning their dead. I fervently hope we can learn and improve from the experience. But COVID is not here to serve me. And I am not cheering.

Seeing how various individuals are processing and understanding COVID reminds me very much of the age-old religious battles, sometimes fought most fiercely among various sects of the same religion, or even members of the same congregation. While many humbly try to “pray in silence” to ask for God’s guidance without ostentation or seeking praise, others have a strong need to proclaim that they know God very well, and can ask Him for special favors, and even tell their ignorant neighbors how wrong they are. And how right they could be, if they would only listen to those few chosen among us who “know God” and are “saved” in the one special way to get through the one special doorway. We know! We are so very enlightened that we can say with authority WHY things happen! And give you advice on how to handle it better, especially when it hits you closer to home. We see it all so well from across the street.

Some of the “Why COVID is happening and how COVID will serve us” posts come across as painfully disconnected from the realities being faced on the ground, even though well-meaning. For those of us who are actually telling patients that they will go onto a respirator, or that they have permanent lung damage, heart failure, or have acquired a secondary infection that will kill them although the virus is now under control, it aches our hearts. For those of us with patients getting sent home while still clearly symptomatic, with strained breathing, and fear in their hearts, it pains us to read the eager COVID predictions about how more people will “see God” and come to think more like the person posting. Glory be!

I can assure you that the patients I have worked directly with do not consider COVID something that has come to serve them and further their agenda. The patients are coming in, mostly out of the blue, not having expected the illness. To add to it, we have had to turn away visitors for the time being, and the policy is confusing and changing day by day. We have had patients physically alone for days or weeks, no one to hold their hand or sleep on the couch beside them. No one to get them a glass of water, help them to the bathroom, comb their hair, or get them lotion, until the overworked staff have time. Hours and days in bed. Not one beloved face walks in. No matter how ill they are. No matter what they are in the hospital for. The staff are doing the best they can, but a sea of strangers cannot replace the faces of their beloved, no matter how kind.

This very day, and into the foreseeable future, patients may literally have to die without a single family member present. Or in some places choose one person alone to come say goodbye, who cannot be switched out for another. As the notice says, one person maximum to sit with the dying. The same individual every day. Anyone who steps out the room must leave the hospital immediately. If you are a dying parent? Well, if the kids are under 16, they will not be allowed in at all. If you have several adult children? Do you flip a coin? Draw straws? Not have anyone come, so no one feels left out? Meanwhile, on another floor, young mothers may be giving birth without their partners, even complex births with unhealthy children who need immediate medical decisions. The loneliness, the sadness of that makes it dissonant indeed to read cheery slogans about how COVID has come to perform modern day miracles – for those who don’t have it.

We just sent a young mother home in a weakened state, on oxygen, to care for her four young children. Can such a person carry out the COVID isolation precautions, such as sleeping in a separate room, using a separate bathroom, using separate dishes, having her laundry washed separately, and staying six feet away from all family members? A healthy teenager who was working in construction and sending money to feed his parents and keep his siblings in school is getting discharged from the hospital while still under quarantine, but he will not be allowed back to sleep at the teen shelter where he presumably caught it. Still breathing laboriously, still feverish, he will be heading to some kind of a COVID warehouse for people who don’t have anywhere else to go under quarantine. His first question was, when will I be allowed to get back to work? A fifteen-year-old. Too much of a baby to be allowed at a dying parent’s bedside, but old enough to come to the US and support a family of five on his earnings. Yes, good things may come of COVID, but not for all of us. Not by a long shot.

Here we are at the apex of wealth, technology and coordination. A major center for epidemiology and infectious disease research, as well as health metrics and vaccine development. We are literally flooded in money and technical capabilities, and if we pooled our resources, including our local tax-subsidized mega-corporations, we could no doubt go for several generations feeding, housing and providing healthcare to every needy resident. Yet I have been on a ward where all the hand gel had disappeared overnight – a long, ghostly row of empty wall-mounted dispensers outside of each room. Who were inside these rooms? Highly vulnerable medically complex immuno-compromised cancer patients. Area hospitals are facing a dangerous lack of masks and other supplies, to varying degrees, with attendant risk to employees and their loved ones. And that is right here, in the bosom of wealth and comfort.

A city in Ecuador has been hard hit over the last couple weeks, and if you can stomach the news footage, you will see human bodies wrapped in garbage bags left out on the street with bricks to keep animals from dragging them away. Morgues and funeral homes overflowing, people literally dumping bodies illegally on the streets. Countless untested, with the ensuing dead notably absent from the global counts. We are only seeing the tip of the iceberg in terms of human suffering. We cannot see the enormity. I invite you to imagine how very many people must be ill without getting care in order to fill the streets with the dead. Imagine how bad conditions would have to get before you, yourself would put the body of your loved one in a garbage bag and set it outside on the sidewalk in front of your house, because it is starting to rot, and there is no one left to pick it up with the dignity we like to accord to our deceased. Please ponder.

For myself, I am trying to serve those impacted by COVID to the best of my ability. And although I too have hopeful visions of how we may emerge from this crisis stronger and more humane, with better values (not coincidentally to match my own excellent ones!) I am doing my best not to co-opt the dialogue and twist COVID into my service. It is bigger than that, and the direct sufferers deserve better than cheery slogans. COVID is a virus that has already killed way more people than will ever be reported. If you don’t believe me, compare the recent news from Ecuador with their official death toll, and extrapolate from there. Given the enormity, unless you are in the trenches, and facing the risk and the physicality of it up close, please be circumspect in bringing claims of coming glory. Let us pray humbly and in silence, if so inclined, and do our good works without ostentation. The vast majority of health workers are already doing just that.

IN PERSON

I have a wonderful situation. My boss at the hospital is allowing me to work completely from home for the foreseeable future. There are still some technical quirks. A few of our video calls get dropped, have delays, or I am looking at ceiling or floor (or in one case, the wringing hands of a nervous doctor) not to mention that I cannot seem to get out of my pajamas, but I am not spreading the Corona virus. I have zero physically proximate contact with patients, colleagues, or people on the bus. And for this I am grateful.

In each of my video calls, I am looking into a room with a patient. Most are in-patient, lying in a hospital bed. Some are on oxygen. Most have IV’s and other equipment running. Some have COVID. Some are on the cancer ward. Others are dealing with transplant issues, emergency surgeries such as broken bones, and the usual specialty hospital cases that many people haven’t even heard of, like pulmonary hypertension, or severe pemphigus.

Today, I helped a young mother figure out how to use a breast pump. Her baby is very ill and was already sent by ambulance to our children’s hospital. The nurse talked at length about post-partum depression, and how the sadness can last from a couple weeks to even a year, so make sure and tell your doctor in case you may need some medicine to help you for a while. The mother had been regularly wiping her tears with the edge of her hospital gown, carefully avoiding the breast pump parts attached to her. When the mother found out she will be allowed to be at the children’s hospital with her baby, her whole face lit up. “I thought because of COVID,” she murmured. It sounds like she will be allowed to board with her baby at the children’s hospital in some kind of quarantine. The nurse was very happy for her, and reminded her to take care of herself there, almost as an older sister would.

I helped another young man with bone cancer, whose doctor praised him for handling the treatment so well, although he has had terrible foot cramps lately. The doctor told him that every time his foot cramps up painfully, remember that it is the tumor shrinking that is making his foot adjust to having more space for its healthy tissue. Yay, foot cramps! Woohoo! We are winning! The cancer is shrinking and dying! You are going to make it through! The doctor was exaggerating her gestures to compensate for having to talk through a mask and via remote interpreting, so she was shaking her fist in the air at the tumor and saying things like “Die, tumor, die!” and making punching motions. The patient smiled and then giggled and so did the doctor, and so did I. It was a sweet moment.

My patients typically relate to staff through their family members, but now they are not allowed to have anyone present with them, no matter how sick they are. Even if they are dying. Even if they are birthing. It sounds so terrible, and of course it is for the patients involved. But this state was an epicenter and our trend is going down surprisingly, lower than all our predictors, and lower than all the other states at this time. Many other states are way up off the charts by comparison. We may even have enough hospital beds for our expected peak in mid-April, at least with current calculations. So there is a sense of cautious optimism. But we are doing it by avoiding each other.

Each patient is now an island. And it can be such a lonely, scary place to be ill and alone. Yet what I have been witnessing in the video remote is that our doctors, nurses, assistants, physical and occupational therapists, social workers, spiritual support, respiratory therapists, and others are filling in the gap left by the absent families. Of course staff are worn off their feet, concerned about their own health, and anxious about the future, but it doesn’t show in the encounters I have seen. They are being patient, warm and concerned in all the encounters I have observed.

For most of our patients, it is the first time they have ever been alone at the doctors. Everyone drags someone along – a teenage son, a second cousin, the husband’s aunt, even a neighbor. Going to the doctor simply isn’t something you do on your own. Patients take great comfort in “strength in numbers”. They feel less vulnerable. In a typical visit, the patients often answer a question by first catching the eye of a family member, questioning how and whether to answer, or directing the family member to answer for them. It must be quite scary to suddenly have to confront staff all alone, with everyone masked and cloaked, and the interpreter on a distant screen.

It has been heartwarming to see that now that patients are “trapped” in the hospital alone, with zero family members allowed to visit, much less stay, these patients are finding a new, perhaps unexpected safety net in the caring staff, kind nurses, thoughtful doctors, and general sweetness of care being provided at this time of crisis. I felt so happy to see these smiles and hear these words of comfort while interpreting today. I have never seen a doctor with her fist in the air yelling, “Die, tumor, die!” but it really brought a smile. And I do believe she was trying to make up for the family absence and the fear by revving up and getting dramatic, and it brought a sparkle of joy to the patient.

Back to the doctor who angled the video remote camera so he showed me only the hands he was wringing. I told him several times that I could not see our patient, but he was unable to adjust the angle, so I dropped it. The patient sounded like an elderly lady who was recovering, perhaps from COVID. She had just come out of Intensive Care and off the respirator, seemingly on a path of rapid improvement. After a long and stressful week of uncertainty, something about watching his wringing hands while hearing their disembodied voices was so delightful, and the off-screen patient was the most delightful of all.

So how have you felt since I saw you yesterday?

Fine, thanks be to God!

How is your pain?

It is quite bearable, praise God! But the pain medicines have caused some – stoppage – you know, doctor. The nurses told me it would. I am taking juice, powders and such. God is great, it is all in his hands.

Oh, yes, these heavy narcotics can cause constipation. I will let the nurses decide how best to manage that part of it, so I will leave you in their hands.

Yes, and you leave me in the most capable hands, indeed! May God keep and protect your nurses, dear doctor, because they have treated me like a queen! So attentive, always caring and kind. They treated me as precious as they treat the eyes in their own face! I couldn’t ask for more, so blessed as I have been here! God is great!

The doctor went on talking about weaning her off the oxygen, and continuing some of the medicines to deal with secondary infections, and her latest blood test results. It was not all good news, but the lady was simply exuberant. Off the respirator! Indeed, God is great in his mercy and kindness. Then she gave a prayer beseeching God to keep the doctor and his family safe, so they could continue to do the important work of caring for the community. “May God keep you and protect you in the overwhelming immensity of His Hand, and keep your loved ones safe, dear Doctor!”

The doctor’s hands suddenly stopped moving as he interlaced his fingers. His chin bobbed down into sight momentarily as he nodded his agreement with his elderly patient.

“Yes,” he assented. “Yes, thank you, and you and yours as well, my dear.”

I rendered “my dear” as “my love” in the target language, because it conveyed the actual meaning. These two human beings, so far apart in their usual daily experiences, now alone together on this COVID island bedside, really were exchanging words of love and comfort. And it makes me so happy to see it. I believe these encounters are a healing for all concerned.

Hats off to all the healthcare workers still attending at bedside in person at this time. May they have enough equipment. May they stay healthy. And may they continue to give excellent healthcare along with a much needed dose of comfort, as they meet these isolated patients whose lack of family presence is a constant, aching burden upon them. And wherever we find ourselves upon this lovely, spinning globe we share, may we remember our shared goal: that when we reunite, we will have the absolute minimum of missing faces in our circles of loved ones.

LAUGH SO YOU DON’T CRY

There is an adage that when things get really bad, and you feel despair, look for the lighter side. Find the humor. Laugh so you don’t cry.

Humor is an age-old way to deal with things that scare us. That make us uncomfortable. For this week, I wish to bring some levity and a respite to the fear we are all fighting, if we are in the fight at all. And I am not alone, by a long shot. People are flooding the internet with home-made song remakes (Mama, I just killed a man – My my my my Corona – Amazing Space, six feet you are). They are creating poetry, art, music, altering famous paintings, sharing their trials and tribulations in humorous ways, and much more.

To what purpose? To keep our spirits up. And to show that we still have fight in us. That we are resilient.

Staying at home:

Having trouble making yourself stay at home? Shave your eyebrows off.

Weekly horoscopes: Aries: Avoid imminent danger by staying at home. Taurus: Avoid imminent danger by staying at home. Gemini: Avoid imminent danger by staying at home….etc…

Let’s have a moment of silence for those who agreed to live with crappy roommates because “when would be ever be at home at the same time for more than a minute?”

A lot of parents schooling at home are about to find out that it actually wasn’t the teacher’s fault.

Stuck at home listening to her owner drone on for hours every day, it dawns on Ginger that she wasn’t cut out to be a support dog after all.

Socially avoidant, pacing restlessly inside your home, obsessively self-cleaning, and somewhat moody? Congratulations, you are now a cat!

Charts:

How to distinguish Corona virus from the cold or flu:

  • Regular cold and flu: I really feel terrible. I think I’ll stay home!
  • Corona: I feel really terrible. I think I’ll fly to Colorado and go white-river rafting with a group, attend a large music festival in a major city, or head to Waikiki and play volleyball on a crowded beach.

Sanitation:

My body has absorbed so much soap and disinfectant lately that when I pee, it actually cleans the toilet.

After years of being too busy at work to thoroughly clean and clear out my house, I have just discovered that wasn’t the reason I didn’t do it.

Coffee filters will work as toilet paper, but it does change the taste of the coffee.

The neighbor kids we had hired to pick up the poop in our backyard just quit. They finally figured out that we don’t have a dog.

The notice said gloves and a mask were enough to go to the grocery store during quarantine. They were so wrong – everybody else had clothes on.

Politics:

News Flash: Dr. Anthony Fauci, head of the US National Institutes of Health Infectious Disease Institute unveils a simple yet effective mask that can potentially save millions of lives. (Photo of a press conference he held with Trump, with duct tape over Trump’s mouth).

Isn’t it strange that those of us who live from paycheck to paycheck are supposed to have months worth of savings to get ourselves through this crisis, while billion-dollar corporations have planned so poorly that they need immediate government bailouts or they will go belly up?

Top world leaders and global activists are gathering for a hush-hush summit on a small island to try and solve the COVID crisis. US President Trump, German Angela Merkel, Brit Boris Gordon, and Swede Greta Thunberg end up alone on the last flight, when the pilot announces that the place is going down, and they will have to grab one of the three parachutes for passengers. Just like with COVID, not enough protective gear to go around. A quick decision must be made, and Trump jumps up. He snatches the gear off of Greta’s lap before she can even unbuckle, and announces, “As the leader of the greatest country ever, and the smartest man living, I am the most important person on this flight!” and he jumps out. Gordon quickly grabs a parachute and jumps out after him, no apology. Merkel jumps up and tells Greta, “grab the last parachute, honey. You are so young with your whole life ahead of you. We are all in this together. Go and live!” Greta smiles and quickly hands each of them a parachute out of the bin. Merkel asks wonderingly as they gear up, “How can we have two left?!?” “Easy,” Greta answers. “The smartest man in the world just stole my backpack.”

Social distancing:

This quarantine has me finally realizing why my dog gets so excited about something moving outside the window. I think I just barked at a squirrel.

Today, the devil came up to me and whispered in my ear, “You are not strong enough to withstand this storm.” And I whispered back, “Get six feet back, you (insert expletive here).”

Corona pickup lines:

Is that hand sanitizer in your pocket, or are you just happy to see me from six feet away?

Dang, they keep saying they gotta flatten the curves but luckily it’s not working on you!

Look, I know this is sudden, but if COVID doesn’t take you out, could I?

More jokes will come, no matter how bad things get, because we won’t be able to process all this without humor. We will continue to make art about it. Continue to talk about it. Continue to laugh in the midst of our fear and sorrow. Remembering our resiliency, reaching out to each other, from at least six feet away, and laughing through our tears.

PLENTY

As a very young lass, I had the opportunity to live in a less industrialized country with a fledgling government in power, promising a new era of equity and social justice that had been a distant dream during years of puppet governments and foreign interference. It was all very exciting, from my point of view. Revolution! Yet there were mass shortages of basic goods and even electricity, and the water supply was turned on for two-hour increments daily. People started hoarding basic food and supplies, and profiteering occurred. The government responded with very strict rationing and other measures, but the shortages went on. There were trade embargoes in place and even things like glass soda bottles became precious. I had come from the land of plenty, where empty shelves were unheard of. I asked a respected local elder what she thought about the shortages. Her response surprised me.

“I think it’s great! Now people are more grateful for what we have. We don’t waste as much. We are more protective of our resources, like running water and electricity, because there has to be enough for all of us to share. ‘We are only as rich as the poorest person among us.’ That is our motto! So I do agree with the strict rationing of basic food items. When everything is run on money, the rich can pay starvation wages and hoard the wealth. Before, poor people could not get what they needed, because it was put out of their price range by profiteers. Now, everyone in the country has the right to the basics, like food, housing, even healthcare and schooling. Share and share alike. Then work hard for your luxuries, if you want them, but nobody should have to starve or steal to feed their children or take care of their sick and elderly.”

I don’t claim that I will revel in it if we get to a point of scarcity where we have to turn off our water for part of the day, or have regular electrical shutoffs, or food rationing. And of course it will be terrifying if people where I live get to the point of civil unrest and even starvation – and let’s pause and acknowledge that this is the reality today in many parts of the world, through no fault of their average citizens. But I do think that this slowdown and even partial shutdown that we are experiencing in an attempt to mitigate the current virus can be an opportunity both individually and collectively to take stock of how we want to live and what matters most to us. What are we working for? Where are we rushing to?

For those few who thrive best in the rat race, there seems to be an anxious urgency to get back to work, not just for food and shelter, but as their recipe for personal success and self-worth. I had a chat across the lawn recently with our new megacorporate neighbors who are both able to work remotely on full salary. But they are “going crazy” as they told me, with their own two toddlers underfoot while the daycare is closed. The little buggers need so much time and attention during Mommy and Daddy’s workday! “Expect to see arts and crafts displayed in the windows soon because we’ll have to find SOMETHING to keep them busy so we can get our work done! We might even have to take some vacation time, because it’s so hard to stay productive!” The gym is closed as well, so they just set up a treadmill in their driveway, and they take turns running in place.

And what about the rest of us, the many of us who don’t measure our success by money, and yet need money to survive and keep paying our bills? Natural to panic and wonder if we will go under before things improve. But I do believe that much of our money problems will resolve themselves. Money, after all, is simply a socially agreed way of owning property and exchanging goods and services, and as policies change, so will our money woes. Remember, the only thing that cannot be forgiven in our society is individual failure: “Don’t go under – or go live in a tent. Your fault if you didn’t pull yourself up by the bootstraps!” But if we all sink or rise together in a shared economy, then large-scale adjustments will have to be made to accommodate the changing circumstances. Dominoes will fall in all directions, and those living hand to mouth will fall first. But collective collapse means a collective solution, and that means our government will have to take action and readjust some basics. Lots to think about. Lots to process. And we have a wide variety of examples from around the globe of how different nations are meeting this challenge. Lots to learn.

In addition to the money woes that all contractors face, in common with the many employees without secure jobs or benefits, and our fellow freelancers and small businesses, those of us who are healthcare workers face a much increased risk during a pandemic that sends contagious patients to our hospitals. While others are ordered to stay home, we are ordered to go to work and care for the sick and dying. Fortunately, many of us have come to peace with death through our years of work. I have accompanied many people on their final journey, and I had the honor to be holding my own dear mother’s hand as she passed away. I can now see death for what it is: the natural and inevitable end to each human existence. And I can see grief for what it is: love that has nowhere to go.

Interacting with other cultures around death and dying has been illuminating, because in our dominant culture, people seem shocked and dismayed by anyone of any age in any condition passing away, as if we just never expected it – as if we didn’t know we are mortal. It is a shame that every death must be a shock and a tragedy in our eyes, rather than the natural next step, and one we can accept. It is enough to lose a loved one and grieve without being in denial and shocked at our mortality as well.

More relevant to me than the specter of death is that I still find great satisfaction in living. I truly treasure the opportunities I have been given to interact with and serve others. I value my health and strength. I am grateful for my home, and my several jobs – including the ones that are not paying me right now (I am a contractor for the bulk of my income). I appreciate the ocean, mountains and forests of my home. I am happy for art and music and learning. Grateful for my readers, of course. And I am most especially happy for the strong connections I have, for my social network, for the people who love me, and allow me to love them. Happy for the outpouring of love and offers of help during my illness. So many people encouraging me as well as offering direct, practical help. Even my childhood sweetheart got in touch, to my exquisite and unmitigated delight.

In all this abundance, all this safety, even in illness, my heart goes out to those who for whatever reason, do not have a soft place to land. Who truly feel that their missing paychecks will lead to economic disaster in a matter of weeks or months. Who are facing health challenges that mean exposure to the virus could put them on a ventilator. Who are isolated and alone in their lives, whether due to relocation, poverty, or family separation, to such a degree that they simply don’t have the comfort of close friends and family nearby who can and will check on them, help them, relieve them. Who don’t have enough people in their circle – even during illness or a crisis – to ease their weary hearts, and provide them with practical help.

Not long ago, someone in my family was asking me how we can best support another family member, a common question for us. What if this happens? What if that happens? How can we help then? I answered, we do what we always do. We run around like a bunch of firefighters with a safety net and we just keep moving it underneath them so they always have a safe place to land. That’s our job. On a small scale, and on a large scale.

As to looming death, speaking philosophically, I can truly die happy, if such is my fate, with renewed appreciation for all that is precious in my life. Hopefully much later, because I am not yet tired of this fragile, scary, beautiful world upon which I am destined to live out my life in this even more fragile, ephemeral and yet resilient snippet of human flesh. Wishing all my readers good health, long life, and lots of love.

CORONA EXPOSURE

The corona virus is not just exposing us to contagion and illness. It is also exposing the cracks in our healthcare system, among other things. Take my experience. I am a healthcare worker. I have excellent private insurance through my employer. I am running a low-grade fever, and have fatigue, but then who doesn’t right about now? I wouldn’t think much of it except I just got a call from my boss that my work wife ( a dear colleague who works right next to me) had been exposed to the virus and is very ill. She was not told about her exposure until after she had been back at work with the rest of us for several days. In fact, as an interpreter, she found out randomly because the clinic “didn’t think to call” interpreter services about the exposure. Yet we are staff hospital employees. Imagine how the contracted agency interpreters will be treated. How likely is it they will be informed of specific exposures and testing needs, and who will test them? And what about all the rest of the self-employed, and others in our communities?

I sought testing, as our hospital website directed, by first contacting my own doctor’s office, and here is how it went for me, an educated, competent healthcare worker, very used to negotiating the healthcare system. When I get through the phone tree, they tell me I cannot talk to a nurse as I usually can, because they are overwhelmed. There is no way they could squeeze me in today for an appointment either (which is their usual policy for urgent needs and why I chose them as my provider). I will have to leave a message and then wait for a call, but no one can say when because they are overwhelmed. I argue to the point of rudeness about getting in, tell the person on the phone that my boss just called to say I have been exposed, and I have a low-grade fever. I need to get tested! Not just for myself, but for others, because I am a healthcare worker. Sorry, she repeats, but we are just slammed. You’ll have to wait.

So what, I posit, would happen if I just show up at your emergency room? Well, she says, they would treat you accordingly. Huh? What are you saying? What is your policy? I don’t understand you. What do you mean by treated accordingly? Will they charge me the thousand dollars plus for any emergency room visit? And if I go there, will they test me on the spot? Do they even have test kits? Well, she confesses, I really didn’t know how to answer that, so that’s why I just said they would treat you accordingly. But if we cannot help you fast enough and you want to try elsewhere, I can give you two hotlines to call. One for the County Public Health, one for the State Public Health. Wow. So my excellent, top of the line (“this is why we need the freedom of private insurance so we can choose to pay for the care we deserve”) insurance is giving me an 800 number for the historically underfunded, battered and beaten public health department.

I ask my doctor’s staff whether these numbers are actually offering testing to the general public, or whether they just have recordings of the general rules and guidelines, like wash your hands and stay home with a fever, and she guesses “a little of both” at which I wonder aloud why I would need to call Public Health and listen to a recording when I have excellent private insurance, and have gone to the same doctor’s office for over 20 years. She just offers me the numbers again and tells me I have to wait for a call from the nurse who “has piles of people to call.” Be patient and stand by.

The nurse calls me back late Friday afternoon at closing time and says I cannot come in today. It will have to be next week. I remind her that they have a Saturday clinic (another reason I chose them) but she tells me there is just one doctor for that clinic so they will not allow anyone to come in for testing on Saturday. They already decided. No exceptions! Sorry! But she can give me an appointment for Monday. That is “just as good” she informs me, because they would simply tell me to rest, drink fluids and isolate myself whether I tested today or Monday. So it should be just fine to wait three more days. Just stay home from work from now on, while we wait for the results that can take 3-4 days to come back.

There are many people in situations like mine, and worse, of course. I specifically took a half-time job at the hospital so I could get health insurance, because health insurance options for the self-employed can cost over a thousand dollars a month even with huge deductibles. So I have health insurance and even sick leave for my hospital hours. I will lose all my court pay for any missed shifts, but at least I have a halftime job with employee benefits for some kind of a safety net. For my many colleagues who exclusively contract, of course, they will get no sick leave, zero pay, and there is no system in place to cover their lost income. Contract medical interpreters are not alone in losing income, of course, but it is worth pointing out that they are exposed at work and still not allowed any recompense or even testing. It is cold consolation to my fellow health workers that eventually we will all be exposed, because people are not able to get tested, self-quarantine, and inform others of the exposure, in a timely and effective manner.

Back to my private doctor’s office and his nurse. We talk on for a few minutes regarding my exposure, risk and symptoms. I thank her for the appointment as if she were doing me a personal favor. I really am grateful, though! So glad I have this wonderful private insurance! As we are about to hang up, she adds, oh! What was your temperature? I carefully explain to her that my normal temperature is 96.7F which is 36C, not 37C which is more typical, so when I get a fever, it runs low, but it is a fever for me. My blood pressure is also 85/55 so I just run lower than the general population overall. I invite her to confirm in my chart (not that she has time) that even when I had pneumonia, my temperature never rose above 101F. Oh, dear, she exclaims! That is a problem.

She is so very sorry, but she has to cancel my Monday appointment after all! She understands that I want to be tested, am symptomatic, and that my boss called to say I was exposed, but I do not qualify to get tested under the government guidelines. We are “not allowed” to use a test kit on someone like you, she explains. There is such a shortage that we are just not allowed to! So I simply must find a way to develop a fever of at least 101.5 if I want to get tested. She ends on a upbeat hope: Maybe your fever will spike up to 101.5 over the weekend and then you can call in for an appointment next week! Fingers crossed for getting a good fever! Okay, thanks.

This is not the county jail nurse I am talking with. That kind soul has fewer resources and staff. It is not the public health department, historically strapped for money in our for-profit society. It is not even the county or the state hospital, where they struggle for full funding and resort to asking for donations (just like our public schools do). This is a private, nonprofit hospital recently bought out by the megalith Providence, a subsidiary of the even more megalith Catholic Church. But I cannot get tested for Corona exposure by my own doctor – as a symptomatic healthcare worker with excellent insurance and a documented exposure – because my body temperature runs low. I guess I can comfort myself that if I do succumb to the virus, at least I can die coolly, and well insured.

I call my hospital’s employee health office, and spend some time on hold with them. No doubt, they are overwhelmed as well. They tell me that I should “follow the guidelines online” and go to my own doctor, because they just cannot test everybody. My doctor won’t test me, I tell them. They repeat that my doctor “should” test me. When I explain that my boss told me I had been exposed at work, and they have a duty and an obligation to test me, an awkward pause ensues. Clearly, the runaround had been working pretty well for the person answering the phone, until now. I told her I had looked over our website, and done online searches, but could not find the specific place to find testing, apply for testing, or any contact information, but this number. She apologized and told me “it should be there”. I told her it was not accessible, and asked her to verbally instruct me as to what the procedure was, as far as she knew it. Presumably Employee Health had been given some training, some information, regarding employee testing? Where do I go? How do I get tested?

Oh, dear! She was sorry but could not tell me any details of the testing options for employees, as “that is being handled by another hospital” which is odd, as that “other hospital” is one recently bought in the series of shell game hospital buyouts and sellouts – by the state hospital where I work. Too bad the person on the phone – my coworker – has no information about how people who work at our hospital – like me – can be tested, how long it takes, or anything about the process, but can only direct me to a website. Why do I feel like I am calling Comcast Customer Service when I am calling my own Employee Health office – part of our Human Resources? Wouldn’t they be the ones to be informed and provide vital healthcare prevention and testing information for vital healthcare workers? But they have no information because a hospital “we” just bought is “doing the testing” so “we” don’t know. Thus, my own doctor refers me to 800-numbers for public health, and my own hospital where I was exposed refers me back to a website.

As of now, I have filled out the employee testing request form (not available to contract interpreters) and am waiting for a call back for a phone interview, to see if I can be granted the chance to waste a precious test kit on my humble nostrils. I would hope that my being a healthcare worker, exposed at work, and now running a fever, might weigh in on my side, and I can feel my fever rising as I type these words. If it rises enough, I may even qualify to get tested.

For the record, I will be as surprised as any of my readers if this becomes my last post, and I fade into the darkness and silence of the grave (especially as I plan to be cremated and have my ashes cast into the sea). My concerns are broader. If I cannot get tested, then who can? These barriers to testing, in the best of circumstances, are bound to increase people’s exposure to the disease. And what about the thousands of contract interpreters across our state and elsewhere, who roam from clinic to hospital, and don’t even have an “employee health” to turn to? Will they all stay home with no income, or just work unless and until very ill, as they unwittingly spread the virus among vulnerable patients? Who if anyone is arranging to have interpreters work via video remote or telephone as possible? And we are of course a miniscule slice of an immense pie.

I dread to think about those millions upon millions without health insurance in the midst of so much concentrated wealth. Those with compromised immune systems or weak lungs. Those who cannot afford to stay home for a week or two just in case. Those who cannot speak the language or for other reasons even begin to negotiate our complex healthcare system. Beyond health risks, the societal implications are unfathomable, with small businesses going under, schools closing, travel bans, and a huge swath of working people facing job loss and financial implosion.

As a contractor myself who pays at least 25% of my adjusted gross business income on taxes, it is surreal to be in a place where huge global corporations – the same ones that have lobbied to use our city as a tax haven while distressing our tax-supported infrastructures to the breaking point – are now considering using a slice of their astronomical profits to produce and deliver free Corona test kits to symptomatic residents as an act of “charity” – a task our public health department could have afforded, if we had a reasonable tax system that was fair and equitable across the board. One of many symptoms of a sick economic structure that the Corona virus merely highlights.

As a healthcare worker, I fervently hope that part of our recovery can be taking a better, closer look at our healthcare. Our patch-work business model healthcare delivery system, with its severe lack of coordination and financial barriers for patients, can turn into a literal death sentence for thousands almost overnight. I fervently hope that this virus may lead to fundamental change in healthcare delivery for our nation. It is past time to create and sustain a viable, funded, staffed and preventive public healthcare system. And no, it is not too late, because this is not the first and will not be the last pandemic. If nothing else, let us learn from our mistakes. Let this be our wake-up call for healthcare reform. Let the Corona virus be an eye-opening blessing in disguise – for those of us who survive it. And for those who succumb to it, rest in peace.