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.