November 18, 2020

I’m sad this evening. It’s all related to Covid of course, how could it not be? The number of US deaths passed one quarter million today. That’s 250,000 families that were intact in February and which are now irretrievably broken. Widows without spouses, children without parents, parents without children. And none of it had to be. Given the nature of the beast we were always going to lose some but with good leadership and public health practices, our losses should be lower by an order of magnitude. As I read through my Covid related news feeds, I’m reading about North Dakota, now the hot spot for the disease not just in the country, but in the entire world. one out of a thousand people there has died of Covid since the beginning of the pandemic. South Dakota, just across the border isn’t faring much better and their seemingly delusional governor is busy running tourist ads to try and get people to come visit. They are completely out of hospital beds in Oklahoma. New York City schools are shutting again. Lockdowns are taking shape on the West Coast.

The current surge, which is much worse than either the initial outbreak of the spring or the higher numbers of July/August, is absolutely predictable. The sages in the epidemiology/virology community stated what would happen quite succinctly and matter of factly this summer if the country did not take things seriously and mask up, social distance, and cancel significant gatherings of people. What did America do? It turned the wearing of masks into some sort of star bellied Sneetches political statement to delineate in and out groups. It sent its children back to school and its young people back to college where they engaged in the behaviors that young people are want to do. It couldn’t live without its motorcycle rallies, its football games, its nights out at the restaurant. It would not exert political leadership to make it economically possible for Americans to choose to take care of each other. With no other source of income, everyone had to go back to whatever work they could find, risks be damned. I’ve worked very hard to be careful but I’m human. I’ve slipped a few times and done things that might have put myself or others at risk. I want my old life back just as much as everyone else.

The virus, of course, cares nothing for any of this. It simply takes advantage of the opportunities afforded to it by human behavior and, with a third of the population convinced that Covid is likely a hoax and certainly not a threat, there’s really no way to contain spread in the population as a whole and you get what we have now which is pretty much uncontained community spread everywhere. I think the saddest story I read this week was from a nurse in South Dakota on the Covid wards who, when calling families of patients who were about to be intubated and like to die and would they like a chance to say goodbye to their loved one was told over and over again that that wouldn’t be necessary as the virus was a hoax. The next call, was of course, to tell them that their loved one had died and the cognitive dissonance that must be causing I can’t even begin to imagine. I have heard that families have come in demanding that death certificates must be changed. It can’t possibly be Covid. It must be pneumonia, flu, an undiagnosed cancer but not Covid because it doesn’t exist.

On a personal note, I’m sad that I won’t be able to see my family as I had planned. After much discussion and reflection, I’ve come to the conclusion that it’s best not to go to Seattle at the moment. Washington state is heading back to mandatory quarantining of out of state visitors (and I can’t take the time for a two week quarantine before seeing anyone at the moment). There’s the heightened chance of exposure through travel and the risks that potentially poses to my soon to be 88 year old father. What I’m going to do with my time off I’m not sure now. I am going to go down to storage and haul out Christmas this next week. As Mame says, ‘We need a little Christmas, right this very minute’. And it will give me the time to figure out which of my multitudinous decorations will work in this new space and which should be rehomed. Then I have to tackle boxes of ephemera and sort out pictures and mementos.

I’m sad for my patients, who were just starting to feel safe coming out of their cocoons who have to go right back into an isolated existence. I’m sad for their families who are often stuck outside of a window or glass door. I’m especially sad for the demented ones who don’t understand what’s happening and why routines have been so disrupted. They need touch and laughter and small children to stay anchored and present in the world and these basic needs are denied them. I try to be a bright spot in their day when they visit me either in person or via video conference but it takes a lot of energy to be that role I’ve perfected for myself over the last three decades.

I’m sad for my colleagues who were, earlier in the fall, starting to feel human again as the pressures of Covid were letting up some on the system and old patterns and schedules were starting to fall back into place. They haven’t recovered and here they’re being asked to gird up their loins and prepare for worse yet. It’s taking a major toll on mental health. I can see it and feel it. People are snappier, less tolerant of minor snafus, more likely to pick fights over turf or disagreements in treatment plans. I know when I get like that, it’s time for a vacation and I schedule one post haste but there’s not enough of us to handle what is happening as some retire, some burn out, and some fall ill. I’m not worried about UAB but nationwide, one fifth of hospitals are at or over capacity as of today and the numbers show no signs of trending down.

I made a deal with myself after Tommy’s death that the way I was going to cope with life was to schedule one thing a month that I could look forward to. A vacation, a long weekend away, a theatrical project. Something that would nurture my soul. I was doing pretty well until March when the world fell apart for me as well as for everyone else. I’ve had little to look forward to and I look out at the horizon and still see a long stretch of months where my usuals still won’t be possible. I have to figure out something to take their place. I just haven’t been able to do so as of yet.

Sorry to be Debbie Downer this evening but some days are just like that. In the meantime you all know the drill: wear your mask, wash your hands, social distance, avoid close crowds.