As the COVID-19 pandemic rages on, as we stand mesmerized watching the numbers and graphs climb every day, as we hear horror stories of hospitalizations, deaths and “death panels”, as we hear the constant cacophony from the right for opening schools and for protecting their “freedom” to not wear masks and the “right” to prevent others from doing so, we are slowly coming to the realization that we are headed for the proverbial cliff and there is little that will be done to prevent the disaster that will unfold in the coming months.
This short emotional essay by Dr. Anna DeForest (Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut) was published in the New England Journal of Medicine this week. It captures the essence of the debilitating suffering of patients, the agony and helplessness of health professionals, the utterly callous policy response by the administration and republican governors, and the sinking feeling that the future simply holds more of the same.
The essay “A New Stability” is addressed to a female patient, whose lungs and organs are ravaged by the COVID-19 virus; while hospital staff struggle to keep her alive, the grim reaper waits patiently in the hallways; the essay ends with the harsh realization that the story will be repeated over and over again, across the country, day after day.
Here are a few snippets from the dark and sobering article (emphasis mine) —
Thirty days before I met you, we didn’t wear masks in the streets or in the halls of the hospital. The CDC said they were no use. Back then, the federal government had few plans for facing the pandemic other than sitting still and hoping for the best. True, the masks and antiviral wipes had vanished from the floors, and the residents were told to sanitize our workstations with inch-wide alcohol swabs, and the international news showed helicopter views of mass graves in Italy and Iran. No one, we were told, could have seen this coming.
This is the day you start to turn. What we suck up from your lungs turns frothy pink and then the frank red of blood. We don’t know if your heart is finally failing or if the virus has destroyed so much tissue that this is necrosis, hemorrhaged in your lungs. There are tests, but no one willing to run them — you are too sick, and you have never cleared the virus. No one would ever want to be what you are now: a hazard, a threat, a frightening object on the edge of death. We try not to touch you. We construct our plans for saving you around staying as far away from you as possible.
I strip in the doorway when I get home, stand in the shower too tired to think or cry. I sing “Happy Birthday” twice over every part of my body. At work I can’t eat, at night I can’t sleep. The dreams I have now have only three themes: gasping for breath; wiping things down; somehow, by accident, being touched by somebody.
The morning you die, I don’t want to be there — like most mornings now, when I rise against my whole will and crawl dejectedly into scrubs. I don’t want to be a plague doctor or a hero on TV.
This paragraph steps out of the hospital and nails the incompetence and cruelty of trump and the GOP — past and future.
Now on the news, White men hold guns and signs that say “live free or die” to protest the lockdown. I imagine what they will look like dying on vents in ICUs staffed by doctors lacking sleep and proper training, soaked in moral fatigue. I imagine what their wives will sound like on the phone as they cry and say “Do everything.” I wonder if these wives will thank me or tell me to be safe.
I look for hope and find none, but I am not allowed to admit to total free fall. “Stronger together” say the screen savers on every screen in the hospital, the banners on the sides of the shuttle bus. What I’ll see in the coming weeks is just how much this isn’t true, how so many of our sickest patients are Black or Brown like you, “essential” and yet unprotected. I will see a 46-year-old Black man, infected with SARS-CoV-2, die instead from having a police officer kneel on his neck. I will see those who protest police brutality, though masked and mostly peaceful, tear-gassed and shot with rubber bullets. I will see unregulated corporate bailouts, record unemployment, record housing insecurity. I will see political polarization recast common-sense public health policy as liberal propaganda. I will see your death multiplied by 10,000, by 100,000, all those bodies, mothers and fathers, daughters and sons. I wish I could tell you how sorry I am, for my fear, for our nation, for what happens next.
The ending is brutal in its honesty -
When the code is called out overhead, your code … With my arms at my sides, I watch through the glass. I have never mattered less in my entire life. …. And this is how you die, near no one who ever loved you, a spectacle of futility and fear. Time is called, and someone calls your husband, and it isn’t me. I am not the one who hears him cry out in grief. Forgive me if I am grateful.
What else is there to say? You are dead, like so many others, and the rest of us are left to live in the absence of any certainty. We can’t go on, and we go on: back to work, back to rounds, back to the next case coming crashing in. It is no use to think about the future, our training, or what happens next. We are all attending now to a historic and global suffering, and learning the limit of the grief our hearts can bear.
The article was originally written in May in Connecticut, but has probably been updated and it accurately captures the devastating situation we are in today.
The article is dark and foreboding; it offers no hope; it captures the feelings of one doctor, although you can sense that she speaks for many. It is a grim reminder that in spite of our sometimes hopeful talk of social distancing, of vaccines and drugs, of doctors, and virologists, of how blue states are doing better — the truth is that the hyenas have taken over the country and we are watching the disaster unfold in slow motion, waiting for November to save us.
And the worse is yet to come, since there is little being done to systematically address the problem. For republicans, politics trumps people; they are fighting for their political lives, not the lives of men, women and children they took the oath to serve.
Other doctors have written similar articles based on their experiences. We wrote a couple of diaries based on the writings of Dr. Craig Spencer from NY. He is still active as ever, trying to spread the truth about the virus and the administration and diligently trying to persuade policy makers to do the right thing.
Stay safe and be prepared for the long haul. And let’s share this article far and wide — it’s a tough read but people need to be reminded of how heinous the party of trump has become.