Tag: Public Health

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Don’t Stop Thinking About Tomorrow

Posted on by Queer Mama Rising

It’s the second week of April, and it has snowed nearly every day this week. The heavy, wet flakes cling together in the shadows, blanketing the barely-awake grass in patches so the snow looked crocheted. It will melt as the sun encroaches, seeping into the cold ground. The brook has finally receded back to its springtime levels after rising a few feet during a day of torrential downpour. By the time we walk in it, it will be impossible to tell which storm or melt moved new boulders into our path. 

The air is no clearer, there are no changes in the traffic on our road. Stay-at-home looks almost no different than when the world is bustling and busy. We still hear a plane maybe once a week; logging trucks still thunder by. 

Our governor declared that Vermont has passed the peak of coronavirus infection. Watching the first signs of a plateau in cases, I am almost ready to be maybe cautiously optimistic. To paraphrase the meme I’ve seen regarding the northern New England states, staying six feet apart seems awfully close. Vermonters have been pretty good about staying, in local terms, one cow apart. 

We have not seen the influx of illness and death that had been projected just 4 weeks ago. Social distancing, “stay home, stay safe” orders, and the Vermont attitudes toward independence and resilience are working to reduce and prevent transmission of Covid-19. 

Working for the hospital as a non-clinical member of the infection prevention team and scrolling through my echo chamber on Facebook have validated this first tingle of hope that we have avoided catastrophe. 

Of course, one only has to blink to see outside that bubble.

I have decided that arguing with men on the internet is a form of self-care I am indulging in during this pandemic. I have not been one to wade in to internet arguments much before; I don’t enjoy feeding trolls. When I did engage, it was not necessarily to argue (ha!) but to correct something blatantly false that wasn’t also a conspiracy theory – I have my limits. But right now, there is a deadly pandemic; a gorgon at the door, its hot breath blowing in from New York and Massachusetts. 

When I worked in EMS, we had to prepare for blizzards and hurricanes, and in 2014, for the possibility of Ebola finding its way to us. My counterparts made the necessary arrangements and backup plans but teased my high level of concern in both situations. I was a newer member of management, relatively young in the field, and one of extremely few women at the table; I was not as jaded when it came to preparing for disasters that never seemed to materialize. I was better at keeping quiet then, too. I did not fool around during PPE training, but I wasn’t as vocal as I am now. 

Seeing the carelessness with which some people are conducting themselves during this pandemic enrages me on every level – personally, professionally, and academically. The misplaced bravado, the utter disdain for guidelines, the willful ignorance of science pumps up my blood pressure. I feel it build like some sort of apocalyptic katamari in my chest, jagged and off-kilter, heating and churning to boiling point when I can’t stop reading for incredulity. I need to release the valve, blow off some of that steam; scalding men on the internet who call me a sheep has been a fun little release (I am specifying men here because when I argue with women, they don’t often respond; and when they do, it lacks the utter condescension and vitriol).

Why is this affecting me so? Why can’t I just scroll past? I don’t like how much time I spend on social media anyway, why can’t I just put my phone down? I have asked myself this several times lately, and the answer comes from my idol, Leslie Knope:

I care too much because I understand the stakes, and I have seen enough suffering.

I have seen the panic in the eyes of the vented patient when the perfectly spaced breaths aren’t enough, when the air sacs in the lungs fail to inflate. I have locked eyes and delivered breaths through long, drawn-out minutes of a power outage, waiting for a generator to click on, and a machine to take over the squeezing of my hands. I have seen the terrified disbelief in the eyes of someone drowning by inches in a dry bed.

I am no stranger to Death. I have seen her come for the unfamiliar and family alike. I have felt the brush of her hair as she has reached past me to spirit away the hand that I hold. I have ignored her gentle admonishment to stop when pushing, pushing, pushing on old and broken ribs. I have seen her leave the memories, a trail of blood-red rose petals to the afterworld; and I have seen her snatch away breath with greedy hands. I have seen her wait patiently for my father, and smooth my mother’s hair away from her soft face. I have seen her cradling my son, tears in her eyes, an unspoken promise to care for him. No, Death and I are not strangers. 

Death has already come for tens of thousands around the world, invited to this grim party by the coronavirus in addition to her normal rounds. Already the numbers have reached those a degree or two away from me. Right now, thankfully, they seem to be plateauing. Our vigilance is working; alternate care sites and negative pressure rooms stand empty, boxes of supplies on the shelf. Staff is still ready, all hands on deck; the hallways echo without visitors. Work pushed aside so quickly in March is starting to pop up on to-do lists for some; furloughs and lay-offs have emptied the common areas. 

I am trying to be extremely deliberate when I say the measures are working – present tense, a current and ongoing action. It will be a long time until we can say it worked. As the internet says, ending quarantine now because it’s working is like stopping medication because you feel better. We just aren’t there yet. Projections show that the curve has been flattened absolutely, some places much more than others; but we have to keep looking down the line. This virus doesn’t magically disappear when we hit a certain date or temperature or season. There is much more work to do. We are not out of the woods yet. 

I understand the gravity of the economic situation. I know hundreds of thousands of people are scared of what the next days will bring, even if the lockdowns were to end immediately. I can see the havoc wreaked by the virus on sectors other than healthcare. I worry about the success of our small businesses, and the education of our students. I miss concerts and baseball and my family. I see the effect quarantines and lockdowns are having on people, and I sympathize – but without people, there won’t be an economy to fix. If we were to lift all the restrictions, the only things different would be that some places would be ready for a second wave of infections and fatalities, and some would continue to be devastated. 

There is no going back to life as we knew it. That is a switch that cannot be flipped, as most in the US were able to do after the Ebola outbreak in 2014. This time, we are heavily involved, whether people want to admit that or not. Going forward, life will be irreversibly changed. No one will be unscathed. If we continue to handle with caution and test tomorrow’s ground with every step, we can maintain this plateau. If we don’t, if we start going out and gathering together in the streets as we did before, we will rewind this tired clock and have to start again. 

And if you want to fight about it, get ready to step. I can keep up this argument as long as the willfully ignorant can.

Keep staying the fuck home, friends.

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Time I Had Some Time Alone

Posted on by Queer Mama Rising

This isn’t the post I have been trying to write. Here there is no research, no fact checking. I realize now why it has been taking me so long to finish that one.

I am anxious as hell.

For those of you who know me well and this is not a revelation, I’ll thank you to keep your “well, duh,” under your breath – behind a mask optional.

I am not anxious about the coronavirus. I earned my master’s in public health just this past year from johns Hopkins Bloomberg School of Public Health, with a certificate in Quality Improvement, Patient Safety, and Outcomes Research. That certificate won out narrowly to one in epidemiology or statistics, two other public health realms near and dear to my heart. I feel I have a pretty solid grasp on the behavior of the virus, the steps to mitigate the spread, and the danger we are in.

I am not anxious about getting the virus. I am a relatively healthy 33 year old; I have high blood pressure, but it’s well controlled on medication. I was recently pregnant and my daughter is exclusively on breastmilk, but there is no indication that this puts either me or my daughter at risk. I have a decent immune system, honed by nearly ten years in emergency medical services, dealing with some level of exposure to whatever is going around. I am vaccinated accordingly, I receive the annual flu shot, and I wash my damn hands.

While I am increasingly worried about Hawthorne contracting the virus, that is not the source of my current gripping anxiety. Hawthorne has poorly controlled asthma, and has for years. Their immune system takes a beating, often. Whenever we are sick together, their symptoms at least twice as long as I do, and the asthma exacerbations continue into weeks. We have sort of made our peace with the fact that Hawthorne will likely come down with it, and we have made preparations for how to handle things if and when they become significantly ill. They have been tested for the coronavirus and are currently quarantined in our home; we have divvied up the silverware and towels, we are following the guidelines as close as we can while not leaving me with all of the parenting, cleaning, chores, and my own work. 

I’ve been up since 4:30 on a day where I do not have to go to the office. Lucy was up every hour last night; it’s strange to think that something that I’m eating is disagreeing with her tiny tummy so much. I couldn’t sleep any longer, couldn’t try. My mind has been racing, my eye twitching. Lucy learned to screech this weekend, and practices every chance she gets, testing it out with every mood. It’s adorable to see her smile, all gums and joy, and then jarring to hear her hellshriek with the same smile. I’m not anxious about the impending couple weeks at home with her on my knee, coffee at my elbow, and data on my screens. 

I am anxious because right now, with seemingly inevitable quarantine (which I agree with!), I am about to lose the hard-won routine and structure I have developed since returning to work after maternity leave. Self-isolating or quarantining leaves a lot of wide open days; Lucy is too young to have lesson plans, and I’ve never worked from home for multiple days in a row. I feel like I have just completed my reentry into work life, crash landing and stumbling out, dazed by the sudden atmospheric shift. I have made it over the first hurdles of balancing work and life with a new baby at home, the first days of not knowing quickly how to proceed when I don’t have childcare, the first extended hours of feeling like a vital and visceral part of me is missing. 

Years ago, Hawthorne helped me realize that one of my coping mechanisms for stress and lack of structure coalesces into overworking myself. Maybe I start spending long hours at work, or banging away at work projects off the clock. Often it means I start looking around the house and the world and everything in between, making lists upon color-coded lists of projects to do. What is coming to surface right now is the drive to help. I feel useless, helpless, here at home when I know how hard my colleagues are working. It doesn’t seem to matter, internally, that I will be back at the office soon and able to jump back in the trenches with them and support. I understand how hard it is to believe that the best thing that I and millions of others can do is simply #staythefuckhome. I’m fighting the urge now to not be involved in every community initiative, moderate every Googledoc, deliver every meal, and write to every isolated senior. 

Part of the reason I never questioned becoming a doctor when I was growing up was I felt that doctors were, above and beyond, helpers. They were able to take care of people, to fix things, to make things better. Watching some of the doctors my father interacted with when diagnosed with ALS scuffed my rose-colored glasses, so long trained on the medical field. I remember my anger at his first neurologist, a jaded man with wire-rimmed glasses on a straight nose and zero compassion. Even at 15, I felt nostalgic for a time I had never known, when doctors visited the homes of their patients and occasionally accepted bread and unlabeled jams as payment. I had watched Patch Adams too many times, I guess. If I was going to be a doctor, I was going to be a doctor who cared.

Jumping headfirst into emergency services felt natural; there, I was helping people, I could see that every day. I did fall into the EMS culture (another story, another day), but mostly, I was able to remember what I walked away with from my original EMT class. When people called 911, they were doing so for a reason. They needed help. People have been taught for decades now that when there is an emergency, you dial 911. No one has done a good job at defining what an emergency is on a wide scale, so the term has become completely subjective to folks outside of the healthcare fields. I don’t get to define what someone else’s emergency is. Maybe it’s loneliness. Maybe it is running out of a medication and not knowing what to do, or maybe it’s a dead cat; whatever it was, there was a reason.

There were, undoubtedly, many more frustrating calls than there were true medical emergencies. It wasn’t prestigious; benefits were practically nonexistent, and the pay was terrible. Then the Fight for 15 began, it became a contentious point in EMS: most people entering the field wouldn’t see a payrate like that for years, even though they are literally the first line of response in life-threatening situations. We weren’t in it for the money; some may have been for the glory, I suppose. It took a lot of work sometimes to remind myself that, as EMS professionals, were being given an honor by the public we served; there were times it took substantial effort to remember that we were being not only called, but invited in to people’s emergencies, their worst moments. We were the ones who showed up in the times when people were most vulnerable. We were the helpers.

I let my card lapse with absolutely no regrets. Since then I have happily remained in a non-clinical role. The decisions I have are not life and death; if I make a mistake, it needs to be fixed, but no soul hangs in the balance. This experience, sitting home while the virus creeps over the land, has made me realize I don’t know how to not be a helper. I know there are thousands upon thousands out there like me, feeling stymied, even as we are doing the best possible thing – staying home. Somehow I will have to find more of an actionable way to help; I just don’t know what yet.