Month: March 2020

A plea from a former ICU doctor at the time of a pandemic

CoV2
Photo from Nature.com

We are all viral now, or at least presumed viral until proven otherwise. And since tests are scarce, and antibody tests are not quite ready for prime time, presumption is all we have.

My life hasn’t changed very much — I get up, I work out, I get to my desk and work, take conference calls, just like I have for the last thirteen years. But there is something in the air that feels different, some foreboding, a tension I notice in people’s faces and shoulders as they appear inside their isolated Hollywood Squares frames on my screen.

There are fewer dreams these days. My friends are suffering from insomnia that fails to consume our cats and dogs. There is this existential worry, and I wonder if the partisan divide simply betrays different manifestations of fear. On the one side there is an incredulity, an inability to believe that whatever deity they worship would do this to them, kill them, maim them, discard a life they see as important. If you dig under this incredulity, you will find fear and an almost primal belief that sticking with your own kind is talismanic against this real or imaginary scourge. Hence, this drive toward the church, to worship communally, to implore, to thank, to show you trust, as though their vain god should respond to such flattery and superstition. On the other side there is an apocalyptic dread of colossal human incompetence emanating from the highest echelons of our government and the price this incompetence will exact on the nation, the world.

No matter how advanced we get, no matter how much technology we fill our lives with, no matter how much scientific understanding we have, no matter how in we are with this transactional god, we are still human, meaning tenuous and fragile, subject to the laws of this ancient and unfathomable universe.

We are all buzzing — our brains, our muscles, our tongues, all turning up the volume, all shouting into the void the virtues of our ____ (fill in the blank: rationality, obedience, obsequiousness, superiority, loyalty, etc.). And yet at the foundation of it all is one simple immovable fact: No matter how advanced we get, no matter how much technology we fill our lives with, no matter how much scientific understanding we have, no matter how in we are with this transactional god, we are still human, meaning tenuous and fragile, subject to the laws of this ancient and unfathomable universe. In all our glory, in this most knowledge-saturated of centuries, the Rube-Goldberg project of evolving humanity can still fall prey to something as trivial as a virus, a measly 30,000-base-pair strand of RNA inside a microscopic machine operating with fury and ruthlessness under the same laws of the same ancient universe. And the fact that we have identified this organism, sequenced its genome, understand how to contain it, have the technology to reduce and mitigate the damage it has evolved to wreak, why that is an awesome testament to human potential.

Please, appreciate that there is a luxury to being a pundit, whether you think we are overblowing this whole pandemic thing or not taking it seriously enough. There is a lot of talk about overwhelming the system. Although true, this framing fails spectacularly at showing you who loses under such conditions. You stand in the middle of a room, the buzzing of institutional fluorescent lights above you. The tan linoleum floor is littered with used alcohol wipes, gauze, tubes, an occasional syringe. Multiple teams swarm around multiple gurneys each with a crashing patient, young and old, each coughing, gasping for air, each writhing, gesticulating, each pair of eyes fixed on you, begging you to save them, all plunged into the same extremis by the same microorganism, as your own disposable protective equipment is on its fifth use, as the exhausted respiratory therapist wheels up yet another ventilator, whispering there are only 2 left in the basement storage, as you hear the raspy respirations of an elder whom you could not save and whose lifeless body will shortly join others outside in that large refrigerated truck out in the loading dock, whose mechanical din is just white noise now because its engine has been running for days. For you there is no time for punditry, no time for anything other than allowing your brain to orchestrate a concerted effort between your reflexes and muscle memory, to allow your hands to do what they know — intubate, flip, cover, soothe, encourage, hold, and wipe tears. And then repeat.

I am a Critical Care doctor who many years ago traded her white coat for the mantle of an epidemiologist. While my dedicated colleagues on the front lines are putting their fragile bodies at risk for you, maybe you can do something for them. Maybe this is the time to adopt caution as a priority. After all, what if you are wrong and this virus really is coming for you and yours, even if you are not in that center of globalism that is Manhattan, even to your tiny town in rural Mississippi? Maybe you can think twice before you buy those deeply discounted plane tickets to Florida. Maybe you can keep your children inside rather than taking them to the playground. Maybe you can get your groceries delivered or shop online for curbside pickup. Maybe you can check in with members of your community who are alone and scared. Maybe you can devise ways to deliver food to those who are food insecure. Maybe you can pray to your god alone or together from your Hollywood Square in your own home. If you’ve always dreamed of being a hero, of pulling someone out of a burning house, or busting a crime ring, or another act of selfless courage, here is your opportunity. Know that there are many ways for us to be heroes. Today for you and me heroism looks like staying home.

If we are capable of identifying this virus, sequencing its genome, understanding how to contain it, having the technology to reduce and mitigate the damage it has evolved to wreak, we, homo wonder-of-wonders sapiens, sentience of the universe, should expect a lot from ourselves. Yet so little is being asked.

We need a broader lens on this crisis. We need to band together as a species, create tighter circles of symbiosis amongst ourselves, and, yes, maybe even sacrifice a little. If we are capable of identifying this virus, sequencing its genome, understanding how to contain it, having the technology to reduce and mitigate the damage it has evolved to wreak, we, homo wonder-of-wonders sapiens, sentience of the universe, should expect a lot from ourselves. Yet so little is being asked.

Please, stay home and give my colleagues a chance to answer their calling, to heal the sick, to comfort the dying, and, most importantly, to come home to the arms of their spouses and children, to their smiles and their soft skin against their faces; to dream their dreams. They are here for you. Please, stay the hell inside for them.