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Posts Tagged ‘Society’

The taverns are full of gadabouts making merry this eve. And though I may press my face against the window like an urchin at a confectioner’s, I am tempted not by the sweetmeats within. A dram in exchange for the pox is an ill bargain, indeed.

From the diary of Samuel Pepys during the Great Plague, London, 1665 (Not really. The quote is a spoof. See comments below.)

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If there are no dogs in Heaven, then when I die, I want to go where they went.

— Will Rogers

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What good is the warmth of summer without the cold of winter to give it sweetness?

— John Steinbeck

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Between too early and too late, there is never more than a moment.

— Franz Werfel

Pepys S

Pepys

Franz Werfel

Werfel

 

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Because of our current and understandable preoccupation with COVID-19, I decided to reread Earth Abides, a post-apocalyptic novel from 1949.

I did so mostly because of the plot, in which a deadly virus wipes out most of the human race in a matter of days, leaving scattered survivors who, for various reasons, were immune to the virus. They are left to cope as earth is reclaimed by nature and the animals.

The novel is interesting, plausible, and reasonably well-written. On a list I found of the 100 best sci-fi novels of all time, it is ranked 43rd. The author, George R. Stewart (1895-1980), was an English professor at Berkeley, a historian, and a prolific writer of fiction and non-fiction.

The novel takes place in the decades post-virus, and the beginning deftly avoids the gruesome concept of a planet full of dead people. As time passes, the story becomes surprisingly positive and uplifting.

Also, I was struck by this quotation, which Stewart presents in the preface to the book:

If a killing type of virus strain should suddenly arise by mutation… it could, because of the rapid transportation in which we indulge nowadays, be carried to the far corners of the earth and cause the deaths of millions of people.” – W. M. Stanley, in Chemical and Engineering News, December 22, 1947.


The author included that ominous thought in order to set the scene, but I was curious about the ellipsis – the dot-dot-dot that indicates an intentional omission from the passage. So I Googled it.

The quotation is, indeed, genuine. Wendell M. Stanley (1904-1971) was a PhD biochemist, a virologist, and one of Stewart’s colleagues at Berkeley.

The ellipsis, it turned out, skipped nothing important. But in his 1947 article, Dr. Stanley added important information about the behavior of viruses. He wrote this:

If a killing type of virus strain should suddenly arise by mutation among the viruses which attack human beings, it could, because of the rapid transportation in which we indulge nowadays, be carried to the far corners of the earth and cause the deaths of millions of people.

Such a killing type of virus cannot perpetuate itself because it soon destroys susceptible individuals. It would then pass from the earth for lack of susceptible cells in which to reproduce. For survival or for perpetuation of a given virus, it must not kill all susceptible hosts.

Thus most of our most common virus diseases are those which are caused by viruses which live in at least partial harmony with their hosts.

In other words, for a virus, wiping out the host population would be self-defeating. I hesitate to say that virus molecules know this instinctively, but the description seems to fit.

The abridged version in Stewart’s novel is appropriately dramatic, but Stanley’s broader explanation is much more illuminating.

It is, however, small comfort in the middle of an actual pandemic.

Anyway, for a worthwhile story about an abrupt end to human civilization and what might come next, check out Earth Abides.

Earth Abides

 

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The Questions…

1. In a traditional deck of playing cards, three of the kings and two of the jacks sport mustaches. Which king and which two jacks are not mustachioed?

2. Which U.S. Presidents and Vice Presidents have won Pulitzer and Nobel Prizes?

3. What is a piccolo trumpet?

4. What is cryptozoology?

5. What color is “falu red”?

The Answers…

1. The king of hearts, the jack of clubs, and the jack of diamonds are clean-shaven.

2. John F. Kennedy won a Pulitzer in 1957 for his book Profiles in Courage. Four Presidents have won Nobel Prizes: Theodore Roosevelt in 1906, Woodrow Wilson in 1920, Jimmy Carter in 2002, and Barack Obama in 2009. Vice President Al Gore won a Nobel in 2007.

3. A piccolo is a small trumpet pitched one octave higher than a standard trumpet. A piccolo trumpet was used in Penny Lane by the Beatles.

4. Cryptozoology sounds scientific and serious, but it’s really a pseudoscience that ponders the existence of mythical beings such as Bigfoot, the Yeti, and the Loch Ness Monster. No real science here, folks. In this usage, “crypto” means hidden.

5. It’s the shade of red typically known as “barn red,” similar to “brick red.” The color comes from hematite, an iron oxide found in rocks and soil. The pigment that creates the color was discovered in the copper mines of the Falun province of Sweden.

Cards

Falu red

 

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Random observations / recollections / stories...

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Staredown

For at least a year after I adopted Jake, I didn’t allow him out of the house off-leash. But I slowly began to trust him, and it was obvious he wasn’t going anywhere. Now I allow him to wander freely while I work in the yard, take out the trash, etc. He never strays far, and all is well.

A few days ago, I heard the familiar sound of the mail truck in the cul de sac, and I said, “Hey, dude, wanna go check the mail?” He executed a vigorous happy dance.

So we walked up the driveway, and I got my mail. When I turned to go back to the house, I was surprised to see Jake in full alert mode. He was fixed in a slight crouch, stock still, eyes blazing, staring at something behind me. I turned to look.

It was a cat, a coal black adult cat, sitting next to a car across the street. He was barely 15 yards away, returning Jake’s stare with murderous yellow eyes. Whether he was confidently standing his ground or afraid to run for it, I can’t say.

Jake,” I said calmly, “Don’t do it. Stay.” He remained frozen, staring at the cat.

Forget it. Stay here,” I told him, taking one step toward the house. “That cat would hurt you. Let’s go.” I took another step.

As if a switch were thrown, Jake emerged from his trance and relaxed. He turned and trotted ahead of me back down the driveway.

I was very proud.

Jake-3-20

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Disappointment

I’ve been good lately about staying home, physical distancing, wearing a mask, etc., but I still take Jake on regular morning walks somewhere around Jefferson. Also, since the restaurants have switched to takeout, I’ll often pick up lunch somewhere and go find an empty picnic table at one of the parks or schools.

Not long ago, the idea of having a couple of Krystal hamburgers popped into my head. The nearest Krystal is 10 miles away, but, hey – my schedule can handle that. So I drove to Commerce and ordered two Krystals and French fries at the drive-through.

Commerce has a large outlet center whose stores are closed, so I decided to go there to enjoy my Krystals.

Five minutes later, I was sitting on a sidewalk bench at the outlet center, looking out at the empty parking lot, enjoying lunch and listening to the silence.

I wasn’t alone for long. I heard footsteps and looked up to see a uniformed sheriff’s deputy walking toward me. He was a white guy in his 40s or 50s. He carried a long silver flashlight, I assumed making security rounds.

When he got within speaking distance, we exchanged greetings. I made a sweeping gesture toward the parking lot. “This is weird,” I said. “I’ve never seen this place empty.”

Me either,” he said. “But it’s nice and quiet.”

For the next several minutes, we chatted about the new normal, the abundance of birds hopping around the pavement, the warm weather, and the puffy spring clouds.

What would you be doing today if this coronavirus thing hadn’t happened?” he asked.

I gestured toward the row of stores on the other side of the parking lot. “I’d probably be here anyway, browsing in Marshall’s,” I said.

Then the conversation went south.

I’ll be honest,” he said, “I don’t trust the news media. I wonder if this virus is being blown out of proportion – if it’s really as bad as they say.”

Oh, crap. A Fox News type. Jerry Falwell, Jr. is probably his source of information about the pandemic. Man, I thought, are the infection rates and the deaths a fiction? Are the videos of patients and doctors and nurses staged?

But, instead of calling him a moron, I just said, Well, viruses can mutate. They can become harmless or become worse. You never know.”

What a disappointment. We were having a nice conversation, and he spoiled it.

Yeah, anything could happen,” he said. “But I think the news media will do anything to hurt the President. I can see them exaggerating this.” I reached into the bag for the other Krystal and didn’t respond.

Well,” he announced, “I’ll let you finish your lunch. Nice talking to you.”

I nodded, and he walked on.

I finished lunch in a funk. What a disappointment.

Tanger

Weird.

———

Green Anoles

At the corner of my house, beside the garage door, is an aluminum downspout that sits flush to the wall. No light shows behind it. The wall itself is covered with overlapped horizontal siding.

This arrangement, I discovered, has created an ecosystem of nooks and crannies behind the downspout. I know this because one day, I noticed a small green lizard peeking out at me.

Specifically, it was a green anole, a common lizard in these parts. When I was a kid, we would catch one of the little guys, tie a piece of thread around its neck, and tie the thread to a buttonhole on your shirt.

The lizard would sit stoically on your shoulder, or sometimes wander around your back, until you got bored and let him go. Typically, anoles don’t bite, but they’re capable of it, and those little jaws are surprisingly strong.

Anyway, it was a green anole peeking out from behind the downspout, and when I got too close, he retreated into a crevice, out of sight.

After that, I regularly looked for him when I passed the downspout. During the warmer months, he always seemed to be there.

Just when I was about to give him a name, I discovered that he wasn’t my only resident lizard. Several times, I saw two of them sunning themselves.

The lifespan of a green anole in the wild, I learned, is about three years. Because my first lizard sighting was several years ago, it’s possible the original fellow is still around.

This year, now that warm weather is back, my lizards are out again.

Anole

 

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Vermont

Score

Anybody else

Qualifying

 

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Nate White is a British advertising copywriter. Last year, he wrote an article that explains Donald Trump’s personality and character with remarkable accuracy. I missed it at the time, but recently ran across it online.

White’s description of Trump is gloriously spot-on. He makes my own attempts seem inadequate, and God knows I’ve labored mightily to find words that adequately describe one of the worst human beings ever to besmirch the planet.

Here is White’s assessment of the Orange Vulgarian.

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Why do some British people not like Donald Trump?

A few things spring to mind. Trump lacks certain qualities which the British traditionally esteem. For instance, he has no class, no charm, no coolness, no credibility, no compassion, no wit, no warmth, no wisdom, no subtlety, no sensitivity, no self-awareness, no humility, no honour and no grace – all qualities, funnily enough, with which his predecessor Mr. Obama was generously blessed. So for us, the stark contrast does rather throw Trump’s limitations into embarrassingly sharp relief.

Plus, we like a laugh. And while Trump may be laughable, he has never once said anything wry, witty or even faintly amusing – not once, ever. I don’t say that rhetorically, I mean it quite literally: not once, not ever.

And that fact is particularly disturbing to the British sensibility – for us, to lack humour is almost inhuman. But with Trump, it’s a fact. He doesn’t even seem to understand what a joke is – his idea of a joke is a crass comment, an illiterate insult, a casual act of cruelty.

Trump is a troll. And like all trolls, he is never funny and he never laughs; he only crows or jeers. And scarily, he doesn’t just talk in crude, witless insults – he actually thinks in them. His mind is a simple bot-like algorithm of petty prejudices and knee-jerk nastiness.

There is never any under-layer of irony, complexity, nuance or depth. It’s all surface. Some Americans might see this as refreshingly upfront. Well, we don’t. We see it as having no inner world, no soul.

And in Britain we traditionally side with David, not Goliath. All our heroes are plucky underdogs: Robin Hood, Dick Whittington, Oliver Twist. Trump is neither plucky, nor an underdog. He is the exact opposite of that. He’s not even a spoiled rich-boy, or a greedy fat-cat. He’s more a fat white slug. A Jabba the Hutt of privilege.

And worse, he is that most unforgivable of all things to the British: a bully. That is, except when he is among bullies; then he suddenly transforms into a snivelling sidekick instead. There are unspoken rules to this stuff – the Queensberry rules of basic decency – and he breaks them all.

He punches downwards – which a gentleman should, would, could never do – and every blow he aims is below the belt. He particularly likes to kick the vulnerable or voiceless – and he kicks them when they are down.

So the fact that a significant minority – perhaps a third – of Americans look at what he does, listen to what he says, and then think “Yeah, he seems like my kind of guy” is a matter of some confusion and no little distress to British people, given that:

• Americans are supposed to be nicer than us, and mostly are.

You don’t need a particularly keen eye for detail to spot a few flaws in the man.

This last point is what especially confuses and dismays British people, and many other people too; his faults seem pretty bloody hard to miss. After all, it’s impossible to read a single tweet, or hear him speak a sentence or two, without staring deep into the abyss. He turns being artless into an art form; he is a Picasso of pettiness; a Shakespeare of shit.

His faults are fractal: even his flaws have flaws, and so on ad infinitum. God knows there have always been stupid people in the world, and plenty of nasty people too. But rarely has stupidity been so nasty, or nastiness so stupid.

He makes Nixon look trustworthy and George W look smart. In fact, if Frankenstein decided to make a monster assembled entirely from human flaws – he would make a Trump.

And a remorseful Doctor Frankenstein would clutch out big clumpfuls of hair and scream in anguish: ‘My God… what… have… I… created?’ If being a twat was a TV show, Trump would be the boxed set.

Nate White, Advertising Creative (2006-present)
Drinks coffee. Writes copy.

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A fat white slug. Assembled entirely from human flaws.

Well said, Mr. White. Well done, sir.

Trump and Elizabeth

 

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Useless Facts

More “Useless Facts for Inquiring Minds.”

The Star Wars character Yoda was introduced in The Empire Strikes Back in 1980. Originally, George Lucas named the character Buffy, which horrified Leigh Brackett, the screenwriter. She convinced Lucas to go with Minch Yoda, which soon was shortened to Yoda.

The Turkish city of Istanbul straddles the Bosporus, the strait separating Europe and Asia. Two-thirds of Istanbul is in Europe, one-third is in Asia. With a population of 15 million, it is Europe’s largest city and the world’s fourth-largest.

In 2005, Bill Nye, the Science Guy, obtained a patent for an improved ballet slipper. His design features added support around the toes and along the outsole to reduce pressure on the feet, which lessens pain and helps prevent injuries.

Grapevines differ according to variety, soil type, and planting location. But on average, a vine produces about 40 clusters of 100 grapes each. The rule of thumb: the yield of one vine is about ten 450ml bottles of wine. Ergo, it takes about 400 grapes to make a bottle of wine.

Grapes

The National Basketball Association was founded in 1946 as the Basketball Association of America. It became the NBA in 1949 after merging with the rival National Basketball League.

In 1954, the league introduced the 24-second shot clock to stop the strategy of stalling. In 1976, the NBA merged with the pesky American Basketball Association, and in 1979, the league adopted the ABA’s three-point field goal to “open up” the game further.

Every summer, a beauty pageant for goats is held in the Lithuanian city of Ramygala, which adopted the goat as its symbol in the 16th century. The pageant does not include a talent competition; the winner is chosen strictly based on good looks.

In 1921, Albert Einstein was awarded the Nobel Prize in Physics for his discovery of “the law of the photoelectric effect.” What is that? Well, when light above a certain frequency hits a thing, energy is transferred from the light to the thing, and particles are emitted.

Einstein explained how it works: the light interacts with photons, causing electrons (called photoelectrons in this case) to be shed. Einstein was the first to identify the photon as an elementary particle.

In 2002, English artist Andy Brown created a portrait of Queen Elizabeth II consisting of over 1,000 teabags, new and used, sewn onto burlap.

Queen E

Prohibition was established in the United States when the Volstead Act was enacted in 1920. The act was repealed in 1933 when Congress legalized the sale of 3.2 percent alcohol. When President Roosevelt signed the repeal, he reportedly said, “I think this would be a good time for a beer.”

English businessman John Cadbury founded the chocolate company Cadbury’s in 1824. His son Richard took over the company in 1861 and was the first to sell chocolates in a box. Specifically, the boxes were adorned with roses and cupids for Valentine’s Day.

Fashion icon Ralph Lauren, the son of immigrants from Belarus, was born Ralph Lifshitz. He changed his last name while attending high school in the Bronx, in an attempt to stop the constant teasing and bullying.

Halley’s Comet swings close to the earth (relatively) every 75 years. Records of its passing go back to 240 BC, but nobody knew it was the same comet until 1705, when English astronomer Edward Halley figured it out. The comet’s most recent appearance was in 1986. Unless events conspire to prevent it, the comet will return in 2061.

Halley's

 

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This Runaway Train

Recently, an ICU nurse wrote a harrowing, sobering account about treating COVID-19 patients. Her original story was on Facebook. I found it later on Imgur. It begins like this:

Julianne Nicole

Julianne Nicole continues in great detail about the reality of life in her ICU. She explains how the virus affects its victims and what can be done for them. Sometimes, very little.

Her report is frightening. On Imgur, the first comment at the end of the post was “Dear God.”

You owe it to yourself to read this.

After that, call your loved ones and pet your dog. Remind yourself that your duty right now is to be smart, venture out in moderation, and maintain a safe distance from others. Do it for the common good. It’s a small price to pay.

In addition, listen to the experts. Ignore the clown in the White House. Ignore the politicians pushing to reopen more businesses and public places, consequences be damned.

And, please, when the time comes, vote the way you know you should, for the sake of us all.

Here is Julianne Nicole’s story…

———

I am a Covid ICU nurse in New York City, and yesterday, like many other days lately, I couldn’t fix my patient. Sure, that happens all the time in the ICU. It definitely wasn’t the first time. It certainly won’t be the last. What makes this patient noteworthy? A few things, actually. He was infected with Covid 19, and he will lose his battle with Covid 19. He is only 23 years old.

I was destroyed by his clinical course in a way that has only happened a few times in my nursing career. It wasn’t his presentation. I’ve seen that before. It wasn’t his complications. I’ve seen that too.

It was the grief. It was his parents. The grief I witnessed yesterday, was grief that I haven’t allowed myself to recognize since this runaway train got rolling here in early March. I could sense it. It was lingering in the periphery of my mind, but yesterday something in me gave way, and that grief rushed in.

I think I was struck by a lot of emotions and realities yesterday. Emotions that have been brewing for weeks, and realities that I have been stifling because I had to in order to do my job effectively. My therapist tells me weekly via facetime that it’s impossible to process trauma when the trauma is still occurring. It just keeps building.

I get home from work, take my trusty companion Apollo immediately out to pee, he’s been home for 14 hours at a time. I have to keep my dog walker safe. No one can come into my apartment.

I’ve already been very sick from my work exposure, and I’m heavily exposed every day that I work since I returned after being 72 hours afebrile, the new standard for healthcare workers. That was after a week of running a fever of 104 even with Tylenol around the clock, but thankfully without respiratory symptoms. I was lucky.

Like every other healthcare worker on the planet right now, I strip inside the door, throw all the scrubs in the wash, bleach wipe all of my everyday carry supplies, shoes and work bag stay at the bottom of the stairs.

You see, there’s a descending level of Covid contamination as you ascend the stairs just inside my apartment door. Work bag and shoes stay at the bottom. Dog walking shoes next step up, then dog leash, then running shoes.

I dodge my excited and doofy German shepherd, who is bringing me every toy he has to play with, and I go and scald myself for 20 minutes in a hot shower. Washing off the germs, metaphorically washing off the weight of the day.

We play fetch after the shower. Once he’s tired, I lay on the floor with him, holding him tight, until I’m ready to get up and eat, but sometimes I just go straight to bed.

Quite honestly, I’m so tired of the death. With three days off from what has been two months of literal hell on earth as a Covid ICU nurse in NYC, I’m having an evening glass of wine, and munching on the twizzlers my dear aunt sent me from Upstate NY, while my dog is bouncing off the walls because I still don’t have the energy to run every day with him.

Is it the residual effects of the virus? Is it just general exhaustion from working three days in a row? Regardless, the thoughts are finally bleeding out of my mind and into a medium that I’m not sure could possibly convey the reality of this experience.

There’s been a significant change in how we approach the critically ill covid-infected patients on a number of different levels over the last two months. We’re learning about the virus. We’re following trends and patterns. We are researching as we are treating.

The reality is, the people who get sick later in this pandemic will have a better chance for survival. Yet, every day working feels like Groundhog Day. All of the patients have developed the same issues. This 23-year-old kid walked around for a week silently hypoxic and silently dying. By the time he got to us, it was already far too late.

First pneumonia, then Acute Respiratory Distress Syndrome (ARDS), essentially lung failure. Then kidney failure from global hypoxia and the medications we were giving in the beginning, desperately trying to find something that works. Then learning that it doesn’t work, it’s doing more harm than good in the critical care Covid population.

Dialysis for the kidneys. They are so sick that your normal three-times weekly dialysis schedule is too harsh on their body. They’re too unstable. So, we, the ICU nurses, run the dialysis slowly and continuously.

They are all obstructing their bowels from the ever-changing array of medications, as we ran out of some medications completely during our surge. We had to substitute alternatives, narcotics, sedatives, and paralytics, medications we’re heavily sedating and treating their pain with, in an effort to help them tolerate barbaric ventilator settings.

Barbaric ventilator settings while lying them on their bellies because their lungs are so damaged that we have to flip them onto their bellies in an effort to perfuse the functioning lung tissue and ventilate the damaged lung tissue.

Lungs that are perfused with blood that doesn’t even have adequate oxygen carrying capacity because of how this virus attacks.

Blood that clots. And bleeds. And clots. And bleeds. Everything in their bodies is deranged. Treat the clots with continuous anticoagulation. Stop the anticoagulation when they bleed.

GI bleeds, brain bleeds, pulmonary emboli, strokes. The brain bleeds will likely die. The GI bleeds get blood transfusions and interventions.

Restart the anticoagulation when they clot their continuous or intermittent dialysis filters, rendering them unusable, because we’re trying not to let them die slowly from renal failure. We are constantly making impossible treatment decisions in the critical care pandemic population.

A lot of people have asked me what it’s like here. I truly don’t have adequate descriptors in my vocabulary, try as I might, so I’ll defer to the metaphor of fire.

We are attempting to put out one fire, while three more are cropping up. Then we find out a week or two later that we unknowingly threw gasoline on one fire, because there’s still so much we don’t know about this virus.

Then suddenly there’s no water to fight the fire with. We’re running around holding ice cubes in an effort to put out an inferno. Oh yeah, and the entire time you’ve been in this burning building, you barely have what you need to protect yourself.

The protection you’re using, the guidelines governing that protection, evolved with the surge. One-time use N95? That’s the prior standard, and after what we’ve been through, that’s honestly hysterical. As we were surging here, the CDC revised their guidelines, because the PPE shortage was so critical.

Use anything, they said. Use whatever you have for as long as you can, and improvise what you don’t have.

 As we’re discussing medication and viral research, starting clinical trials, talking treatment options in morning rounds for your patient with the team of doctors and clinical pharmacists, suddenly, surprise! Your patient developed a mucous plug in his breathing tube.

Yes, that vital, precious tube that’s connected to the ventilator that’s breathing for them. It’s completely plugged. Blocked. No oxygen or carbon dioxide in or out. It’s a critical emergency.

Even with nebulizer treatments, once we finally had the closed-delivery systems we needed to administer these medications and keep ourselves safe, they’re still plugging. We cannot even routinely suction unless we absolutely have to because suctioning steals all of the positive pressure that’s keeping them alive from the ventilator circuit. One routine suction pass down the breathing tube could kill someone, or leave their body and vital organs hypoxic for hours after.

Well, now they’re plugged. We are then faced with a choice. Both choices place the respiratory therapists, nurses, and doctors at extremely high risk for aerosolized exposure.

We could exchange the breathing tube, but that could take too long, the patient may die in the 2–3 minutes we need to assemble the supplies and manpower needed, and it’s one of the highest-risk procedures for our providers that we could possibly carry out.

Or we could use the clamps that have been the best addition to my every day carry nursing arsenal. You yell for help, you’re alone in the room. Your friends and coworkers, respiratory therapists, doctors, are all rushing to get their PPE on and get into the room to help.

You move around the room cluttered with machines and life sustaining therapies to set up what you need to stave off death. You move deliberately, and you move FAST. The patient is decompensating in the now-familiar and coordinated effort to intervene.

Attach the ambu bag to wall oxygen. Turn it all the way up. Where’s the PEEP valve? God, someone go grab me the PEEP valve off the ambu bag in room 11 next door. We ran out of those a month ago, too. It’s all covid anyway, all of it is covid. Risk cross-contamination or risk imminent death for your patient, risk extreme viral load exposure for you and your coworkers, and most certain death for your patient if you intervene without a PEEP valve.

You clamp the breathing tube, tight. The respiratory therapist shuts off the ventilator, because that side of the circuit can aerosolize and spray virus too if you leave it blasting air after you disconnect. Open the circuit. Respiratory therapy attaches the ambu bag. You unclamp. Bag, bag, bag. Clear the plug. The patient’s oxygen saturation is 23%. Their heart rate is slowing. Their blood pressure is tanking. Max all your drips, then watch and wait while this patient takes 3 hours to recover to a measly oxygen saturation of 82%, the best you’ll get from them all shift. These patients have no pulmonary reserve.

All of our choices to intervene in this situation risk our own health and safety. In the beginning we were more cautious with ourselves. We don’t want to get sick. We don’t want to be a patient in our own ICU. We’ve cared for our own staff in our ICUs. We don’t want to die. Now? I’ve already been sick. I am so, so tired of the constant death that is the ICU, that personally, I will do anything as long as I have my weeks-old N95 and face shield on, just to keep someone alive.

I’ve realized that for many of these patients in the ICU, it won’t matter what I do. It won’t matter how hard I work, though I’ll still work like a crazy person all day, aggressively advocate for my patients in the same way.

My coworkers will go without meals, even though they’re being donated and delivered by people who love and support you. Generous people are helping to keep local restaurants afloat. We can always take the meal home for dinner, or I can devour a slice of pizza as I walk out to my truck parked on the pier, a walk I look forward to every day, because it gives me about eight minutes of silence. To process. To reflect.

I’ll chug a Gatorade when I start feeling lightheaded and I’m seeing stars, immediately after I just pushed an amp of bicarb on a patient and I know I have at least five minutes of a stable blood pressure to step out of the unit, take off my mask and actually breathe.

Every dedicated staff member is working tirelessly to help. The now-closed dental clinic staff has been trained to work in the respiratory lab to run our arterial blood gases, so that the absolutely incredible respiratory therapists who we so desperately need can take care of the patients with us.

Nurses in procedural areas that were closed have been repurposed to work as runners. To run for supplies while the primary nurse is in an isolation room trying to stabilize a patient without the supplies they need, runners to run for blood transfusions.

Physical therapists, occupational therapists, speech and language pathologists being repurposed to be part of the proning teams that helps the nurses turn patients onto their backs and bellies amidst a tangled web of critical lines and tubes, where one small error could mean death for the patient, and exposure for all staff.

Anesthesiologists and residents are managing airways and lines when carrying out these massive patient position changes. Surgical residents are all over the hospital just to put in the critical invasive lines we need in all of our patients.

The travel nurses who rushed into this burning building to help us are easing a healthcare system. The first travel nurse I met came all the way from Texas. Others terminated their steady employment to enlist with a travel agency to help us. Every day there are more travelers arriving.

A nurse from LA came to me after she found out I was part of the home staff, in my home unit, where this all first started in my hospital what feels like a lifetime ago, and said, “I came here for you. For all of the nurses. Because I couldn’t imagine working the way you guys were working for how long you were working like that”.

During our surge and peak in the ICU, we were 1:3 ratios with three patients who normally would be a 1:1 assignment. And they were all trying to die at the same time. We were having to choose which patients we were rushing to because we couldn’t help them all at the same time.

The overhead pages for emergencies throughout the hospital rang out and echoed endlessly. Every minute, another rapid response call. Another anesthesia page for an intubation. Another cardiopulmonary arrest. A hospital bursting at the seams with death. Refrigerated trailers being filled.

First it was our normal white body bags. Then orange disaster bags. Then blue tarp bags. We ran out of those too. Now, black bags.


The heartbreakingly unique part of this pandemic, is that these patients are so alone. We are here, but they are suffering alone, with no familiar face or voice. They are dying alone, surrounded by strangers crying into their own masks, trying not to let our precious N95 get wet, trying not to touch our faces with contaminated hands.

Their families are home, waiting for the phone call with their daily update. Some of their loved ones are also sick and quarantined at home.

Can you even IMAGINE? Your husband or wife, mother or father. Sibling. Your child. You drop your loved one off at the emergency department entrance, and you never, ever see them alive again.

Families are home, getting phone calls every day that they’re getting worse. Or maybe they’re getting better. Unfortunately, the ICU in what has quickly become the global epicenter for this pandemic is not a happy place. We are mostly purgatory where I work, so this snapshot may be more morbid than most.

These people are saying goodbye to their loved ones, while they’re still walking and talking, and then maybe a week or two later, they’re just gone. It’s like they disappeared into thin air.

That level of grief is absolutely astounding to me, and thaht’s coming from a person who knows grief. I was there at the bedside, I held my young husband’s hand when I watched his heart stop beating. I was there. That grief changes you immeasurably. 

But this grief? This pandemic grief? It’s inconceivable. These families will suffer horribly, every day for the rest of their lives. They might not even be able to bury their loved one. God, if they can’t afford a funeral with an economic shut-down, their loved one will be buried in a mass grave on Hart Island with thousands of others like them. What grave will they have to visit on birthdays and holidays?

Yesterday, I was preparing for a bedside endoscopy procedure to secure a catastrophic GI bleed in this 23-year-old patient.

It was a bleed that required a massive transfusion protocol where the blood bank releases coolers of uncrossmatched O negative blood in an emergency, an overhead page that, ironically, I heard as I was getting into the elevator to head to the fourth floor for my shift yesterday morning; a massive transfusion protocol that I found out I would own as a primary nurse, as I desperately squeezed liters of IV fluids into this patient until we got the cooler full of blood products, and then pumped this patient full of units of blood until we could intervene with endoscopy.

Before the procedure, I stopped everything I was doing that wasn’t life-sustaining. I stopped gathering supplies to start and assist with the procedure.


I told the doctors that I would not do a required “time-out” procedure until I got my phone out, and I facetimed this kid’s mom because I didn’t think he would survive the bedside procedure.

She cried. She wailed. She begged her son to open his eyes, to breathe. She begged me to help her. Ayudame. Ayudame. She begged me to help him. She sang to him. She told him he was strong. She told him how much she loved him. I listened to her heart breaking in real time while she talked to her son, while she saw his swollen face, her baby boy, dying before her eyes through a phone.

Later in the day, after the procedure, his mom and dad came to the hospital. He survived the securement of the bleed, but he was still getting worse no matter what we did. He’s going to die. And against policy, we fought to get them up to see their son.

We found them masks and gowns that we’re still rationing in the hospital, and we let his parents see him, hold him. We let them be with their son.

Like every other nurse would do in the ICU here, I bounced around the room, moving mom from one side of the bed to the other and back again, so I could do what I needed to do, setting up my continuous dialysis machine, with the ONE filter that supply sent up for my use to initiate dialysis therapy. This spaceship-like machine, finicky as all hell, and I had one shot to prime this machine successfully to start dialysis therapy to try to slowly correct the metabolic acidosis that was just ONE of the problems that was killing him as his systolic blood pressure lingered in the 70s, despite maxing all of my blood pressure mediations.

Continuous dialysis started. You press start and hold your breath. You’re not removing any fluid, just filtering the blood, but even the tiniest of fluid shifts in this patient could kill him. But you have no choice.

His vital signs started to look concerning. I could feel the dread in the pit of my stomach, this was going south very quickly. Another nurse and the patient’s father had to physically drag this mother out of the room so we could fill the room with the brains and eyes and hands that would keep this boy alive for another hour.

She wailed in the hallway. Nurses in the next unit down the hall heard her crties through two sets of closed fire doors. We worked furiously to stabilize him for the next four hours.

Twenty minutes before the end of my shift last night, I sat with the attending physician and the parents in a quiet and deserted family waiting room outside the unit. I told his mother that no matter what I do, I cannot fix this. I have maximized everything I have, every tool and medicine at my disposal to save her son. I can’t save her son.

The doctor explained that no matter what we do, his body is failing him. No matter what we do, her son will die. They realized that no matter how hard they pray, no matter how much they want to tear down walls, no matter how many times his mother begs and pleads, “take me instead, I would rather die myself than lose my son”, we cannot save him.

We stayed while she screamed. We stayed until she finally let go of her vice grip on my hands, her body trembling uncontrollably, as she dissolved into her grief, in the arms of her husband.

This  is ONE patient. One patient, in one ICU, in one hospital, in one city, in one country, on a planet being ravaged by a virus.

This is the tiniest, devastating snapshot of one patient and one family and their unimaginable grief. Yet, the weight is enormous.

The world should feel that weight too. Because this grief, this heartbreak is everywhere in many forms. Every person on this planet is grieving the loss of something.

Whether that’s freedom or autonomy sacrificed for the greater good. Whether that’s a paycheck or a business, or their livelihood, or maybe they’re grieving the loss of a loved one while still fighting to earn a paycheck, or waiting for government financial relief that they don’t know for certain will come.

Maybe they’re a high school senior who will never get to have the graduation they dreamed of. Maybe they’re a college senior, who won’t get to have their senior game they so looked forward to. Maybe they’re afraid that the government is encroaching on their constitutional rights. Maybe it’s their first pregnancy, and it’s nothing like they imagined because of the terrifying world surrounding them.

Or maybe they lost a loved one, maybe someone they love is sick, and they can’t go see them, because there are no visitors allowed and they’re an essential worker. Maybe all they can see of someone they love is a random Facetime call in the middle of the day from an area code and a number they don’t know.

Everyone is grieving. We’ve heard plenty of the public’s grief.

I don’t blame anyone for how they’re coping with that grief, even if it frustrates the ever-living hell out of me as I drown in death every day at work. It’s all valid. Everyone’s grief is different, but it doesn’t change the discomfort, the despair on various levels. We are at the bottom of Maslow’s hierarchy of needs. Basic survival, physiological and safety needs. I’ve been here before. I know this feeling. How we survive is how we survive.

Now that I’ve had the time to reflect and write, now that I’ve let the walls down in my mind to let the grief flood in, now that I’ve seen this grief for what feels like the thousandth time since the first week of March as a nurse in a Covid ICU in New York City, it’s time you heard our side.

This is devastating. This is our reality. This is our grief.

———–

Her original Facebook post is here.

How this will end is anyone’s guess. But things will be different for a long time.

This is our reality.

ICU

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One of the most horrible features of war is that all the war-propaganda, all the screaming and lies and hatred, comes invariably from people who are not fighting.

George Orwell

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Success is the ability to go from failure to failure without losing your enthusiasm.

Winston Churchill

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If you can’t explain it to a six-year-old, you don’t understand it yourself.

Albert Einstein

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I like nonsense. It wakes up the brain cells.

Dr. Seuss (Theodor Seuss Geisel)

Orwell

Orwell

Geisel TS

Geisel

 

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HEALDSBURG, CALIFORNIA – In February, a storage tank at a Sonoma County winery sprung a leak, sending thousands of gallons of Cabernet Sauvignon gushing into a creek and downstream into the Russian River.

The winery said the spill involved 20 to 25 percent of the contents of a 97,000-gallon tank, or about 20,000 to 25,000 gallons of wine.

State authorities said all wine in the tanks on the property was relocated, and the tanks are being inspected. The winery also assigned a contractor to pump wine out of the river.

Officials said the Russian River is noted for swift currents and muddy water in the winter, which will help dilute the spill. No fish kills have been reported, but the acidity of the wine is expected to kill some insect and plant life.

An investigation is underway to determine possible charges and penalties.

Winery

OWOSSO, MICHIGAN – A Michigan man who paid $20 for a used couch at a thrift store discovered more than $40,000 in cash hidden inside a cushion.

Howard Kirby bought the couch at the Habitat for Humanity ReStore for his man cave. He noticed that one spot on a cushion was lumpy, so he opened a seam to investigate. Inside were envelopes of cash totaling $43,170.

Although the money legally was his, Kirby said he wasn’t comfortable with keeping it. He got the name of the couch’s donor from ReStore, contacted her, and gave her the money.

The woman said the couch had belonged to her grandfather, who died recently. She said the grandfather always preferred to pay cash, but no one knew about the money.

To thank Kirby for doing the right thing, neighbors and local businesses re-roofed his house.

Couch money

ORLANDO, FLORIDA – An Orlando man on his way to go boating stopped at a 7-Eleven to gas up, but pumped the fuel into a fishing pole holder instead of the gas tank.

Police said the man pumped $60 worth of gasoline into the holder and onto the floor of the boat, then put another $40 worth of gas, correctly, into the fuel tank of his truck.

When the sloshing fuel in the boat was discovered, the station made an emergency call to Orange County Fire Rescue. A hazmat team responded and siphoned out most of the gasoline. No injuries were reported.

Fuel spill

 

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