New York is that cab. I am that cab. Hell, we are all that cab. Balanced precariously, not on the tip of a friendly well-trained nose, but on the edge of the undomesticated and aggressive Covid-19, while the sun continues to rise in the background each day, unconcerned by the dramas and traumas of human beings.
I’ve ranted over the past couple of weeks, vented the anger and frustration of not enough people in the US taking this seriously enough, the hideous politics of a literal pandemic while we have a president and administration that cares nothing for its citizens. These last days, though, no matter how I try to hold tight to the protective coating of anger, anxiety has continued to ratchet up and fear has coated the surface of every thought. Writing, whether fiction or blogging, is my way of taking control and muddling through, always has been. So I’m writing now hoping it will help me get a handle on this. I’m not sure it’s possible, with no end in sight and no certainty as to the scope we’re facing. I may or may not actually post this one.
If you are a reader who follows Mrs Fringe, whether long term or more recent, you know I’ve spent more than my fair share of time in emergency rooms, ICUs, hospitals. More than most, not as much as too many. My fears today, the anxiety that’s taken a blowtorch to my gut over the past month, comes from those experiences, from knowing how these things are “supposed” to go, from being able to envision but not able to face what lies ahead for too many of us. The other day I went to the grocery store. A long line to get inside, but once I was all was neat and organized, people (for the most part) working to keep their distance from each other. Not necessarily six feet, but this is Manhattan, it just isn’t physically possible in most shared indoor spaces. As I walked up the frozen food aisle I had to stop because the cases on either side of me took on the gray fuzziness of oh shit, am I going to pass out? I wasn’t, and am not, ill. This wasn’t the first time I got dizzy while out and running a necessary errand in recent weeks, had a moment of oh my god, this is not right, not a personal trauma, the world is wrong and will never be the same. Not even the first time it’s happened outside of Covid-19. I have a strong stomach and high tolerance for medical stuff, but oh man did my knees go out weeks? after Husband’s second open heart surgery, when the physician’s assistant was removing the drainage tubes from his chest and abdomen and I heard the peculiar, specific, sucking, squishing thwok of that first seal being broken. Other times also, with no particular, obvious trigger, always after a crisis has passed, when the fear, emotion, excess caffeine, lack of sleep and often lack of decent nutrition hit me in a mundane moment of checking for a ripe avocado. This time my brain isn’t waiting until after. I’m panicked now.
I, Mrs Fringe, am fucking terrified. Our closest hospital is one we’ve been to many times, both their adult ER and the Peds ER sections. Many fine doctors there, some inpatient units are excellent, never had any problems in the ped ER. The adult ER? Another story entirely, and over the years it’s gotten worse and worse, to the point where I’ve said I will not go there for anything anymore. Why? Because they’re chronically understaffed, and an understaffed and overcrowded ER is dangerous, no matter how good and well trained the nurses are. Less than a year ago we were there, Husband, it was a guy from housekeeping who turned on the oxygen and gave him a nasal canula when I couldn’t get a doctor or nurse to come over when his o2 was dropping. One story of many, and that’s with me there, staying out of the way when I can/need to and making noise when I need to do that too. Again, not the fault of uncaring or lackadaisical nurses, but the limits of how many high needs patients any one person can reasonably care for, with new patients streaming in and needing assessments every few minutes. Stretchers stacked like a damned game of Tetris, many times I watched workers from transport needing to move 4-10 patients just to reach the patient they were there for and be able to get them to their next stop in the hospital.
I stay when Husband is in. I stay when Art Child is in. For all our hospital time, we don’t go unless it’s absolutely necessary. And part of when an ER visit or hospital stay is absolutely necessary, by definition, means the person being seen/assessed/admitted isn’t feeling strong, maybe can’t speak, certainly can’t make a fuss if they need something and staff are busy elsewhere. Other hospitals. It was me who yelled for the nurses in the step-down CICU after Husband’s first open heart surgery, when he turned blue and all tubes and bags filled with blood, his aorta ruptured along the suture line of his new valve. Would they have come running thirty seconds later? Would thirty seconds have mattered? It might have, considering they needed to reopen his chest there in the room and manually pump his heart on the way back to the OR. Or when Husband was on a vent and the ICU dr decided this was the perfect time to preen for the nurses and show off how the temporary pacemaker leads were/weren’t working, giving unnecessary shocks until I spoke up because he didn’t know about damage to a nerve he was expecting to see a response from because of a prior surgery (Husband, obviously, unable to tell him). Or, less crucial but important, when we had the (thankfully rare) experience of an unkind EEG tech who was too rough placing leads on my girl’s head, and she was too terrified to do anything other than cry quietly. Or the times food service sent non-diabetic meals to Husband. Or the many other times when calories in take precedent over what type of calories, so I go out for foods to tempt while the hospital trays sit uneaten. Or with MIL, when some slick talker from billing came into the room to offer threats about insurance claims and what would be owed. Yes, I kindly invited him to get the fuck out and take it up with Medicare, not a vulnerable elderly woman who’d had her chest cracked open two days before who’d only been off the vent a matter of hours.
These are just a few bad moments of lapsed or potential lapsed treatment in otherwise great care, with many, mostly reassuring moments. Every ICU nurse I’ve ever interacted with (Peds, cardiac, or general) has been great to oh my god this person should be nominated for sainthood). ICU nurses are extraordinary, with training that goes well beyond the nurse drawing blood at your local GP’s office. But when hospitals have literally overflowed into tents, it isn’t just equipment that will be in short supply, it will be staff, doctors, nurses, nurses aides, physician’s assistants, because both there are too many patients and because they themselves who are getting sick.
Yes, there are the very real extra fears that go with knowing people in my immediate world are particularly vulnerable to more severe manifestations of this virus because of pre-existing conditions. And it’s more than that. If one of those I love needs to be admitted because of Covid-19, or what about the non-Covid-19 related reasons I have the experiences I do that haven’t magically disappeared, how will I be able to just leave them there? Maybe in a hospital, maybe in a fucking tent? Nerd Child isn’t even here. He’s safe and healthy, for now, but if things go sideways and he was to get sick? I couldn’t go to him. If Husband or Art Child or Man Child was to need hospitalization he couldn’t come to be with them either. The thought of walking away, not being there if Husband is on a vent? Literally makes me sick. One of my children? I can’t imagine it, because the pain of that very real possibility overwhelms my ability to paint that mental picture. But I can’t stop thinking about it, at least the edges of the possibility, because I have been there in “normal” times. Our normal abnormal. In fully staffed hospitals with all the needed equipment. It’s knowing that if medical equipment needs to be rationed, there’s the very real possibility those preexisting conditions will render them ineligible for a needed ventilator. It’s the incredibly stupid comments I continue to see and hear online, in the news, in the community, from stupid people still blaming the ACA, or Obama, or saying those same rationing conditions existed under “Obamacare.” Wrong. Wrong, wrong, wrong.
If you’ve never experienced a loved one on a ventilator I’m glad for you. I hope you never do. It’s awful, and illness, injuries and novel viruses don’t give a shit who you vote for. But for those of us who have, repeatedly, who deal with chronic illness and disorders that make things like staffing patterns, hospital admissions, ICUs (hell, the fact that we “joke” about July being the worst time to have a crisis requiring admission because that’s when the new residents come on board), know the best cart to get coffee from part of our basic facts of life, there’s an entirely different level to this hell we call the Covid-19 pandemic.
This isn’t a potential crisis, it is a crisis. It’s real and it’s here. That was a few days ago. As of last night, there were 26,697 confirmed cases of Covid-19 in this city, 5,250 hospitalized, 1,175 in ICUs, and 450 deaths. Those numbers are just in NYC, just the confirmed cases. It may or may not be futile, but I’m doing all I can to keep me and mine safe, keep others safe from us should one of us get it. Please, please, all of you do the same.