Episode 7: Remembering a Pandemic
SYNOPSIS
Where did the pandemic become real for you? This has been the most significant global public health crisis in a generation, but we each experienced it through a different set of eyes.
In this episode, we piece together a contemporaneous history of the pandemic through the stories of healthcare workers. The big picture comes into focus as we articulate it through fragments of individual experiences.
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Contributors
This episode features the voices of: Gabriel Bosslet, MD, MA; Jackie Castellanos, MS; Jessica Dong, MD, MBA; Fiona Doolan; Sarah Dulaney, RN, CNS; Lori-Ann Edwards, MD; Neda Frayha, MD; Allison Horan, MD, MSc; Lauren Klingman, MD; Sylvia Owusu-Ansah, MD; Laura Perry, MD; Mike Reid, MD, MPH, MA; Hui-wen Sato, RN, MSN, MPH, CCRN; Lakshmana Swamy, MD; Neel Vahil; Charlie Varon; Bridget Wild, MD; David Zodda, MD; and other healthcare workers who wish to remain anonymous.
CREDITS
Host: Emily Silverman, MD
Podcast Producer: Adelaide Papazoglou
Associate Producers: Isabel Ostrer, Molly Rose-Williams
“Pandemic Theme” composed by Yosef Munro
Series illustrations by Nazila Jamalifard
Audio Engineer: Jon Oliver
Production Assistants: Hannah Yemane, Ricky Paez, Siyou Song
Support for The Nocturnists comes from the California Medical Association, the Patrick J. McGovern Foundation, the California Health Care Foundation, and people like you who have contributed through our website and Patreon page.
TRANSCRIPT
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The Nocturnists: Stories from a Pandemic: Part II
Episode 7: "Remembering a Pandemic"
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Stories from a Pandemic. I'm Emily Silverman. The middle part of this pandemic has been a blur. The initial shock has given way to a relentlessness as COVID has gone from a looming threat to the water we swim in. Eventually, everything succumbs to entropy, even once in a generation pandemics. We keep hearing that the end is nigh. But, where exactly are we going? And are we there yet? In this episode, we invite you to remember back to the beginning of a pandemic that we experienced both individually and collectively. When did the pandemic become real for you? This is our seventh episode, "Remembering a Pandemic."
Marie S.
The beginning of the pandemic, I felt it, I felt it in my soul, I felt it in my bones. It was this feeling of impending doom. This is the same feeling when HIV/AIDS hit. I'd ministered a lot and lost a lot of people then. And when these cases were just a footnote, it was like no, they're connected. It's all connected.
Mike Reid
I watched these scenes of increasing panic about this respiratory infection that was spreading in Wuhan, China. And I remember thinking - I think it was New Year's Eve - like holy shit, this is bad. In February, I took a work trip to Ghana and on the way back, sitting in the waiting room in Paris, Charles de Gaulle airport watching the, the TV monitors, there were these video clips of of how they were building a massive hospital and a parking lot outside of Wuhan cause they couldn't keep up with the increasing number of cases that they were seeing. And again, I remember thinking holy shit, this is bad.
Laura Perry
I remember one of my patients who was an immigrant from China, whose daughter had started stockpiling equipment like rubber gloves, and hand sanitizer because she was watching the Chinese news. And so she was much better informed early on than most of my other patients. And I remember about a month later, when we were calling all of our patients to make sure that they had everything that they needed, being really impressed that they'd been paying attention and preparing appropriately. I remember myself reading about what was happening in Italy, and being terrified, especially when I saw some data shortly thereafter about how much deadlier it was in older patients than it wasn't younger patients and thinking, is everyone just going to be wiped out?
Sarah
What I recall from the beginning of the pandemic, is the Twitter feed out of Italy. I recall watching my husband who's an intensivist read those posts, and looking at them myself and realizing that this wasn't going to be contained. And it was coming. And it was going to be devastating.
Charlie Varon
I think I was in denial. My older son who was living in New York at the time, was saying this, this is something to watch out for this is, this could be a real problem. And he sent us hand sanitizer. And I did not, uh, I'm a person of great denial capabilities when it comes to catastrophe. And so I, I did not think much of it until it really arrived here in San Francisco.
Neda Frayha
I remember the date vividly actually. My family and my husband's family had all gotten together at True Foods Kitchen in Bethesda, Maryland. There were 12 of us total. And it was just a wonderful gathering. Being in a crowded restaurant didn't feel weird or abnormal at all. Like it was completely still normal to be in that kind of an environment. And of course, at the end of the time together, we all hugged and said, "see you soon." And I think we knew on some level that we might not be able to get together in that way for a little while. But I don't think any of us knew what was coming.
Hui-wen Sato
In the beginning, I didn't take the pandemic that seriously. I heard it was a coronavirus that was coming out of China. And I thought, we see all kinds of coronaviruses show up in our unit all the time, they don't really do that much damage. But then I remember getting the notice that my children's school was going to be closing down for at least a couple of weeks. And even though I had no idea at the time that it was going to turn into an over a year of the campus being shut down, I remember being at the gates, picking up my kids and thinking, oh my gosh, we don't just shut down schools, they're shutting this town. Someone is calling this a real threat. This thing is really, really serious.
Eleanor
I remember in the beginning of the pandemic, there was discussion, sort of just a footnote news story about the pandemic emerging in Wuhan. But relatively recently, the Ebola pandemic had emerged, and our hospital had major preparations, including these space suits that we had to train on. And it was just a really comprehensive and full tilt preparation for Ebola that really never arrived. These viruses, these illnesses crop up from time to time in other countries, we don't really ever see them in the United States. And so, you know, I definitely didn't pay that much attention to it in the beginning. But when cases started hitting, I think Seattle was one of the first cities that was affected, I started getting nervous.
Sylvia Owusu-Ansah
What do I recall from the beginning of the worst pandemic of the century? I recall being very complacent, and very comfortable. Thinking that this was not a problem that would concern us, meaning Americans, meaning the United States, that this was a problem abroad.
Lakshmana Swamy
I started hearing about it, reading about it in the news. And I was one of those people who said it's just another flu. But that was the environment in those, in those very early days. First, it started with not even thinking it's real. Then it was this period of just, just dreadful anticipation, and fear. And then it came and it was this, this chaos. And we I mean, we weren't ready for this. I don't know if we could have done more at the time. We didn't have the knowledge, but we certainly, we certainly weren't.
Bridget Wild
I remember specifically on March 12th in the noon hour, I had been anticipating an inaugural meeting for this women in medicine task force that I'd been selected to participate in and I was really excited about. And instead, there was a call to action and duty to attend a briefing for our Incident Command Center as a member of our emergency preparedness committee. And I recall hearing the briefing that day. And standing in a large room watching our CMO and our head of Infectious Disease give a full presentation, slide by slide, with updates straight from Wuhan about what to expect on CT scans, on labs and trying to commit it to memory quickly like I was in med school all over again. And understanding that we were talking about dedicating one of our entire hospitals to just COVID cases, that this was going to be radical. I remember feeling at that point, like that first surge might be it. That was so naive, I totally should have known better.
Lakshmana Swamy
The next thing that I remember was going into this kind of extreme preparation mode where the whole hospital suddenly kind of got on board and said we're, we're anticipating a surge of patients and I remember walking through the ICU on one of my early shifts as we were preparing and it was, it was surreal because we had kind of emptied it out. And we were just waiting.
Neel Vahil
I was on my surgery rotation. And we first started getting some news out of Washington. There had been a couple of cases of COVID and I remember I don't know the details of those but I vividly remember running on a treadmill one day after, after I left the hospital. And I was watching the news, and they were saying, I think they were saying something about that there's a cruise ship, and then they're just docked near, was it near Seattle? Oh, near Oakland. The, the cruise ship that had been docked near Oakland because I think a number of people on that cruise ship had tested positive for COVID, or had COVID. And I remember thinking that, I remember I didn't think it was very serious. At no point in the preceding months, before March, did I think that COVID was going to be as destructive to my life as it ended up being.
Jackie Castellanos
What I recall from the pandemic, I was also in surgery, I remember, after surgery ended, after we were done taking our exam, Neel and I flew, I think it was like the last weekend in February, we flew to Denver to meet each other. And I remember going on the plane and seeing a guy with one of those hoodies, and a face mask, sunglasses, and then like, gloves, like hospital gloves. I'm like, okay, like, is there something that I don't know?
Allison Horan
I most clearly remember sitting in my room and my friend John calling me to tell me that he was planning on leaving the island of Manhattan the next day and to ask me if I wanted a ride out of the island. And hearing the fear in his voice and hearing him talk about what he felt was an inevitable future where the bridges would close down and there he was imagining food shortages. That was a moment of a real awakening for me that we were in trouble.
Jackie Castellanos
I also remember very vividly getting an email from school, you know, trying to make sure that we weren't freaking out, saying, you know, this is not something to be worried about. The flu, infects this many people per year and this many hospitalizations from the flu and people die from the flu. And, and I remember that rhetoric was really strong towards the beginning up until, that, basically that Friday, when they shut everything down, and removed all students from the hospital. After that, it was the whole city was shut down in San Francisco and seeing so many people out, it was weird. Everyone was walking, everyone was running. Like for like exercise. And there was lines for grocery stores. And then the freeways just had no cars anymore. And the bridge had no traffic, everything just stopped.
Allison Horan
I also really remember walking down I think it was Fifth Avenue, recording one of my first podcasts and how weird it was to be talking into my phone walking in the middle of the street of this street that used to be this bustling metropolis. And it just being completely dead.
Sarah Dulaney
I guess early March is when I realized that it was real. And when there was no toilet paper, and you know, talking to caregivers, and they couldn't get medications refilled. And yeah, there were, there was a month or two of near panic. And then yeah, mid March when everybody was sent home from the day programs and people couldn't visit loved ones in facilities.
Jessica Dong
I remember in the very early days, I would read about this virus in a far off land on the news and would devour the news articles about it but it never seemed like it would actually come here. There'd been so many other pandemics like Ebola, like SARS, like MERS that had started in other places and never made it here. And so it never really occurred to me that this would be the one that would spread all over the world. And even when it did make it here, I remember learning about the first cases in the Bay Area, in Washington, and it really didn't hit that this was going to be something that completely changed our lives until suddenly, we realized that there were people getting it who weren't directly connected to the people that we already knew having it. And in one day, I remember the switch going off in my head that it's out there in the community spreading in a way that we can't track anymore. And it's not going to be able to be contained.
Lauren Klingman
For me, it started with a patient who came in to the ER. He had a cough that was dry, and he just could not shake this fever. I remember, I didn't wear a mask in the room to see him. And I called Infectious disease and I said, "Can I test him for COVID?" And they laughed at me. This doctor said, "No, you can't test him for COVID, we have no tests." And so I discharged him.
Lakshmana Swamy
It was so much conflict about what to do, policies changing, you know, at that point, it felt like not even day by day, hour by hour. PPE was just such a concern it was like it had all just disappeared one day. And there was so much scrutiny around who's wearing a mask. In the starting it was don't wear a mask around the hospital. You're sending the wrong message. Such a bizarre time.
Jessica Dong
The first thought and reaction that I and my my co-residents had was oh, well, you know, it, it's inevitable, we'll all end up getting it. And it's more contagious than the flu. But it seems like it's just going to be a bad flu and we'll all get it, we'll all get over it and we'll move on with our lives. It quickly became clear that this was something that was far more dangerous. And then there was a lot of fear about you know, if we are all going to get it, then that means we will all probably know someone that dies of it. If it really does have a one to two percent mortality rate, you know, there's more than 100 people in the internal medicine residency. If we all get it, a couple of us are going to die. And that was something that was really difficult to grapple with. Also hearing about the fact that there were young people who were otherwise healthy, ventilated on ECMO, those stories started to come out pretty early on and that's when I think we realized that this was not just going to be a bad flu season. And then another senior resident told me, "No, like we do not have to all succumb to the inevitability of all getting this disease if we protect ourselves correctly." This was back in the days when there actually wasn't enough PPE for us to all even get masks in the hospital. And we had to advocate with the residency and with the hospital to let us wear masks in the hospital, which now seems crazy.
Lauren Klingman
I was in the COVID ICU, and this woman was in her 30s proned on a vent. She was dying of COVID in front of us. And I just remember that my attending and the senior resident and I all looked at each other. And my attending was like, "This is real."
Lori-Ann Edwards
No one knew how to treat it. No one knew how it even affected the body.
David Zodda
I remember getting naked in my hallway. I would come home from work after a long shift in the ER in my scrubs. And we didn't have any showers at work and my wife was three months pregnant at the time and I wanted to be extra careful about not bringing any virus into the apartment. I would drive home. I'd get out of my car, I'd walk up to our second floor of our apartment building. I would strip down outside my front door, throw all of my scrubs and shoes and underwear into a garbage bag that was sitting out there for me, tie it up, run in the house right into the shower, scrub like I was preparing to go into surgery. That was until I felt like it was still too dangerous to even do that. And I eventually moved into a hotel.
Martha S.
I knew everything was different when I decided to not be around my one year old granddaughter. We had tried it by putting barriers between her and me outside in the backyard. But she tried to crawl over them and under them and did not understand why I was keeping my distance.
Sylvia Owusu-Ansah
I found out a really good friend of mine got very sick with COVID and was close to having to go to the intensive care unit for care. Then I became scared. Then I became worried.
Gabriel Bosslet
You know, when I think back, we were in a surge here and it was very scary. It's emotional to think about what we've been through as a person, as a physician caring for these patients, as a program director shepherding trainees through this, as a dad and a husband. My wife was diagnosed with breast cancer right as the pandemic began. The first time that I was unable to go to a chemotherapy appointment with her, we had no warning. We showed up at the door, and they wouldn't let me in.
Fiona Doolan
The beginning of the pandemic was quite strange, because the feeling was that it would only last momentarily, perhaps a few weeks when the first lockdown took effect, but it really began for me when my partner became sick in late March 2020. And before their hospitalization, I was caring for them every day.
Gabriel Bosslet
Hospitals are so much different. It's like there's tumbleweeds going down the hallways. There's, there's almost no emotion. There's no cries of laughter from grandchildren seeing grandpa. There's no sobs of sadness of someone who just got bad news about their loved one. All of that's gone now. And it's, it's like a ghost town in the hospital.
Allison Horan
I remember the day that the freezer truck pulled up next to my dorm building, kind of right between my dorm where I lived and the hospital that I ended up working at. This huge white truck pulled up with a loud generator that we all - no one told us it was a freezer truck - but we all just knew immediately what it was. And they tried to hide it behind this big fence that they covered in astroturf, like that fake grass. But you could just hear the hum of the freezers going and peek through kind of the gaps in the fence. And just it was this visual reminder from outside of the hospital, just just how much death was accumulating inside the hospital.
Gabriel Bosslet
I'm very angry. I'm not angry, that COVID's here. I don't think anyone did this to anyone else. This is part of the human condition. I am quite angry at the lack of leadership in the United States in how we've dealt with it. We had a government who decided not to participate. I don't think it had to be this bad.
Missy C.
I think one of the hardest differences between now and back in the spring of 2020 when COVID was first here. In the beginning brought us comfort to see their pictures with their families and their children their grandchildren. Months later, we were all so just devastated, and dare I say over everything. It was just so hard to care for these patients month after month after month after month. And it, it became more and more difficult to see those pictures. We just refused to put them up. It sounds mean and not human. But when you do this day after day, it was the only thing that was actually getting us through the shift. If you associated the grandchildren and the children and the sons and the mothers and the daughters and the spouses of 40 years with these people you actually couldn't do your job.
Charlie Varon
We cannot hold at all. If I were to tell a story about the pandemic, it's, it's that this is a story for, of overload of what happens to a psyche, individually or collectively that is already flooded, before anything starts. And then the floodwaters just rise and rise and rise and rise. And will we ever get dry? How many years will it take? You cannot hold it all. You're busy coping and trying to put one foot in front of the other. And for people in frontline jobs trying to survive, it doesn't succumb to traditional storytelling. It's too, it's just too much. You can get little angles on it, you can get little moments, but you cannot get the totality of it. And I kind of wonder what will we think 5 years from now, 10 years from now, how much of it will we really remember? And how much will our memory sand down. I'm an easily overwhelmed person to start with. So I would like to speak on behalf of the overwhelmed among us, those who are easily flooded by too much information, and just say, this has been too fucking much. This is too much for any human psyche. It'll be interesting as we move into the next phase, to see whether, whether we're able to come to some collective meaning, collective understanding, collective storytelling. But my guess is it'll be a mosaic of hundreds of different pieces of the story and that there will be no way to unify it, it's too big. It's really important to remember that what should have been a unifying event, polarized us. And I think it's really important that we not forget how much that cost us as a country, as human beings, and in terms of the number of lives lost.
Emily Silverman
Thanks for listening. If you liked what you heard you can find more from us on Apple Podcasts, Amazon Music, or wherever you get your podcasts. The Nocturnists is produced by Director of Story Development, Adelaide Papazoglou; Associate Producers Molly Rose-Williams and Isabel Ostrer; and me. Our Student Production Assistants are Hannah Yemane, Ricky Paez, and Siyou Song. Original theme was composed by Yosef Munro. Our Audio Engineer is Jon Oliver. And our illustrations are by Nazila Jamalifard. Our Executive Producer is Ali Block, our Chief Operating Officer is Rebecca Groves, our Admin Assistant is Suparna Jasuja, and our Social Media Intern is Yuki Schwab. The Nocturnists is made possible by the California Medical Association, a physician-led organization that works tirelessly to make sure that the doctor patient relationship remains at the center of medicine. To learn more about the CMA visit cmadocs.org. Support for The Nocturnists also comes from the Patrick J. McGovern Foundation, the California Health Care Foundation and people like you who have contributed through our website and Patreon page. Thank you for supporting our work in storytelling. We hope you'll join us next week for our series finale, "A Call to Arms." I'm your host, Emily Silverman. See you then.