Episode 8: A Call to Arms
SYNOPSIS
It’s been over a year since the first case of COVID-19 appeared in Seattle, and it’s been a long cold lonely winter. But in our series finale, we wanted to hear about a bright spot in all the darkness: the first vaccines that found their way into the arms of healthcare workers all around the country.
In this episode, healthcare workers reflect on what the vaccine has meant for them. We hear one doctor’s vision for a transformed medical system, and another doctor’s unexpected opportunity to make history. We also remember Grumpster, whose life was bookended by two of this century’s major medical moments: he was an incubator baby on display at the World's Fair in the 1930’s and in spring of 2020, he died of COVID-19.
LISTEN
featuring
This episode features recordings by: Marina del Rios, MD, MS; Fiona Doolan; Lori-Ann Edwards, MD; Neda Frayha, MD; Kirk Klocke; Sylvia Owusu-Ansah, MD, MPH, FAAP; Laura Perry, MD; Mike Reid, MD, MPH, MA; Hui-wen Sato, RN, MSN, MPH, CCRN; Charlie Varon; Bridget Wild, 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
“Here Comes the Sun” by George Harrison performed by Swen Hendrickson and accompanied by the voices of Eve Bloomgarden, MD and her children; Gabe Bosslet, MD; Lori-Ann Edwards, MD; Greta Peng, MD; Theodore Peng, MD; and Mike Reid, MD.
“Pandemic Theme” composed by Yosef Munro
Series illustrations by Nazila Jamalifard
Audio Engineer: Jon Oliver
Production Assistants: Ricky Paez, Siyou Song, Hannah Yemane
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 8: "A Call to Arms"
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.
Kirk Klocke
Now I've already recovered from COVID, but a few nights ago I had this dream. I was waiting in a line of people at a nondescript clinic hallway, sort of socially distanced, but not really, maybe a few feet at most. As it was nearing my turn, I entered the room where a middle aged man in dark blue scrubs was giving people the shots. He had them sit down one at a time, sign a form. But when my turn came, something struck me as odd. The man grabbed a tiny glass from the counter. You might liken it to a shot glass. He drew a syrupy brown fluid from a small spigot attached to a sort of hopper. Actually, it kind of looked like a cafeteria lemonade dispenser. I grew more uncomfortable as he used his teeth to decap a new syringe then draw a few milliliters of the brown liquid out of the shot glass. “Is that--?” "Oh, we got it in bulk," he said. I looked closer at the vessel and it had a white label. Moderna SarsCoV2 was handwritten on it in bad handwriting. “Doesn't this stuff need to be stored, uh, you know, frozen?" "Don't worry," he said, "We thawed it out just this morning." He rubbed his hand along the side of the vessel, "Still cold." I felt the side of the tank and it was indeed cold. I shrugged, sat down, roll up my sleeve. He gave me the shot and said, "Other sleeve please." "What?" I asked. "For a second dose." "But that's not, that's not how it--" I looked down and saw the last of a second shot of the brown liquid going into my upper arm. He put Band-Aids on both sides and both arms started to get sore right away. I got up in disbelief and walked through the door frame into darkness.
Emily Silverman
You're listening to The Nocturnists: Stories from a Pandemic. I'm Emily Silverman. It's been over a year since the first case of COVID-19 appeared in Seattle. And it's been a long, cold, lonely winter. In our series finale, we wanted to hear about a bright spot in all the darkness. The first vaccines, which found their way into the arms of healthcare workers all around the country. But there are no fairytale endings here. The only thing we know for sure, is that we still have a long way to go. This is episode eight, "A Call to Arms."
Anonymous
I'm a durable medical equipment delivery driver in the southern United States. I do pediatric equipment and supplies. So these days, it's a lot of panicked patients and their caregivers. I see a lot of signs now about staying out of the house, washing your hands if you come in the house, take off your shoes. We have a fragile kid. But at the same time, some parents tell me that I should take off my mask because I'm being controlled. I'm hearing more of that now that we're seeing publicity about the vaccine. I've had some parents ask me if I'm going to get it. And the answer is: I may have already gotten it. I'm a subject in the Pfizer double blind phase three study. I got a communication from the investigation people today saying that if I'm eligible to receive the vaccine now that it's got emergency use authorization, that they have a protocol where they can unblind me and figure out if I was in the vaccine group or in the placebo group. And if I was in the placebo group, they will give me the vaccine. So I'm excited about that. I didn't really feel like I had much of a way to contribute in the pandemic effort. Joining the study was something that I could do that was simple, that was straightforward, and that was helpful.
Mike Reid
So I'm an infectious disease doctor working in the COVID pandemic. I wanted to say that rather than being anti Vax, or pro Vax, I want to assert the case for vaccine Pro Plus perspective. So I work on contact tracing; yesterday, we had our weekly meeting. And we always have guest speakers, we had coach Steve Kerr, come and speak to us. I mean, just epically inspiring. And, he ended by just saying how hopeful he was for a vaccine, and how it was going to end the pandemic. And I wanted to sort of share a different perspective. One of my favorite American authors is Anne Lamott. And, and she, she says it just beautifully, she says, "Hope begins in the dark. But with enough hard work, and grit, the dawn will soon come." And that's totally my experience of the work of our contact tracers. It's a truly patient-centered holistic approach to public health. And, so for me, the idea that a vaccine is the thing that's going to end this epidemic is just incomplete. We, as a public health response to COVID-19, are just getting started. And and so my hope is that the dawn that comes is not a vaccine, it's a transformed public health system.
Bridget Wild
I'm a pediatric hospitalist in Evanston, Illinois, and I am married to an outpatient pediatrician as well. We have three young children. I have a second grader, a four year old, and a now two year old who has lived a significant portion of her life during this pandemic. We kind of saw this coming at the beginning of March. And we kind of anticipated that as two healthcare providers, understandably, people might avoid us, including our own family, and not feel safe seeing us at all. Other than brief, masked encounters outside, which is, is hard when you have young kids who, who are just trying to grow up and experience all the things that they deserve to experience. You think about those days and how hard they were to get through, how everything at work took extra mental energy, workflows changed by the week, and we were trying to do remote learning without a lot of infrastructure support with a four year old who didn't understand why his world had been completely shut down. And so he kind of shut down as well. I never want to go back to those days. I got pictures of my four year old literally laying on the sidewalk in fetal position, just not wanting to move or do anything and having very little insight for himself as to why.
We did lose a family member, my husband's grandfather, who had actually been one of the very first babies to reap the benefits of a modern incubator and was on display in the 30s in the Chicago World's exposition. His life was bookended by dying in the first surge due to COVID. And although he was hospitalized at my own hospital system, we couldn't visit him. And on his last day, they set up a Zoom call and we said our goodbyes to him and just looked at him for hours, including my kids who had a really close relationship with Grumpster. And when we buried him, although this was a really proud man with a really big life and a really big personality, it was a very small, lonely moment, where only his grandkids were at the grave side. You know, his own daughters watched from their cars at the roadside, just in terror of possibly catching COVID.
And I'm gonna get vaccinated tomorrow. And every time I think about it, I get teary, and it feels like hope is on the way. Today, they overheaded it in our hospital, you know, "Please welcome to North Shore, the COVID vaccine." And you could hear cheers everywhere. People crying, people dancing. They played "Here Comes the Sun" over the loudspeakers and I am not nervous at all. I am welcoming, maybe feeling sick for a few days. And just knowing that when I go to work, I'm not risking leaving my children without a mother, is huge. I, there's just not words good enough for it. So wish me luck.
Presenter
"We here at vaccination have been working to make sure that the staff here have all the information that they need. We also began distribute, distributing vaccine, really today. And so the Lonardo Hospital has also received more doses of vaccine that they will be able to store and start vaccinating larger numbers of patients. And what's happening here is we've got basically, the pharmacy has already drawn up the vaccine dose. Each vaccine dose includes both a very carefully measured amount of vaccine mixed with something to dilute the vaccine. You might have heard this vaccine, is stored in ultra cold temperatures, but it is brought all the way up to room temperature before it's going into anybody's arm. So that's a question that we get a lot. So in each case, here we track very carefully the timing between when the vaccine leaves the warehouse, whether that is the, the warehouse or the manufacturer, or the Chicago Department of Public Health warehouse. We track very carefully the time and temperature and then we, basically by the time we get to the patient, we are ready to go. Okay. All right. So are we ready? So what we're gonna see -- the doctor is going to clean off the patient's arm. Very standard procedure, just like a regular vaccine. Ready? I'm ready. Okay, here we go."
Sylvia Owusu-Ansah
I am a pediatric emergency medicine physician in Pittsburgh, Pennsylvania. COVID has instilled a fear in me that I've never experienced before. I forced myself to look at the glass half full. I recognize that because of the COVID pandemic, people have now awoken to the plight of African Americans and blacks in the United States. And so, I wanted to hold on to that. I was selected by the leadership of my hospital to get the vaccine. And so you know, I just thought that basically I was getting it early because I was a frontline provider. It wasn't until I reached the hospital, and when I walked into the conference room, it was filled with cameras and video recorders. And then it started to sink in the impact, the historical impact it would be especially as an African American female physician. And then they said, "Sit over there, you're going to be number two." I'm thinking to myself, number two for what? Number two in the state of Pennsylvania to get this vaccination. And even then, sitting in front of all those cameras with four other colleagues, there was a total of five of us, and the Chief Quality Officer preparing to give us the vaccinations.
It didn't really hit me until we received calls in from The New York Times. And my phone began to blow up with dings, text of friends and family members saying, "We see you on TV." And then the impact really began to hit. And so when it came to the question and answer session, I realized that this was my moment to say something impactful, this was my moment, to make a difference, to make a pledge, particularly to the African American community. So we were sitting in a conference room with all these cameras. It was a typical Pittsburgh, cloudy, semi cloudy day, extremely cold in the 30s. And here I was with the opportunity to basically tell the world why they need to get this vaccine, and particularly my people. And so when The New York Times asked the question, I responded by saying that, you know, I'm here for my community, I'm here to say that it is okay to get this vaccine. I'm here to say that this is what is going to keep us as a people alive. We have been disproportionately affected by the COVID Pandemic, as in so many other health disparities. It is time that we take a stand, I don't want to be having funerals that are connected to health disparities that could be prevented. Just as we don't want to have any more funerals for senseless murders or shootings of our African American loved ones. So it was an incredible day, but it really didn't sink in till, I think after the press conference session was done. I felt at peace in getting the vaccine, felt confident, I felt had done the right thing.
News Reporter
"Star Knight says it was less painful than a tetanus shot."
News Interviewee
"It feels like I have an extra piece of armor on. Knowing that I'm vaccinated will help me feel more confident as I go into those rooms. The patients' COVID statuses are unknown. And patients who I know have COVID."
News Reporter
"The first shots come as the Bay Area experiences a surge of COVID cases. In Sonoma County supervisors have approved spending plans from watching the county's..."
Kristine M.
I'm driving to work. Just a few minutes ago, I left my house and already there's news reports about the first COVID vaccine recipients at my workplace and I hear my coworkers on NPR. So there's a lot of great hope and joy that I'm feeling right now, and excitement.
Hui-wen Sato
I live in West Los Angeles, California and I'm a pediatric ICU nurse. You know, working in a pediatric hospital in a lot of ways it feels like COVID has been held just a little bit at arm's length. And that doesn't mean that we haven't gotten COVID patients in our hospital and in our ICU. But we haven't seen the overwhelming numbers that adult hospitals have seen and we haven't seen the amount of deaths from COVID that adult hospitals have seen. I have worried a great deal about bringing it home to my children. I have two daughters, they are five and seven. So they're in kindergarten and second grade. And so while I was learning the new rules of being a nurse in a pandemic, I was also learning the new rules of being a homeschooling parent. I as a, as an introvert, I think I really just lost the alone time and the quiet that I need to recharge from the intensity of work. My husband is a health inspector as well. And I at times have feared for his safety with the amount of anger that has been directed towards the health department and so the exhaustion that I have been wearing on my shoulders has just been pretty indescribable.
I did have one scare at work when I was in my PPE helping with a intubated patient who had COVID. And we were just turning him and changing his linens and his ventilator tubing briefly disconnected as we were turning him. And it just sprayed a shower of secretions right at me, and I saw secretions hit my face shield and just thought, Okay, I've been showered in COVID. But we still had to finish taking care of him. And then when I exited the room, graciously, my charge nurse was able to send me home. And I didn't touch a thing and showered and just prayed that the PPE did its job, which thankfully it did. But it's always been this looming threat, that I was just, I just had so many things to constantly manage externally, that I probably didn't have that much time on a conscious level to process my own anxiety about getting it myself in the sense that I just, I just had to keep going. I just had things that I needed to do. And I think when I heard that the vaccine was available, that was probably the moment I realized how much tension I'd actually been carrying, in just wondering what if I've caught it? What if I get it? What if today's the day I go to work and I get that exposure to a patient? What if, what if I get it, I-- what would happen and this vaccine changes that.
I will also say that I was scared. I was scared about the speed at which it was developed. Is that safe? Is that okay? Why was it able to be developed so fast? Did they cut corners, the side effects and everything? But I knew that as soon as it became available at my workplace, I was going to sign up. The day that I went to get vaccinated, it was a very mild December morning in Southern California. I walked into this, like a conference room area where they had set up the whole station for vaccines. And I sat down with this lovely nurse who I had never met before. And she said, "I'm here to give you this vaccine," and I just looked at her and said, "Thank you so much. Thank you."
And she started to talk to me about anticipated side effects. And I just said, "You know it's weird that I, I, I, don't care really about the side effects. I will, I would choose that any day over over this disease. And so I barely felt the vaccine go and I was surprised at how smooth it went. And I was resusc nurse for ICU that day. So 12 hours of walking throughout the unit, we had a few COVID patients. But I just noticed this new layer of confidence that I had of my body is making immunity. And if I'm exposed today, my body is making immunity to this virus. And I think in that excitement, I forgot that there even amongst some of my coworkers would still be some who have doubts about it, who have some hesitations. And so I just you know, excitedly was talking to people throughout the day. "Did you get your shot yet? Did you get your shot yet?" And a lot of people did and shared the excitement and then a couple people responded with hesitation and almost a little bit of embarrassment of, "I don't know. I, I'm not sure I think I want to wait." And I realized in that moment that there is actually this element of shame and embarrassment of I know, we're all supposed to be excited about this, and I'm not there yet. And we have to just be so sensitive and so careful in how we engage these conversations. So that we can as an entire country and world get to a place where we can come out of this dark time.
Sounds at a vaccination site
"All right. Okay, here it goes... Oooooohh... Oh my god, I'm gonna cry."
"Okay, you guys. It's funny to not be able to hug you. Let's go... Okay, thank you. Thanks, everybody."
"Are you excited to be getting a shot today?"
"Oh, yeah, absolutely. I'm very excited. I am looking forward to it. I think it'll relieve a lot of anxiety, while I'm fairly hopeful. Thank you."
"You're all set."
"All right. Thanks very much. Thanks."
"We are all done."
"Awesome. Thank you so much. That's super easy."
"Good! You were expecting it to hurt?"
"Oh, no."
"Alright, let's do it!"
"Get it on video."
"Okay, let me."
"Yeah. Feels like hope. Actually, I didn't feel that at all."
Hui-wen Sato
I'll know the pandemic is over, not when my kids' school has fully reopened, not when we stop seeing serious cases of COVID come through our hospital. But I will know it is over when I stop hearing about poor countries with extraordinarily high death rates, with hospitals bursting at the seams, with lack of access to vaccinations. When I stop hearing those stories from the least regarded countries in this world, that's when I will know.
Neda Frayha
I will know the pandemic is over when I can see footage of large group gatherings indoors and not feel an existential sense of dread that there will immediately be a spike in cases to follow and then hospitalizations, intensive care stays and then death to follow those. And I will really know that the pandemic is over when I feel comfortable being indoors with a large group of people again.
Laura Perry
How will I know when the pandemic is over? I think I'll just feel different. I think that's the way I'll know. I'll be less afraid and I'll be less tired. And maybe some of my optimism will return.
Bridget Wild
How will I know when the pandemic is over? You know, when I can look at The New York Times or CNN any given day and not see a new COVID story. I'll have the realization that it's, it's over or been over. Because at this point, the pandemic is more than just the number of cases that we're seeing, right. It's the the COVID-adjacent outcomes. It's the impact on people's mental health and their families and their relationships with one another and the economy. This has rocked the world. When my kids can play with other kids without masks on, that'll be the beginning of the end. When people can go to concerts or a theater show. That's the beginning of the end. But we've got the COVID long haul ahead of us still.
Charlie Varon
How will I know when the pandemic is over? I guess when I can get on the streetcar again and hug all my friends.
Sylvia Owusu-Ansah
I will know the pandemic is over when globally, when India and Brazil and the European nations and the nations of the African continent see a slow or an ending to deaths from COVID. And 80 to 90% of our global population becomes vaccinated. We have a long ways to go.
Mike Reid
How will we know if the pandemic is over? Oh, geez, I don't know. You know, before I came to San Francisco, I worked as an HIV doctor in rural Botswana. It's profoundly poor. It's an incredibly poor country. And as I think about like, when we would know that the pandemic is over, it's, it's when everybody in that tiny village of Tshabong, in the middle of the Kalahari Desert, has access to a vaccine and is safe from COVID-19.
Martha S.
I figure I'll know it's over when I don't feel naked without a mask, when I'm not afraid, without a mask, even around people I know well, and trust. I'll know it's over, when I don't worry about being a danger to other people.
Eleanor
I am a resuscitation and COVID ICU nurse and I will probably never know the end of COVID-19. But I suppose I'll know the pandemic is over when I no longer feel just deep, anxious dread on my drive to the hospital.
Lori-Ann Edwards
I will know when the pandemic is over when I can hug my parents again, when I can create travel memories again. And when I can plan my future without this nagging feeling of doom.
Sarah
I'm a COVID cancer survivor. And I will know this pandemic is over when I can go to a robotics competition or a symphony concert or a soccer game and sit next to friends and hug them and enjoy watching our children thrive. I'll also know that this pandemic is over when I can go to have a medical procedure done and have my family with me the whole time.
Marie S.
When will this be over? This pandemic won't ever be over. What does over mean? Tell me more. Tell me more about what being over means to others. What does being over mean?
Fiona Doolan
I will know the pandemic is over when my friend's three year old girl who is too young to truly understand that which she cannot see, shakes off the fear that has been present for a third of her lifetime of any stranger and the illness they might bring.
Child of Eve Bloomgarden
(Singing) Sun, sun, sun, here it comes.
Eve Bloomgarden and her children, Gabriel Bosslett, Lori-Ann Edwards, Greta and Theodore Peng, and Mike Reid
(Singing) Here comes the sun do, do, do/ Here comes the sun/ And I say it's all right/ Little darling, it's been a long cold lonely winter/ Little darling, it seems like years since it's been here/ Here comes the sun do, do, do/ Here comes the sun/ And I say it's all right
Emily Silverman
That's our show. 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. Here Comes the Sun was written by George Harrison, and was performed by Swen Hendrickson on ukulele. Thank you to the voices of Mike Reid, Eve Bloomgarden, Gabriel Bosslett, Lori-Ann Edwards, and Greta and Theodore Peng. Until we meet again, I'm your host, Emily Silverman, and this has been The Nocturnists: Stories from a Pandemic.
Eve Bloomgarden and her children, Gabriel Bosslett, Lori-Ann Edwards, Greta and Theodore Peng, and Mike Reid
(Singing) Here comes the sun do, do, do/ Here comes the sun/ And I say it's all right/ Little darling, the smiles returning to the faces/ Little darling, it feels like years since it's been here/ Here comes the sun do, do, do/ Here comes the sun/ And I say it's all right/ Sun, sun, sun, here it comes/ Sun, sun, sun, here it comes/ Sun, sun, sun, here it comes/ Sun, sun, sun, here it comes/ Sun, sun, sun, here it comes/ Sun, sun, sun, here it comes