Dispatch from the Covidicene Era

I’m a nurse practitioner and I’ve been working at Boston Health Care for the Homeless Program for twenty years. Yesterday, March 25th, I was called in to work at our main facility, on a floor where one wing is hastily being transformed into a COVID-19 unit, where we can receive homeless folks who have been infected with the novel virus, and care for them separately from our other ill and injured patients. Heavy translucent plastic curtains with zippered doorways have been installed, sealing off one end of the main corridor, two layers of portal creating a jerry-rigged airlock between the COVID unit and the wing where we are caring for our current patients. As of yesterday, there were no homeless people in Boston infected with the Corona virus who required our care; the zippered doors were drawn open, and I could see down the corridor, where monitors, oxygen tank, and stacked boxes of supplies lined the walls outside the as-of-yet empty patient rooms. Outside the building in a nearby parking lot, contractors had erected two elaborate tents for testing people and quarantining them safely away from shelter and street if they tested positive. It looked as if the circus is coming to town, but this one will not be for our entertainment. 

     I recently turned sixty, and Health Care for the Homeless management has determined that older clinicians like me, who are at higher risk for serious complications from the Corona virus, won’t be working as front line caregivers in this unfolding crisis. So I’m part of the support team, caring for our “regular” patients, freeing up younger clinicians to prepare for the coming storm. Of course, homeless people’s struggles with lung cancer, HIV, addiction, diabetes, frostbite, and liver failure don’t evaporate just because there’s a new virus in town. We have plenty of work on our hands, and everyone is on edge because of the media reports, the school and business closures, and the sudden profound restrictions of social distancing. Patients’ anxieties are subdued but palpable: people are grateful to be receiving care for their acute problems, as they worry about what the world will hold for them outside when they are ready to leave. They are keenly aware that the health care system is turning its attention away from their everyday problems as everyone braces for COVID-19. We now facilitate most specialists’ appointments by telephone to minimize face-to-face contact, and elective procedures and health maintenance appointments are being canceled left and right. A man healing from a badly broken ankle learned that his hernia operation was postponed indefinitely. He graciously tried to contain his disappointment, staring out the window with clenched teeth. A woman with a heart condition was trying to get into a recovery program, and she paces the hall all day long, joking nervously with her roommates, waiting. 

     Last weekend I was outside enjoying some fresh air, cleaning up the yard, and I noticed a bottle cap lying at the edge of the driveway. I picked it up and turned it over. It was a Corona. “You bastard,” I thought, “you’re already everywhere,” and I slipped the cap into my pocket for safekeeping. Best to keep your enemies close.

     All day long at work, we catch bits of news flashes, staff reports, and rumors flying around the building. Yesterday, there were 1159 confirmed cases of COVID-19 infection in Massachusetts. Today that number has climbed to 1838. Several days ago, we heard there were five people on ventilators in the Mass General Hospital ICU, and we have no idea how many are there now. Administrators rail about the criminal lack of accessibility to protective equipment, how much time they are wasting while searching far and wide on the internet to score N95 masks and face shields, trying to conserve as much PPE as possible for the front line clinicians. On this floor we are mostly mask-less, wearing gloves only for procedures. I wash my hands thirty-plus times a shift: between each patient, every time I pull a door handle or move an equipment cart, or at least I try to. I talk to patients from a respectful distance, laying hands on them or listening to their heart and lungs only if really necessary, scrubbing down my stethoscope afterwards with antiseptic wipes. These are precautions, as we all try to protect one another, and our current situation is not anything like the grim reports we hear coming from Washington State and New York City. But it feels as if we could be several weeks away from those horror shows. 

     Years ago, I rode out a hurricane in my parents’ summer house on the coast of Maine. The house was on high ground, and we decided it would be safest to shelter in place as the storm rolled up the seaboard. When it hit, trees lashed all around us, but the house held together. Then the eye of the storm passed directly over us, and I ventured outside to experience the sudden change. Overhead, the sun shone down out of an achingly blue sky, the air stilled, and a few stunned birds tentatively picked up their song. This eerie tranquility lasted several long minutes, and then the trailing storm wall slammed in, and we were lashed again. 

      This current moment feels as if we all have somehow been dropped into the eye of an epidemiological hurricane: all is preternaturally quiet, and a faint electricity hangs in the air, as if we are soon to be slammed with something unknowable. I am moved by how kind everyone seems these days, all us: unit secretaries and administrators and nurses and janitors and case managers and the security detail. All of us seem genuinely glad to see one another, taking an extra moment to check in, “How are you doing? How is your family?” while trying to maintain proper social distancing on a bustling floor. Even the patients, for the most part, seem more courteous than usual.  

     It feels like a great blessing to work with such kind, committed people. Colleagues who set about their tasks at hand with focus and compassion, setting aside their worries as much as they can for the moment. With all of the profound social upheavals this virus has wrought over the past few weeks around the globe, when so many are sick or exhausted or fearful or isolated, it seems a privilege to be part of a community of human beings with a job to do, a clear sense of purpose when so much is falling apart. They help me to carry my worries and keep them in check: my son who is ill with flu-like symptoms and living alone in Brooklyn; my elderly parents in a retirement community, who are healthy now, but who knows when I’ll be able to see them again; all the front-line clinicians who are being asked to perform miracles with inadequate equipment and support; my wife and stepdaughters at home; all the casualties who are sure to mount. And Mortality, that fickle bugger who requires acknowledgement but not too much, then is best slipped into a pocket like a talisman. It is good to be human. How wonderful that we can all care for each other.    

Please consider donating to Boston Health Care for the Homeless Program, who has outlined their response to the COVID crisis with the BHCHP COVID-19 Response Fund.

Robbie Gamble holds an MFA in poetry from Lesley University. His poems and essays have appeared in Scoundrel Time, Writers Resist, Stonecoast Review, Solstice, and Poet Lore. He was the winner of the 2017 Carve Poetry prize. He lives in Brookline, Massachusetts, and works as a nurse practitioner caring for homeless people in Boston.

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