I work in COVID wards in the country with the most COVID cases: the U.S.
I work in COVID wards in the state with the most COVID cases: California.
I work in the counties in that state with the most COVID cases, moving from city to city to help where needed, a traveling EMT.
I’ve found I usually go where the fires are, because the staff at those medical centers are so understaffed because of employees being quarantined, employees quitting, and employees having to evacuate due to the fires. Which means it’s often the case where I’ll be in a COVID ward, get my one fifteen-minute break for the entire shift (if that even happens at all, usually not) and then I have to decide if I should stay in the COVID ward or go outside where the air quality is “Unhealthy for Sensitive Groups” or “Very Unhealthy” or worse. I always choose to go outside. Usually I put the trash out, take off my mask for a moment, my earlobes throbbing from the straps, and I breathe in the smell of smoke, which I do have to admit I prefer to the smell of feces, urine, and vomit.
I had a coworker say the smell reminds them of camping, but, for me, I just smell someone’s house on fire.
Then I go back inside and what I’ve noticed, since I’m floating from different medical center to different medical center, is that the nurses like to give me the worst of the COVID patients. The worst patients in the worst counties in the worst state in the worst country for COVID.
They give me them because they tend to be the ones who cough a lot, have fevers, have shortness of breath, are the most contagious. And so I go in, with all my PPE (personal protective equipment), and I do two things that I’ve learned are incredibly helpful. I ask two questions: are you hot or cold? That is, do you want another blanket? And are you thirsty? Do you want something to drink? Simple. Not rocket science. Not even middle school science. It’s just basic human needs. Who wants to be hot or cold or thirsty? Not me. Especially not when they have multiple signs and symptoms they’re dealing with. And I’ve run across all of them—fever, chills, cough, difficulty breathing, fatigue, muscle aches, headache, loss of taste/smell, sore throat, runny nose, confusion, cyanotic-blue lips, diarrhea, nausea, vomiting. So I get them blankets and water, pillows and juice, move their bed up and down and down further and up and up further to whatever point that makes them comfortable and I go get them another blanket.
And this has happened before: I’ve asked, “Do you want another blanket?”
And they instantly reply, “Yes.” (A lot of the patients only speak one word. That’s it. Shortness of breath doesn’t make for long sentences. Coughs don’t make you talkative.) So I get the blanket, come back, put it on them, and then I learned something very important from doing this over and over. Don’t leave. Not right away. In the past, when I first started, I thought my mission was done. But I learned that you always ask them, “Do you want another blanket?”
She nodded yes.
So I went in the linen closet, got another blanket, came back, tucked her in. That’s an important part. Patients will have arms, legs, hands, feet, all that look perfectly healthy, but so many patients can’t move them. The hypercoagulation that comes with COVID causes strokes, heart attacks, and those can leave you with arms that no longer move, fingers that are no longer functional. Moving a blanket for a patient can be hugely helpful. And who doesn’t like to be tucked in? I love being tucked in and I’m in my fifties. I feel old as hell, but any time someone tucks me in, I’m instantly transformed to five years old and I love it. So I tucked her in.
“Do you want another blanket?”
I get it, come back, put it on her. “Another?”
I get it for her.
She nods yes.
I go get it, come back, tuck her in again.
“No,” she says, “I’m good.” And she is. I can see it on her face, contentment.
Now, that’s called being cold. That’s chills. That’s hypothermia. That’s a CNA who never checked in with her once the entire previous shift, the blankets off of her and her unable to pull them up so that she’s lying there, skin exposed, the fan cranked in the room for the patient next to her who is having a fever, so she just freezes.
Until someone puts blankets on her.
And then she’s happy.
A lot of these patients are dying. By my count, from the wards I’ve been at, so far, we’ve had seven patients die. Two of them were a mother and daughter. The daughter got COVID, gave it to her mother, and, in the end, they both ended up dying. I know Trump says not to fear COVID. But I fear COVID. And I fear Trump. I have plenty of fear to go around. I think if I were a billionaire, I wouldn’t fear COVID. I read that there’s close to three thousand billionaires in the world. So that’s three thousand people who don’t have to fear COVID. But the other seven billion plus people in the world might want to fear it, at least a little bit. Especially those who wouldn’t be able to afford the $100,000 medical bill that Trump would have gotten for his treatment, if wasn’t free for him, completely free. That’s how the system works. If you’re a billionaire, it’s free. If you’re poor, the medical bill’s take everything you have. I had a patient just ask me a couple days ago, when I asked her if she wanted to go outside for some fresh air, “How much’ll it cost?” “It’s free,” I said. She didn’t believe me. I took her outside, a back area where we were allowed to take the COVID patients one at a time, and after a minute she wanted to go back inside, worried it’d cost more the longer she stayed out there, no matter how much I tried to convince her it wasn’t the case.
My ex-girlfriend’s two biggest fears in the world, she told me, are being paralyzed and dying of thirst. She has polydipsia. Which means “great thirst.” She drinks water all day long. The reason is idiopathic. Which means “unknown.” I told her about COVID patients’ paralysis and about CNAs forgetting to give them water for entire shifts and she said it’d be hell.
“It is hell,” I said.
And it is.
You walk into a COVID center and there’s this immediate sense that you’re leaving the real world behind.
I took a course in Witchcraft, Magic, and the Occult when I was an undergrad at Central Michigan University and the professor taught us about the netherworld and shamans, about how, in order to gain access to another world, you have to undergo a great change in your body, in your clothing. He said that a shaman will put on entirely different garments from normal everyday wear, that you have to disguise yourself, become monstrous in your appearance so that when the monsters of the netherworld see you, they don’t eat you immediately, knowing that you’re just a mere human. You have to take on a different appearance. It conjures up Marilyn Manson and trick-or-treating and weddings and crossing the equator in the military and all these other liminal spaces and places and moments in time where significant change happens. And when I walk into a COVID ward, the gown/gloves/mask/face shield make me look so odd, so different, so inhuman and unhuman.
We just had a hospice worker come in last night and I thought he was a nurse. He looked scared at the door. He asked what he should do. The head night-shift CNA ignored him.
I said, “Put a mask on, for starters.” He’d entered with no mask.
“OK,” he said, and stood there.
“No,” I said, “Now.”
“I don’t have one.”
I rushed over with a mask, had him put it on. Then I dressed him. He wasn’t a nurse. He was a preacher. “Haven’t you ever been to a COVID ward before?”
“No,” he said.
He struggled to get the gloves on. They are difficult to get on, but I’d done it thousands of times. My God, tens of thousands?
He had no idea how the face shield went on.
The gown completely puzzled him.
I dressed him.
Like he was a little boy. Helped him thread his arm through the sleeves. Tied the back for him. This eighty-year-old man. Seventies? I wasn’t sure.
He had what I’m guessing was a Nigerian accent. Was very thin. Very. Very regal. I always think of ‘regal’ as the opposite of ‘lager.’ He was a total teetotaler. He walked so stiff and erect that you got the impression he was careful with every step, putting thought into every movement, as if he were walking on a tightrope and if he relaxed he might fall into a pit to hell.
The head CNA hated him instantly, wouldn’t even look at him. She sat slouched at the nurse’s desk, the worst posture I’d ever seen, early-stage kyphosis. Meaning ‘spine curvature.’ Obviously, she had gotten drunk multiple, multiple times in her life. You could see it in her face, broken capillaries. And, in this moment, you could also see that she was an atheist. A devout atheist. A faithful atheist.
He walked by her, to a room in back, the far back. It felt to me like the further back a patient was placed, the more likely that they would be dead soon. I noticed these patients were the farthest from the nurse’s desk. I also noticed that these patients screamed the most. Mostly, “help!” You’d go in the room, ask what they wanted, and they’d just look at you and yell “help!” again.
“But what do you want?”
“You want ‘help’?”
There wasn’t much you could do. You’d have to guess what they needed, but, in reality, what they needed was a Stanford Medical School team of doctors. Or a preacher. Not an EMT. Not a CNA.
The preacher said hello to the woman, introduced himself, and said, “Do you know Jesus?”
Previously, with us, the woman had been hugely unresponsive, unable to get her to communicate much of anything, but she shook her head yes and smiled. Actually smiled. I was stunned.
“Jesus,” he said, “Jesus!” As if he were conjuring up the presence of Jesus. As if he were introducing her to Jesus. As if Jesus had just entered the room. Maybe he had.
I stood in the doorway. I actually moved to the side, in case Jesus wanted to walk in, so I wouldn’t be blocking the entrance.
“Can she drink?” the preacher asked.
I was surprised the preacher noticed this, but there’s a definite look patients get when they are dehydrated.
“Yes,” I said, “But, look.”
I went to the table, took the cup by her bed, a little medicine cup, filled with water. There was an eye dropper, so that we could take out just a little bit of water. I put it to the woman’s lips, squeezed a few drops of water into her mouth. At first, she was pleased with this, but then instantly shook her head no, no more. She had extreme dysphagia, the inability to swallow. The first drops helped the dryness of her mouth but as soon as the water reached the back of her throat, it was horrible for her. A terrible condition where she desperately wanted water, but couldn’t drink it. She had a DNR. Do Not Resuscitate. A word that, when I first heard it, I’d confuse with ‘resurrect.’ This was end-of-life care.
The preacher asked, “Can I touch her?”
“Yes,” I said, “Of course. Just wear the gloves. And then after, throw the gloves here.” I showed him where.
I introduced myself, told him to yell my name if he needed anything, told him to take as long as he’d like.
I went into a room of another patient who was rapidly declining, had been moved to hospice so that we were instructed we could no longer call 911 for him.
I heard the word “hallelujah!” from the other room.
“Hallelujah” repeated the man in the bed in front of me, like he didn’t understand the word, like he was trying to solve its meaning. This same man, earlier in the day, I’d gone into his room and given him a glass of water. He drank it through the straw in one long sip.
“You want more water?”
“Yes,” he said, a desperation.
“I’ll go get you some.” I went, came back, put the straw in his mouth. He couldn’t use one arm, had much trouble with the other one. He drank it all again, one long nonstop sip.
“You want more?”
“Yes,” he said, the same desperation.
I got him another glass. He drank it all again. This time pausing before finishing it.
“More,” he said, “More.”
I got him another glass. He drank it all again.
“More,” he said.
He drank another glass.
“Do you want more?” I asked.
“No,” he said, “No.”
Bio: Ron Riekki’s books include My Ancestors are Reindeer Herders and I Am Melting in Extinction (Loyola University Maryland’s Apprentice House Press), Posttraumatic (Hoot ‘n’ Waddle), and U.P. (Ghost Road Press). Riekki has edited eight books, including Here (Michigan State University Press, Independent Publisher Book Award), and The Way North (Wayne State University Press, Michigan Notable Book). Right now, Riekki’s listening to a lecture on antinociception.