In a Plague-Time, the Heroic (in Hospitals) and Not-Heroic (in the White House)
Third in an ongoing series, “Notes from a Plague-Time”
As I get older, after a lifetime of mixing it up with the human parade, I have come to a conclusion about people, which is:
The ultimate difference between people? Caring for others. There are those who do — care for their fellow human beings — and there are those who don’t, for whom the concept of “fellow human being” is as foreign as….a virus. So constituted, these people are driven not by humanity, of which they are bereft, but ego and vainglory.
But: Those who care for others can live-stream (as it were) the lives of others — their fear, their pain — as if they were their own, because: They are. They feel the humanity of others. And, doing so, they feel a responsibility to act — to assuage fear and pain. While such a panoramic view of humanity may drain, it also elevates and sustains.
These models of humanity are now found, in this plague-time of coronavirus, in the hospitals across the land, on the front lines treating COVID-19 patients — the doctors of all specialties, the nurses of all grades, the various technicians, the EMTs bringing in the infected. While these paragons tend to their patients’ physical bodies — what Franz Kafka called “His Majesty, the body” — they also, majestically, seek to save the above-cited human vessel housing fear and pain, and hope.
But what makes these paragons heroic, beyond run-of-the-mill humanity, is this: Their caring for others brings with it mortal peril to themselves — infection from a deadly and fast-acting virus that medical science itself still does not understand, in fact is using this pandemic to study. These heroes understand their caring can kill; they themselves could die. They understand, as one anesthesiologist put it, “You’re basically right next to the nuclear reactor.”
Of course not all medical heroes are of paragon character; there are those driven by ego and vainglory, too. But, by their action in this plague-time, they are not much in view; stories of medical heroes abound (here, here, here, here, here, here, and here).
Where the un-heroic abounds is in the White House, whose occupant risks nothing while our medical heroes risk all.
Staying with the heroic, I shall focus on the above-cited anesthesiologist — Dr. Cory Deburghgraeve — who works in a large state hospital at the University of Illinois-Chicago and whose riveting as-told-to-story in The Washington Post immerses one in the action at COVID-19’s front lines — and in heroic humanity.
As Dr. Deburghgraeve tells us, his “entire job” now — 14 hours a day, six nights a week — is intubation: “When patients aren’t getting enough oxygen, I place a tube down their airway so we can put them on a vent [ventilator]. It buys their body time to fight the virus.” He adds matter-of-factly: “It’s also probably the most dangerous procedure a doctor can do when it comes to personal exposure. I’m getting within a few inches of the patient’s face. I’m leaning in toward the mouth, placing my fingers on the gums, opening up the airway. All it takes is a cough. A gag. If anything goes badly, you can have a room full of virus.” He reflects: “So, there’s a possibility I get sick. Maybe a probability. I don’t know. I have my own underlying condition” — bad asthma as a kid — “but I try not to dwell on it.”
But he can’t help but dwell on it: Being “right next to the nuclear reactor” (“My mask and hood can get covered in fluid”), the doctor notes, “I go in confident and fast, because if you miss on the first try, you have to do it again, and then you’re bringing out a ton more virus.” His fears are held universally by his colleagues, from doctors to EMTs (here, here, and here), especially in light of the lack of testing for this virus.
Mortal peril established, Dr. Deburghgraeve tells of two actions that strike me as instructive. One: He describes a staff meeting where it was agreed one person should do COVID intubations during the day and another at night: “….and I started thinking: I’m 33 years old. I don’t have any kids at home. I don’t live with older relatives. About an hour after the meeting, I emailed my supervisor. ‘I’m happy to do this. It should be me.’” “I’m happy to do this. It should be me….”
Two: He describes doing rounds with the doctors in the I.C.U. to check on patients he’s intubated; these patients are not allowed family or visitors. Then, this: “I’m not a religious person, but I do like to stand there for a minute outside the room and think about them and what they’re going through. I try to think about something positive — a positive expectation.” I do like to stand there….and think about them and what they’re going through….” He adds: “I have to find a way to hold it together in order to do this job. I tear up sometimes, and if I do, it can fog up my face shield.”
I go into detail here to make a contrast — between the heroic Dr. Deburghgraeve and the un-heroic Donald Trump — in order to make this point: Can anybody imagine Donald Trump making the moral choice — “I’m happy to do this. It should be me” — or, regarding anybody stricken with COVID-19 and fighting for air and for life, feeling, “I do like to….think about them and what they’re going through”?
But this contrast is more than character. It carries life-and-death weight.
The un-heroic Trump, being deficient in humanity and thus feeling, compounds the peril to our medical heroes by his abject failure to provide them with the PPE — protective personal equipment: masks, shields, capes, respirators — that they have been begging for, almost a month now. And he continues to refuse to invoke broadly the Defense Production Act that would require American manufacturing to retool and produce this PPE. Unlike Franklin Roosevelt who reorganized American manufacturing in World War II to meet its moment, Trump cannot meet this pandemic moment with even something so simple as a mask? (Citizens are rushing to their sewing machines and turning out masks on their own.)
And when asked about masks at a press briefing, Trump’s response? “We’re not a shipping clerk.” “We’re not a shipping clerk….”? (Not for Trump, the moral directive “It should be me” of Dr. Deburghgraeve.) Responding to Trump’s “shipping clerk” crack, Dr. Sophie Greenberg writes in the Post, “I am not a seamstress, but this week I found myself sewing my own mask.” She adds, “Normally, a mask is discarded after every patient encounter; now, we are given one mask to use for an entire week.”
It brings to mind a scholar’s post-Inauguration crack, that, in Trump, we find “malevolence tempered by incompetence,” though this pandemic amends that to “malevolence amplified by incompetence.” I think also of Shakespeare’s line given to Brutus, anxious at Julius Caesar’s exercise of power: “Th’ abuse of greatness is when it disjoins / Remorse from power.”
Of course, also at issue — along with the contrast in humanity of medical heroes and Mr. Trump — is the eternal debate between Republicans and Democrats on the role of the federal government. But if anything is learned — will it? — from the disarray this pandemic has cast America into, it is the imperative that the federal government must lead the 50 states in organizing the response to national disaster. (Right now 50 governors are competing with their peers for PPE.) And, imperatively, at the apex of federal power, we need a human being who feels for other human beings.
Who will at least provide masks to our medical heroes.
Whose numbers, admirably, grow — despite the lack of PPE. As in war, veterans are recalled — retired doctors and nurses are returning to duty (also here) — and draftees called up — medical students are being graduated early — all to join the COVID-19 front lines.
My anxiety for medical workers is personal: I come from a medical family — father a doctor, mother a nurse when they met. I got used to seeing doctors as saviors when, driving Dad on his house calls, upon entering the house of a seriously ill patient, the whole family turned to him: “Doctor! You’re here!,” as if to say, “Save us!” Mom could recall being sprayed by the contents of a tubercular man’s lungs when he “expired”; she’d be a nut on PPE. Our proud family tradition continues (I was pre-med for all of two weeks: I couldn’t hack chemistry): A nurse niece and the doctor daughter of a cousin are both serving on the COVID-19 front lines.
Crisis lifts curtains. Yes, crisis also brings chaos, which begets more chaos. But: If we look with intent, crisis lifts curtains, it clarifies. Certainly, this pandemic — the life-and-death battle being waged, the economic collapse soon to befall — clarifies, both the horror of our defective president and the crying need for skilled and humane heroes. Fortunately such heroes are in our midst, working at this moment in our hosptials at perilous risk to themselves. It is their stories, viewed from the safety of “sheltering in place,” that stirs a frightened nation (and belies the Modernist anti-hero). We observe these true heroes and tell ourselves, “Remember this.”
But will we remember? America since 9/11 has been lost, flailing. Preceded by the go-go ’90s, 9/11 — for a brief while — brought us civility, seriousness, a yearning for normalcy. But in very short order, the go-go returned, turbo-charged even, as seen in the “heroes” that soon swallowed the spotlight: Tony Soprano “whacking” his rivals dead, Walter White “breaking bad” as a chemistry teacher producing meth. Pop culture might normally be extraneous to the point, but: Out of this skewed pop culture came…Donald Trump, host of a so-called “reality” TV show called “The Apprentice,” who — History’s bad joke — is now apprenticing as President of the United States of America and pretending to lead the nation through a pandemic.
This pandemic, more even than 9/11, could spell curtains for America — politically, economically, culturally. The only way we can reverse America’s decline is — along with embracing truth and expertise again — to exalt (and elect) authentic skill, moral character, deep humanity.
Our medical heroes working the COVID-19 front lines point the way — upward.
Image: Plague doctor, circa 1656, during bubonic plague, Rome.