Lauralee Morris is a physician who lives in Brampton, Ont.
I am sitting in the car and talking on my cellphone with the nurse who is looking after my husband. I patiently explain to her why she needs to let me in to see him. I use logic, I try charm, I plug my credentials. My husband is very sick, I say, and the hospital website says there can be exceptions to the no-visitor rule. She won’t budge. I can’t believe she won’t let me in!
As a physician who remembers SARS and was on the front lines of the Ebola epidemic in Sierra Leone, I think, “Good for her.” After all, the no-visitor policy makes sense. It protects vulnerable patients and critical staff from contracting COVID-19. But as the wife of an ill patient, I am irate. My husband is a long-term survivor of non-Hodgkin lymphoma, a form of hematologic cancer. Last August, he developed an entirely new type of cancer. The cruel irony is that the multiple rounds of radiation and chemotherapy that cured his lymphoma 15 years ago have now caused his second cancer. It drives home the idea that much of medicine is a double-edged sword: The good news is that we can cure your lymphoma, the bad news is that if you live long enough, you will develop a second, even more deadly cancer.
I call my husband. He’s somewhere in the hospital fortress, on a unit called Acute Care for the Frail Elderly. The name says it all. He sounds shaky. As a physician himself, he understands why he needs to be there, but he desperately wants to come home. We debate the pros and cons of staying in the hospital versus just making a run for it, even if we have to sign out against medical advice. Reason wins out, and we decide to wait and see what the next lab work shows. After I hang up, I call his nurse again. I want to yell and rant but I remind myself that she is just doing her job. She tries to be kind and patient. I try to be reasonable and appreciative.
My phone is almost out of power, so there’s not much point in sitting out in the parking lot any more. I pay an outrageous $16 for parking (the thought of just crashing through the barrier occurs to me) and drive home defeated. I feel like crying but I don’t. After a lifetime of holding it together for the sake of getting on with my job, I am pretty good at stuffing it down – a little too good possibly. It’s hard to work when you are sobbing, after all. It’s also hard to drive.
Traffic is light and the sidewalks are empty. It reminds me of Freetown in lockdown. In fact, more and more I am reminded of Sierra Leone in 2014: the fear and panic, the scramble for masks and medical supplies, the closed borders, the forced quarantines. I am surprised by how familiar it all feels.
When I get home, I turn on the news and notice gloomily that many poor countries are starting to record cases of COVID-19. What will happen when the virus gets out in the slums of Freetown, Nairobi and Manila? Or even worse, in the crowded refugee camps around the world – Dadaab, Kutupalong, Azraq? I have worked in all those camps and the idea of asking people there to practise physical distancing seems like an insulting joke. ICU beds? Ventilators? Not a chance. Not even for the young.
You don’t have to look overseas to find groups of people who could be devastated by an illness such as COVID-19. Here at home, we already have concerns about outbreaks in homeless populations, shelters, nursing homes and Indigenous communities. As a young doctor, I worked in remote areas of Northern Ontario and the Arctic. I would fly into settlements out of the main hospital hubs of Moose Factory, Sioux Lookout and Iqaluit, so long ago now that Iqaluit was still called Frobisher Bay. These remote communities had nursing stations run by nurse practitioners – usually very experienced and capable nurse practitioners. But there were no permanent doctors, no ICUs and no ventilators. Very sick patients would get medevacked down to the hub or farther, depending on the circumstances. As you can imagine, taking care of very sick patients in this setting is extremely difficult, and the odds of survival are diminished.
On CBC, a string of serious provincial health officers report the growing tally. They are starting to look tired and fed up. On CNN, the U.S. President praises an entirely untested malaria drug as a possible treatment for coronavirus. I finally fall asleep on the couch with the phone beside me.
At midnight, I get a call from my husband. He tells me he thinks he’s dying. Years ago a stern old nurse offered me some advice: If a patient ever tells you they are dying, you should believe them. I want to rush over to the hospital, break through security, put my husband in a wheelchair and roll him out of there as fast as I can.
In Sierra Leone, people died alone in their tents, without the people who loved them. If they were lucky, a faceless health-care worker in head-to-toe personal protective equipment held their hand. The thought grips me that my husband will die alone. I phone the nurse. She tries to reassure me that everything is okay. It doesn’t work. I lie back down on the couch and close my eyes. CNN drones on.
Epidemics shake the foundations of society. They cleave families and communities and leave the sick and vulnerable to fend for themselves. They uncover the ugly disparities between the haves and have-nots of this world. It has always been this way – think leper colonies in the Bible.
In Sierra Leone, I worked with hundreds of nurses and other health-care workers who risked their lives every day to go to work. They often lived separately from their families and suffered stigma for working in Ebola treatment centres. I felt perpetually guilty about the fact that if I got Ebola I would be medevacked back home to receive all the benefits of modern medicine. I would have a good chance of surviving. It would be quite a different matter for these brave young people. If they got Ebola, there would no medevac to a rich First World country, no fancy ICU, no million-dollar treatment. In all likelihood, they would die.
The next morning, I call my husband. I feel relieved when he answers the phone. He’s just had his blood work done, but we decide that it doesn’t really matter what it shows – he’s coming home anyway.
I sit on the couch in my winter coat, my laptop in front of me displaying the hospital portal. I hit refresh over and over hoping the lab results will pop up. The phone rings. It’s the nurse from the floor. Good news! The blood work is better, the doctor is just doing up the discharge papers. I burst into tears and thank her copiously. I guess you can only stuff it down for so long.
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