Thursday, April 9, 2020

‘Your instinct is to run to the patient’ — but you can’t

Mount Sinai nurse Kimberly Lipetzky.

     This is the second installment of my three-part series on treating the COVID-19 at Mount Sinai Hospital. The first part is here

     The COVID-19 pandemic is not taking place in a vacuum. Car accidents and gunshots and burns and falls and heart attacks and strokes still happen, and those patients, too, are rushed to Level One trauma centers such as Mount Sinai Hospital, where every patient who rolls in must be treated as if they have COVID-19.
     “Your instinct is to run to the patient,” said ER nurse Kimberly Lipetzky, who had just treated a man who had fallen 20 feet off a roof. As medical staff tended to him, they discovered he had been sick for a week, probably with COVID-19, so “then you have this added level.”
     What does that added level mean? If you wear PPE — personal protective equipment — to see a COVID-19 patient, you first must strip off the gown and gloves and booties and hairnets and mask before seeing the next patient, or risk infecting someone who may not have the deadly ailment. And if you’re not suited up and a COVID patient suddenly gets into trouble, you have put on all that PPE — and fast.
     “Someone is in respiratory distress. You’ve got to move quickly,” said Lipetzky. “Got to goggle and gown and hair cover. It’s a lot.”
     Getting it one can take three key minutes, and it’s such a struggle that non-medical staff are jumping in to help.
     “You have unit secretaries coming out from behind their desks, putting PPEs on, making sure gowns were tied,” said Michele Mazurek, chief nursing officer for Sinai Health Systems.
     Mazurek, who is also leader of Incident Command at Mount Sinai, added: “This is a group effort. We did not need to ask any of these individuals to do what they’re doing.”
     Even with all hands on deck, the stress builds up. The hand-washing is endless.
     “It’s constant and then just scrubbing your hands,” she said. “Our hands are ragged.”
     Every patient is carefully questioned. The symptoms of COVID-19 span the range, from none at all to gasping for air.

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Wednesday, April 8, 2020

At Mount Sinai, ‘moments of chaos and calm’

     Those N95 masks hurt.
     To work, they must be worn tight. Within 20 minutes, the straps pinch your ears and the mask starts digging into your nose.
     The masks need a tight seal to keep the coronavirus out. Doctors and nurses at Mount Sinai Hospital test their masks by reading aloud while saccharine is sprayed in their faces. If they taste sweetness through the mask, they’re dead — or they might be, if that mist were coronavirus droplets instead. Stubble on men can also throw off a mask’s fit.
     Add goggles and gloves and hairnets and protective body coverings, then start treating a patient.
     ”It gets hot, it gets a little claustrophobic,” said Kimberly Lipetzky, a nurse at Mount Sinai. “I had a couple codes, doing CPR in full gear. Your goggles fog, and you’re trying to navigate this situation while of course performing at peak ability.”
     ”After an hour it starts getting really uncomfortable,” said nurse Adam Garrison. “It feels like the bridge of your nose is going to disintegrate.” 
     The COVID-19 crisis is gathering force in Chicago. Right now, infected patients still arrive at Mount Sinai, on Chicago’s West Side, in fits and starts.
     ”We’re definitely vacillating between moments of chaos and calm,” said Lipetzky. “Overall, there’s this heaviness, this weight in the air when you’re wondering, what’s going to come in the door? How do you be ready?”
     In part by wearing two masks, layered, with donated, handmade cloth masks on the outside to protect the integrity of the vital N95 underneath. But that brings its own difficulty.
     ”It’s not exactly easy to speak,” said Garrison.
     Which can impede the complicated, life-or-death communication that goes on in a hospital. A COVID-19 patient can deteriorate rapidly, can walk into the hospital in the morning complaining of shortness of breath and be on a ventilator by afternoon.

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Tuesday, April 7, 2020

Temps perdu

      "Lost time," is how one mother down the block described her kids' experience since school closed in the face of the COVID-19 pandemic. Oh, they do the worksheets, she said. But it just isn't the same. They're not learning. And given the lockstep curriculum, she worries that when school picks up in the fall—if school picks up in the fall—then her kids will be woefully behind where they should be.
    At least they'll have plenty of company.
    This wasn't a scientific survey, mind you. Not even journalism. Just conversation. Though the Sun-Times' own Nader Issa looked at this issue last week and found e-education at best uneven. It makes sense that a system that struggles to teach kids in the flesh would not be able to seamlessly transition on short notice to a whole different manner of instruction.
      I had the topic on my mind because I had just passed a series of chalk cris de coeur from another mother, of a special needs child, who the day before had explained how that child's teacher dumped a bunch of curriculum on her at 9 p.m. on a Sunday night, and then promptly vanished when she had questions about it.
     My reporter's gut tells me that people without kids, or whose kids have been long grown, might not be all that sympathetic. Even a bit judgmental. In their eyes, what person is in a better position to teach their kids than their own parents? Just grab a piece of chalk and do it.
     Forgetting that teaching is a skill.  Forgetting that we are no longer in the 1950s, and many mothers have jobs, despite the virus, and can't suddenly morph into 7th grade social studies instructors, or whatever. They wouldn't take that approach about health care. Parents can give an aspirin, but they don't become doctors.
     I was never any good at teaching my boys. I remember when the older one was writing a report on Andrew Jackson. He was sitting at my desk, was reading the Wikipedia entry on Jackson while I stood beside him, holding open one of those gorgeous graphic history books, the kind with cool layouts—oil portraits and maps and relics, gold pocket watches as if they were sitting on the page. I had snagged the book at work and kept it, waiting for this moment, to supplement his education. But first, I had to get him to shift his eyes from the screen to the book in my hands, held within his field of vision. I failed. He told me, in essence, to scram, and I shut the book and retreated.
     Teaching is hard. I bumped into a teacher and her husband out walking Tuesday morning. I asked her how remote teaching was. "Kids don't listen online as easily as they don't listen in person," she replied.
     No, a few months lost to the tender mercies of public education won't ruin many kids, particularly not in the suburbs. On one hand, some students go through years of school and don't learn squat. On the other, the loss to education posed by the virus doesn't seem to be on the radar of many. Perhaps we're too worried about dying. But it seems it should be a topic of conversation, on par with the risk to the football season.

Monday, April 6, 2020

This Passover, we seem to be back in Egypt

Not this year. 
     “I will pass over you. No destructive plague will touch you.” — Exodus 12:13

     When my wife told me we would not be hosting Passover this year, my immediate reaction was a pout almost presidential in its historical inaccuracy.
     “But they had Passover in Auschwitz!” I complained.
     Meaning that holding the Seder in tough times is what Jews do. Jews don’t cave. We don’t throw tradition to the wind just because there are Crusaders or Cossacks or coronavirus or whatever prowling around outside. Because there’s always something trying to get us. We persevere. We must do Passover, which begins Wednesday evening, or else COVID-19 wins.
     In my defense, this was a historical age ago — so very mid-March 2020 — before almost everybody wrapped their heads around the enormity of this crisis. Before my wife said, in essence: We are not killing our aged relatives for a festive meal. Before I checked history and found that while a few mumbled prayers might have been said in a few camps, it wasn’t like they were ladling out the chopped liver in the Nazis’ main death factory. A nice story, but, like the Exodus itself, only a story.
     Besides, we are having a Seder. We just aren’t inviting anybody, no relatives hullooing into the house hauling trays covered in foil. No Bob handing me cigars. No Alan leafing extra prayers and readings into the Haggadah.
     No crowd in the foyer, no logjam in the kitchen. No clatter, no crash, no strangers invited by a cousin. No babies to coo over nor any kindergartner to emerge beaming from beneath the dining room table, like a mermaid up from the depths, face aglow at her own naughtiness.

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Sunday, April 5, 2020

Everything is everywhere

     "You want to go for a walk?"
     "I'll walk one of your cigars."
     "That sounds like a plan."
     Except I was down to my last one—a holdover from Thanksgiving. The weather wasn't conducive, and I've cut back on the habit. Unhealthy. But extraordinary times demand extraordinary measures. I told my wife that the boys and I were driving over to Binny's. My wife was against it—not the cigars, this time, but the outing. Exposing ourselves to plague.
    I promised to wash my hands before and after. And wear a mask.
    I had a package of 3M dust masks I used in my shop, for sanding and such. We grabbed a pair.
    In the Binny's parking lot, I put it on, fitted the elastic bands around my head, pressed the metal strip to the contour of my nose. I checked out myself in the rear view mirror.
    "I look like I'm going to rob the place," I said.
    We went in. I wanted to get a case of Pabst NA—they come in cans—but they were out. I went up to two Binny's clerks to interrupt their conversation and asked if they had moved the Pabst. As I did, I inadvertently coughed. I'm not sure why. The mask, a mote of dust blown off a bottle of The Macallan 18.  Something. A dry cough.
    One of the clerks stepped back so fast it was as if he was yanked on a string. I almost mumbled, "Not a sick cough, just a cough cough. My wife is making me wear the mask." But that seemed unnecessary. They aren't carrying Pabst NA anymore, but could special order. Nah, no need, not in the current crisis. I said I only really need it when I go up to the UP in the fall—the guys had the regular Pabst and I had the NA. We had a Pabst theme going. But otherwise, Clausthaler is fine; tastes far better, in fact. I just liked the cans and figured, with the future uncertain, Pabst represented a laudable economy.
    Five cigars. Rocky Patel Vintage 1990s; some standards must be maintained. A few other shoppers also wore masks. That helped, incredibly so. Support. Approval. We are such social animals. You'd feel comfortable wearing your underwear on your head as a hat if enough people on the block were doing the same. Our president is killing people, not wearing one. But then his hands are already red up to the shoulder. In for a dime, in for a thousand dollars.
     Back at the car, we squirted hand sanitizer on our fingers, rubbed it around, then removed our masks.
     "I guess those hijabs aren't a problem anymore," I said.
      "All that hubbub to ban headscarfs and burkas and such. I guess people covering their faces in public isn't a problem anymore."
     "That was just in France," he said.
      Nothing is just in France anymore. Or China. Or here. Everything is everywhere. That's one lesson of this thing.

Saturday, April 4, 2020

Flashback 2000: The g-r-r-r-r-r-eatest threat to mankind

Tiger, by Kishi Ganku (Metropolitan Museum)
     I'm trying to never say that I enjoy having the boys around, because it's a short hop from that to "Isn't this pandemic FUN?" and I want to avoid that at all costs. 
    Still, I think it's safe to say I am more plugged in with them under my roof. For instance, the burst of publicity over the aptly-named hit "Tiger King: Murder, Mayhem and Madness" documentary series on Netflix meant nothing to me. Low rent Florida Safari Steves in mullets and eyebrow rings peddling nature's most beautiful animal to underwrite their louche lives. Pass. That lasted until my older son said, "You want to watch a series about tigers?"
    "Sure," I said, and watched the first two episodes Thursday night. OMG. I must admit, I recommend it. Yes, the people are thoroughly unpleasant, every single one. But the thing does explain how we ended up with Trump. And the tigers are gorgeous. It made me think of this column—Tip No. 3 is particularly relevant, as you'll see if you watch the program. I can't believe I haven't posted it before. Back then, I wondered how so many people can be mauled by tigers. Having seen two episodes, the wonder is that there aren't many more. 

     The drawback of these political conventions is they don't address the real problems facing Americans today.
     Tiger attacks, for example.
     While politicians talk, the risk of tiger attack is on the rise, based on my unscientific reading of the news wires, and nobody is doing anything about it.
     Just this week, the latest mauling took place in Boise, Idaho. A woman was attending a fund-raiser at the Boise Zoo (it calls itself "Zoo Boise," but that doesn't mean we have to). The unfortunate lady at the annual "Feast for the Beast" (I wonder what the fundamentalists make of that) found herself in a hallway outside the tiger building, the door of which, in a curious lapse, was left unlatched.
    She got off pretty light, considering. At least she had her arms and legs when the tiger was done, which is not always the case with tigers. The most damage seems to have been inflicted not by the animal, but by a local police officer, who showed up on the scene and managed to shoot the woman in the thigh, breaking the bone. (Geez, what are the odds that being mauled by a tiger isn't the worst thing to happen to you in one day?)
     You might be so cavalier as to find this funny, forgetting that there is a real woman resting uncomfortably at Saint Alphonsus Regional Medical Center.
     I wouldn't dream of laughing at such a thing, not publicly, anyway. Rather, I am offering it as a cautionary tale. Since tiger attacks are, if not rising, then not nearly as infrequent as they should be, I have studied the alarming number of incidents over the last few years and come up with this list of commonsense tips to help you avoid tiger-induced injury. Think it couldn't happen to you? So did these people.

Tip No. 1: Children and tigers don't mix.

     A surprising number of parents in this country permit their children to get in very close proximity to a tiger.
     Lorin Casey Villafana, 10, was actually in the cage last year with her stepfather's pet tigers in Texas when one of them turned and killed her.
     Last March, a 4-year-old Texas boy, Jayton Tildwell, wandered away from a family reunion unnoticed, back to where the tiger pen was. He had his right arm bitten off at the elbow.
     In 1996, a 7-year-old girl visiting a television station was mauled by a tiger about to appear on a television program with her father, the education director of the Cincinnati Zoo.

Tip No. 2: Cameras don't make you immune.

     Jannell Waldo, 45, of San Jose, was clawed by a tiger in 1998 after falling while having her picture taken next to Juma, a 340-pound tiger, at Marine World in San Jose.
     Rather than scare people off, the attack prompted a surge of interest in Marine World's exotic animal photo sessions, though the theme park decided to exclude tigers, no doubt to people's disappointment.

Tip No. 3: Don't stick your arm in the cage:

     In May, a volunteer at the Prairie Wind Wild Animal Refuge in Colorado was asked if the tigers there were friendly.
     To demonstrate, she reached into the cage of Boris, a full-grown Siberian tiger, and petted him. Boris reacted by chewing the woman's arm off.

Tip No. 4: Be particularly careful if the tiger already has killed somebody.

     In November 1998, Doris Guay, a Florida tiger trainer, was leading Jupiter, a 400-pound white Bengal she had raised from a cub, when the animal turned on her and killed her with a single bite to the neck.
     A month previous, the same cat had killed its trainer, Charles Lizza, also with a bite to the neck. At the time Guay insisted Jupiter was not vicious.
     The tiger issue will not go away. I invited both the Brookfield and the Lincoln Park zoos to address tiger safety, and both refused. This timidity will not help anyone. Be careful around tigers.
              —Originally published in Sun-Times, Aug. 17, 2000

Friday, April 3, 2020

Can’t get to AA? Read this now and every day as necessary

Hello, my name is Neil and I’m an alcoholic.

Hello, Neil!

Welcome to the Friday Morning Inky Newshound Fellowship Meeting of Alcoholics Anonymous, where we gather to (reading from a card) “share our experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.”

I’m glad to be here — I’m glad to be anywhere — and glad that you’re here, especially the newcomers. As you know, the COVID-19 virus has caused the cancellation of thousands of AA meetings usually held in church basements and conference rooms. And since attending an online meeting is, for some, well, weird, I thought I would convene one here.

General chair scraping, coffee sipping. Somebody rushes in. “Sorry I’m late,” he says, stating the obvious. There’s a lot of that in AA, stating of the obvious. But since ignoring the obvious, for years, is how a person gets here, that’s actually useful.

No worries. There’s a chair at the back. The good thing about a meeting like this — sprung by surprise — is that it’s hard to avoid. None of that “I don’t have time” or “I’m stuck inside” or “Every aspect of life is convulsed by a global plague” to keep you from attending.

Amidst the havoc, this pandemic is serving up the two things most dangerous to an alcoholic: isolation and an excuse. Oh, and lack of employment. So, three things most dangerous ...

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