Texas Walkabout

     Between the three-day series on Mount Sinai Hospital that ended Friday and Sunday's 3,000-word Easter special, I'm pretty toasted. Lights on, but nobody home. So I'm grateful that my friend Caren stepped up with this stroll around her Austin, Texas neighborhood. Caren is one of the many folks I've met across the country through "Out of the Wreck I Rise," the book I wrote with Sara Bader. When she said that she is interested in finding an audience for her writing, I volunteered the readers of EGD as a test market. Thanks Caren for sharing your perambulations with us, and thank you readers for welcoming a new voice. 

     I walked over 23,000 steps today on what I am now calling my almost daily COVID Walkabouts. That’s over 10 miles of creeks, frogs, persistent Austin sunshine, searching for shade, lemonade stops, budding trees and popping flowers, making six-foot arcs around passers by, nodding and waving galore, confused puppies doubting their charm, ripe loquats plucked out of trees and eaten, their seeds saved in pockets, graffiti, Birkenstocks, blisters, grackles and choruses of frogs as dark fell. This epic walk also included a family Zoom perched on a curb and a lady walking down the street crying due to an abusive live-in boyfriend who has moved his mother and criminal son in with them without her permission. I wanted to help her but he came a-lookin’ and she didn’t want him to see us talking. At least I was able to show her the full moon and remind her to call 911 if she felt in danger.
     If it wasn’t for the blisters and tired legs I’d have kept going under this full moon, perhaps for ten more miles. Truth is I am avoiding my home that my seemingly callous and uncaring landlord is taking away from me at the end of June when my lease ends, despite the risks that will be associated with my looking for a new place during this state of emergency as well as a bigger risk of moving if shelter in place is still in effect at that time. 

      In cities and towns around the country and the 
world it is not allowed to end leases, use moving companies, or have anyone outside of one’s household help with a move to prevent spread of the virus, but just as Texas has been way behind the curve in getting on board with strict social distancing, tenants’ rights are just as far behind. Time will tell if she can kick me out or not if shelter in place is still in effect. I may even want to move on my own volition before that time just to get away from an uncaring and unstable situation. The thought of being at the whims of this young and unsavvy landlady had my blood boiling and my body shaking for days before I realized that I am tired of being angry and I am ready to let the sunshine back in.
     As a single person who lives alone with no pets my saving grace during this isolation has been biking and walking, as well as sitting outside on patches of grass or stone walls far away from others. I saw my first water moccasin in the arroyo the other day, while simultaneously discovering three beautifully built cairns—those rock sculptures often found in nature—in the flowing water. On another walkabout I met the cairn builder, a lovely neighbor named Lynna who I plan to reconnect with when we are again allowed to visit each others’ homes. I long for that day when we can sit around a bonfire and share songs and stories.
     When I was in my 20s I read a book called Always Running. I forget the author’s name and what the story was about, but that book title used to come to my mind constantly in my many years of running around the world from Belize to Africa to Jordan and many places in between. Many of my travels were local—I’ve always loved to walk from Rogers Park, my home neighborhood in Chicago, all along Kedzie past stores filled with hummus and cardamom and hookahs into Logan Square and then east to the lake where I’d sometimes end up at Tibet House off of Sheridan for a meal and then back home to Rogers Park. 

Caren

      Always meandering, almost always alone, the city streets my path towards and away from myself. Walkabouts seem to keep me out of my head that’s sometimes filled with fear and worry, and into my body, and connected to the earth in a very real way.
     When I was living in the closet of a studio apartment off of Jonquil Terrace with a felon on the run while a grad student at the University of Chicago that was a different kind of running. The running of an addict creating an impossible life in order to not ever have to think about the reality of life and of growing up and becoming an adult. Today I aim to walk closer and closer to a life of calm refuge so I can be a part of this world and see what I can pack into the stream of life as my mentors say. I hope that the solitude and time I’ve been granted to practice meditation, cooking meals at home, plenty of time for exercise due to sheltering in place mostly alone will continue to lead me closer to a life of sublime beauty rather than trying to catch up to the Jones’.

‘We’re scared. They’re scared’

Gabrielle DuFour

     Many struggle with COVID-19 without ever being infected.
     Think of how worrisome this epidemic is to rational folks sheltering in comfort at home. Now, consider the mentally ill, the disturbed patients treated at a place like Mount Sinai Hospital — the psychotic and bi-polar, schizophrenic and depressed. Like your world, their worlds, too, are turned upside down, though they often have far less ability to cope with events that even the most stable person can have trouble processing.
     “We are seeing more patients experiencing more ill effects of emotional distress,” said Dr. Paul Berkowitz, chairman of the department of psychiatry and behavioral health at Sinai.
“Not just from fears and concerns associated with the virus, but social distancing and isolation. People are having less and less contact and are more overwhelmed. Perhaps they’ll not be checking in with family members, perhaps [they’ll be] coming off medication, relapsing on drugs or alcohol if that has been a problem. All of these make for ... more people coming in for psychiatric symptom exacerbation. We’ve seen that already at Holy Cross and Mount Sinai behavioral units.”
     Staff also must make sure their own stress and anxiety doesn’t overwhelm them.
     “I’ve been a disaster nurse for 25 years. I never thought I’d see this,” said Michele Mazurek, chief nursing officer for Sinai Health Systems. “We’re seeing hardened nurses having a rough time.”
     Early on, a doctor at Sinai contracted COVID-19. That rattled everyone.
     “When we had a caregiver test positive, it caused a lot of concern,” said nurse Adam Garrison. “It really brought the reality to the caregivers. It was an eye-opener: ‘This can happen to me.’”

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‘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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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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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.
 

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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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.
     "What?"
     "All that hubbub to ban headscarves 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.