My Covid-RN-aversary

content warning: suicidal ideation

This is Cassie, and I’ve prescheduled this post to go live on 3/14, which is the first day I took care of a covid patient at my hospital last year. I know it was 3/14 because I made it my pinned tweet on twitter, the same twitter thread I made walking on my way into work that day.

This is likely going to be a mess of a post, so bear with me.

I’ve always had a tiny deathwish. It’s a little echo that follows me around and on an exhausting day whispers, “I wish I was dead,” into my ear for me to think. Don’t worry about me, it’s not very loud, and when things are good and I’m well rested and I have things to look forward to it mostly goes away.

It was louder when I worked on nightshift, just because I was literally tired all the time, but like, look, you’ve probably heard it too, your very own version.

Is there anyone who’s ever driven over an overpass who hasn’t thought, ‘You know, I could yank this wheel over right now’?

The key is to not get stuck there. (I know, because = therapy.) If you keep thinking like that, and it gets louder and sharper, then you need to do something.

The reason I mention this though is because it’s much the same thought process that made me set my alarm early on 3/14, so I could get into work before the assignment sheets were set in stone — and also I called dibs on my ICU’s private FB group the night before.

My thinking was this: I don’t have kids. I don’t do elder care. I figured after so many years of being a burn nurse in isolation gear my game was pretty tight and…basically?

I kinda wanted to see if I could hack it. (And maybe didn’t 100% care if I could not.)

Nurses at a certain level…aren’t exactly built ‘right’. (Or, perhaps more honestly, the job molds you into the person it needs you to be, and what it does not need is a normal human being. Normal people aren’t interested in hanging out with other people at their lowest moments, possibly covered in shit or blood.)

So that day (and for that working stretch) I had two possible covid patients. This was before rapid testing, when we’d piss through gear for days before we’d find out if someone actually had it or not.

One of my patients was awake and watching the television and getting frustrated that she was living out the Andromeda Strain.

The other was intubated and not doing so hot.

They were both in negative pressure isolation rooms with a little antechamber full of isolation gear between them. We didn’t know then that a gear shortage was right around the corner, it’d never even occurred to us we might run out. This was back when we still had shields for our CAPRs — hell, back when we still had CAPRs, little personalized positive pressure breathing systems that kept bad air out and filtered good air for you — and when we still thought said-shields should be disposable, rather than reused all day, every day, wiped down with bleach wipes.

(You will never not convince me that the scent of bleach is safety. From here on out, for the rest of my life, I will have a visceral scent association that bleach = safe.)

The awake person was pretty pissed, actually. She was a long term smoker and her nicotine patch wasn’t cutting it. She was on oxygen at home, and had COPD. She didn’t understand why we were acting like she was an alien. She was cranky and she was hungry and we weren’t letting her eat because we were worried we might have to intubate her. I think she was mad at us because we were treating her weird and I’m sure it scared her.

I wish I could say that I was totally fearless in there, but I was not.

Just because I always kinda-sorta-itty-bitty wanna die doesn’t mean that I want to die right-now-this-very-moment.

So while I put on a good game, because I’m nothing if not adept at hiding my emotions (when I feel like it), a part of me was still, “Why the fuckkkkkkk did we do this to ourselves, Casssssiiieeeeee. You have so much to live foooooorrrrr and so many books to writttteeeee.”

And she’s hacking with her smoker’s cough and all I can see is what I think of as germs billowing out of her mouth and plastering themselves against the outside of my shield’s plastic screen, covering me up in a fine film of death-mist.

Eventually our doctors decide they’re not going to intubate her, today at least, so they decide she can have some dinner, and I brought it in with me.

When patients are on isolation you don’t take anything back out of their rooms, so even their food comes in on disposable trays, and while I’m trying to air-lock-seal the door behind me so everything she’s coughing doesn’t get into my antechamber, while holding a flimsy cardboard tray, while my hands are shaking probably — I dump her whole food tray on the floor.

We both watch it fall.

The food she’s been waiting for for two days, just, gone, splat.

And of course it makes a mess everywhere, which I now have to clean up, and she starts yelling at me and I start apologizing because I do feel like an asshole but there’s nothing I can do. I get it clean, I hop out of her room, and I order her more, and then I go hide in my other patient’s room, who, while notably sicker, is at least not yelling at me, because he’s intubated and all.

I’m in there, doing something-something patient care, I don’t really remember.

What I do remember clearly is my coworker, Kellie, coming over to rap on the glass door with her fist. She gets my attention and then she holds her hands and crosses them into a plus-sign.

He’s positive.

For reals.

I’m in there with him.

And the fear of the still-possibly-imaginary-death-mist of my other patient evaporates as I realize I’m actually in the presence of it now, one hundred percent legitimately.

It’s easier to nurse when there’s no one watching, that’s for sure. No one listening to you when you talk to yourself behind your mask, psyching yourself up to do what needs doing.

I think that’s one of the reasons I like ICU, as opposed to other forms of nursing with more ‘lively’ patients. It’s a lot easier to be crazy there, because your patients aren’t usually awake enough to care, as long as their outcomes are good (as can be expected, given the scenario).

So as long as no one’s crashing, you can stand in the corner of a room for quite some time if you need to, with the lights off even, in the dark, sorting your shit out before it’s go-time. [(If you only knew how many nights I cried through shifts due to personal stuff and my own brain-hating me, with only the bodies of the patients I gently steered away from mortal reefs as witness. And a lot of the time, when you’re nursing, you’re too busy to worry about your own shit, which makes it a really good occupation for me, seeing as ‘getting too up in my own head’ is a perennial danger. (I am admitting to this here because I know enough other nurses have also nursed like this as well. Surprise! The people who care for you at your darkest hours are still human, and not robots.)]

Now that we knew he was positive, it wasn’t like anyone else wanted to come into the room with me besides.

Nor would I have let them. (You should’ve seen the contortions we went through in those days to make absolutely sure there was no reason for any other person or service to go into the positive rooms. We left nothing for the break nurses to do, if at all possible. Just think of how badly we want to keep you safe — we wanted to keep our coworkers a thousand-times safer.) ((And you should’ve also seen how the doctors were back then, standing outside the glass, peering in, shouting instructions at you, rather than coming into the rooms themselves…. I couldn’t entirely blame them, but more than one of them had the gall to call us brave because we were physically in the room with the patients, like we had a choice…like they apparently did.))

I did my job and kept swimming, that day, and the next. I think our tests were running 4-5 days then? And I hadn’t taken back my offer to volunteer for covid patients because I’m stupidly stubborn like that (so I lived on the covid wing for months.)

I got my pair back after a day off, and it turned out that the smoker didn’t have covid. I get to be the one to tell her, and she’s ecstatic about it. We talk about things — like, that particular week in March was when shit really started hitting the fan, and she’s been watching news that whole time, so our fears for her seemed really legit. It’d all sunk in, and she really was scared. She couldn’t wait to go home and go back to her life.

And me, I’m thinking, ‘Wow. She’s one of the few people in the US right now who actually knows that they don’t have covid — and the second she leaves here, she can’t be sure of that anymore, really.’

I did try to impress that on her, that just because she’d had a negative test, it was just a snapshot of a moment, and didn’t mean she’d be safe for an extended period of time.

She promised me she understood.

Meanwhile my other intubated patient…got better?

Like, way better.

We extubated him successfully.

This was before we knew how shitty the chances of that really were.

To us it seemed like a given, I mean he was in his 30s, quite healthy in all other respects.

It was kind of cheating to get a win so early in the game. It let me think that wins were possible, and it really set my expectations out of whack.

When we extubated him he’d been under for seven days, so it was like talking to a time traveler in a way. He had no idea what’d happened to him, whereas I got to talk to him about the world’s new horrific problems.

Turns out he was an Olympic swimming contender from his home country. He credited that for making his lungs strong. It seemed good enough reason as any — I was just glad he was alive, although I’d learn soon after that how much I couldn’t take anything covid-related for granted.

We were getting more cases, things were ramping up and people were starting to lock down and…well…you all know the rest.

At home, that first night, we started a new normal routine — my husband would open up the laundry room for me, and I’d enter in the house through that door instead of the front one. I’d kick off my shoes and strip naked down there and shove everything in the washer, before coming up to take a scalding hot shower (which is what I’ve done literally every shift since.)

(And wasn’t it lovely, when the lockdown was real? I could drive 85 mph home down empty freeways with MUSE blasting on the stereo as God intended (knowing if a cop pulled me over I’d get the benefit of the health-care-covid-worker-doubt) with all of my windows down, howlingly crying, hoping that the wind was somehow peeling the germs off of me, like if I just drove fast enough or rocked out hard enough I could reach escape velocity from…everything.)

Things are…better now.

For some definitions thereof.

Well, the whole vaccine angle, obviously. AND THE FACT THAT MY ICU JUST WENT TWO WEEKS WITHOUT A COVID PATIENT. (Way to bury the lede, Cassie!)

That was just recently!!! It’s over now, we’ve got them again, but just that brief break — you can’t imagine what a difference that made to all of us, all of our souls, at work.

If I’d known last year, scooping mashed potatoes up off the ground in that one woman’s room that this year would’ve gone down like this…man, I don’t know.

It’s probably a good thing I didn’t know how dark it’d get and how long it’d go on for — or how much tragedy and brokenness I’d see, participate in, and feel personally.

But it sure would’ve been nice to know that there would be, at the end of it (and I know just for me at least, and not for, say, the half-a-mil dead ppl, victims of our inept gov’t at the time) a ‘happy’ ending.

I still spent thirty minutes crying like a relative had died last week though, over a beloved sickly plant.

I am still — and will always and ever be now — tired of death. (My own I’m not particularly concerned with, but I could go the rest of my life and not need to see anyone else die, ever again, please.)

I’m still very mad at people who let me down this past year, and I haven’t figured out how to reconcile that with my on-going life. Should I lance and drain, or should I let it cyst and fester? And to some degree, I know that those aren’t even choices I get to consciously make, no matter how much I might want to, you know? Sometimes your psyche just does what it’s gonna do for you, without your input.

I do know — like everyone else on the planet — that I never want to go through another year like this in my life.

I don’t want to scream at a maskless woman in the grocery store as I have a panic attack that, “I SEE PEOPLE DIE ALL THE TIME. WHAT THE FUCK IS WRONG WITH YOU? WHY AREN’T YOU MASKED? WHERE IS YOUR MASK???”

I don’t want to shriek at my husband, who’s been home alone all day and has come down the stairs to see me as I take off all my clothes after a shift because he just wants to see another human in real life and say hi, as I shout, “GET BACK! GET BACK! GET BACK!”

I don’t want to tell idiots on the internet to stop being selfish dickweeds and how can they be so cavalier with other people’s LIVES, aren’t they ashamed of themselves and their actions?

I don’t want to have to scream through glass with an n95 on so that my coworkers can hear what it is I need them to bring me so I don’t have to come out of the room I’m in….

Basically, I would like to be done with shouting.

So I hope now as things (knocks on wood, crosses fingers, prays to a God she does not believe in) wind down some sort of protean new normal will arrive.

I don’t know what it looks like yet, and to be honest I haven’t started looking very hard.

I’m afraid that the act of accepting that it’s time to come out of the cave will somehow set a new wave of trauma off.

ICU nurses and authors have a lot in common, brain-wise, because as a nurse my job is to be the Worst Case Scenario detector, and as an author it’s my job to come up with savvy plot twists. Which all boils down to that I am smart enough to not be superstitious, while simultaneously actually being superstitious all the time.

Like a beat dog, in a manner of speaking, and boy oh boy, did covid beat me down.

But I’m here. Still. Despite not always taking the best care of myself, despite volunteering like a dumbass, despite all the tears, the days I couldn’t get out of bed, and the days my alarm went off for work and I had no choice but to —

Still.

Here.

I know it’s a survivor’s prerogative to hype yourself up over having overcome a thing, which isn’t fair in the least to all the people who didn’t, who likely didn’t have a choice, and whose lives had every bit as much meaning to them as yours does to yourself (and possibly more so, their presence or absence of deathwishes depending.)

So it’d be bullshit of the highest form to say that I’ve Learned Things About Myself or that I Can Survive Anything Now, because…have I really? Will I? Could I?

Perhaps more importantly: would I honestly want to?

The author in me wants to turn this into a story (like I do to most anything else) because stories are sexy and fun and they always have meaning. Beginnings, middles, ends, and ‘oh wasn’t that nice, look at all the friends they made along the way!’

But I think it’d be unfair to pretend that this past year was anything but a shitshow of the highest order, that half a million people died for nothing, and that the psychic scars of that — and of the cognitive dissonance of many more millions of people not caring — aren’t going to resonate onward for a very long time.

So I’m not gonna say anything braggy here about ‘surviving’ because yee-fucking-haw, I met the basic demands of humanity when needed, and part of me even enjoyed it, because I am a person who likes to stare into abysses and run towards spinning knives.

I am very glad the worst of it is over. But I know for a lot of people (and perhaps even me) there’s still more shockwaves to come.

That said, though….

One of the shitty things about being an author is that you never know when to feel publicly excited about anything.

Most people don’t know how book publication works and what a curse this is to bear. You make a sale, but you can’t announce it till the publisher does in Publishers Marketplace like six months later, and by then the joy’s seeped out of the moment because your neurotic little brain is already worried about pulling off the sequel. Foreign rights, TV options, etc — everything’s always hush-hush and on someone else’s timeframe, and frankly it’s exhausting.

So when I was doing traditionally pubbed books — I learned to celebrate secretly, with trusted friends, in the moment, because ‘wins’ in the publishing arena are so few and far between.

And so let me tell you this — we’ve all made it through a year here. I’m absolutely sure all of our pandemic-a-versaries have occurred already or are just about to come up.

I know shit was intolerably sad for so very long. I saw it, and I felt it in my bones. I’m sure some of you have suffered much deeper personal losses than the ones I merely bore witness too, as a bystander.

It’s hard to scrape those shadows off of you, I know that too, especially when we’re all riding this same trauma-pterosaur together, heh. It’s ever so easy for things to echo, and for any joys we do feel to try to diminish them, because we don’t want to hurt anyone else along the way.

It’s gonna be really fucking rocky here for a long time — so maybe I was wrong, and I can guess our new normal — because so many people are so damaged, and it’s going to take them so very long to put themselves back together, if they ever even can.

But at the same time — if you’re reading this — you’re also Still Here.

With me.

And that’s worth celebrating, a little. In the moment.

I don’t want to gloat, but, fuck — we’re still alive.

Sometimes through no fault of our own, and despite our best efforts even, heh.

So yeah. This past year sucked. Hard. Innnnndubitably.

But we’ve got the rest of this year, above ground, ahead of us now.

And I know it’s not always healthy to shut the door on the past — and I’m not asking you to do that, in no way shape or form.

But at least those of us who’re still here — we’ve got a future now.

I was super tempted there to say something grandiose like, ‘So spend it wisely’, because that’s a thing like a book protag’s wise mentor would say, heh.

But nah, don’t do that! Just be free, get free, do whatever the fuck you want, get laid, get high, just hold onto life now that you’re sure you’ve got one. Figure out what you really want to do and then do it.

I’m not going to dare to try to put a positive spin on a year of horrors.

But at the same time, after what we all went through communally — it wasn’t the end of our stories, and it wasn’t the end of us. It’s OK to be scared and sad about what happened…but if you’re moved by any joy right now, as we all stumble out of the darkness together, grasp it with both hands.

Shamelessly.

We’re all breathing, my loves, and we’ve all got more time to go. And, personally? I’ve got more books to write, more overpasses to ignore.

More soon,

— Cassie