May 28, 2020
Brooklyn, New York
Dear Adam,
I was walking back to my place in Brooklyn just now, when the cheers erupted. They still happen every evening at seven o’clock. I’m sure you’ve seen the videos. My neighbors lean from their windows or step out onto their balconies, and start hooting and clapping. Some bang pots and pans, others shake bottles filled with metal coins. I try not to be on the street when it starts, especially if I’m walking home from a long day at the clinic, like I was today. All that applause brings up hard thoughts, and I’ve never been one to shed tears in public.
As you know, I’m a doctor, still working in the only public tuberculosis clinic left standing in New York City. Practicing medicine in this city is a singular experience, and those of us who’ve done our medical training here form a kind of extended family. Like the members of any oversized family, we lose touch with one another at times, but we don’t forget that we’ve been together during some of the toughest moments of our lives, and so all it takes is one phone call or private message on social media to pick up exactly where we left off. That lasting intimacy is a privilege, but it’s also the reason that, lately, we’ve been shaken by a lot of loss. And whenever the cheers start up, I begin to think of the losses.
A nurse I know comes to mind. We worked together years ago in the emergency department up at NewYork–Presbyterian. I could tell you that he was one of the most capable nurses I’d ever known, a man who could throw two IVs into a patient and draw six tubes of blood faster than I could write the orders to do so, but that wouldn’t explain why I think about him still, over a month after he died of COVID-19. A man’s worth, after all, cannot be measured by how well he performs his duties, even if he performs them right up until the end. So what stays with me now is not how good he was at his job, but rather that moment years ago, when in the wake of a chaotic shift from the Ninth Circle, he placed a hospital-issued plastic cup of apple sauce on the workstation counter between us, a running inside joke whose punch line I now no longer recall but at the time sent me home in a burst of laughter. Funny when all that remains of a person is the memory of how they made you feel. I think about the joy, the authentic human energy, my friend released into this world while he lived, and I grieve for how much of it was lost when he suddenly had to go.
At these moments, my thoughts also turn to my sister, Maria, a cardiac care nurse, who’s alive and healthy, although I don’t envy her, working in one of the hardest hit hospitals in Brooklyn. When we have time, we call and check up on each other. Healthcare worker morale is low, and my sister and I are no exceptions. Sure we’re used to taking care of the sick and dying; it’s what we trained for. We just didn’t expect the sick and dying to be our friends at work, or possibly one of us. We talk about the debatable utility of a negative nasal swab, the unknown implications of a positive antibody test, the vaccine trials that seem to be moving too fast for their own good. Mostly we talk about the unknowns, which doesn’t make us uncomfortable. We are women of science, and science is built on the hypothetical, not on hard fact. But when the conversation turns to the personal, things do make us squirm. We tell each other that we’re okay, that we just have to push through, as if saying these bland words aloud will convince us that they’re true. But my sister, unlike me, has a daughter, who just turned three. Is it awful to say that that’s another thing I don’t envy her for? The burden of knowing that the decisions you make—how often you take off your mask during a shift, how much time you spend in close contact with a new patient—are not only decisions you make for yourself but also for the child who needs you to go on existing. Sometimes, after my sister and I hang up, I replay the same ugly question over and over in my head: Which would be worse, my death or hers? Right or wrong, my answer is always the same: I’m not the one with the daughter.
And then of course I think of my own patients. Tuberculosis is not COVID-19, but there are small similarities. They can both evolve into deadly respiratory infections, and both, as I write this, are global pandemics. You might recall that in the early ‘90s, tuberculosis was ravaging this city, or I should say, the people most vulnerable in it. And although rigorous public health measures have since flattened its curve, the tuberculosis bacterium still lives on in these vulnerable communities. My patients are homeless, or newly arrived to the country, many without insurance, some without papers or the power to prove that they legally exist here. If they come into the clinic (though many now refuse), they’re more anxious about COVID than they are about their tuberculosis, and perhaps rightly so—people of color, the working poor, the out-of-work poor all account for a disproportionate number of coronavirus body bags. So in the clinic, we often spend time talking about the virus, but when our fifteen minutes are up, it’s back to the overcrowded shelter, back to the one-room apartment shared by a family of six, back to the unforgiving streets. Aside from a mask, I have little protection to give them as they go. And I am left with the painful impression that a doctor with no answers is no doctor at all.
My best friend from med school called me the other day. She’s a cancer surgeon in Manhattan, and is about to finish her fellowship training, over a decade after we both started. This new term “healthcare heroes” is so fucking lame, she told me. I asked her what she would suggest as a replacement. She wasn’t sure, but she said that for so long the general consensus had been that we are all a bunch of over-privileged, rich “jerks,” and only now was everyone pivoting and calling us “heroes”—now, when they wanted us to risk our lives with no protection, to separate from our families, and in the case of residents and fellows, to do it for little more than minimum wage. It’s opportunistic pandering, she said, aimed at stroking our egos so that we’re willing to throw ourselves into the flames.
She had a point. I thought of this country sending young boys off to war pumped up on hero-soldier myths with no understanding of their role as disposable pawns. And tonight, when the cheers rained down, and a few of my tears with it, I again considered what she’d said, and realized that even if she were right, she, along with my sister and my colleagues, had always been my personal heroes, long before coronavirus had sounded its battle cry. And so they will remain, long after this virus is contained.
Yours in hope and solidarity,
L.B.
In lieu of payment, our friends and contributors to the Corona Correspondences are dedicating donations to nonprofits and independent businesses in their communities. Browne’s contribution will be directed to The Bowery Mission.