Tales from Isolation: Day 20/Update #20

I have been isolating with my family since March 11. Today is day 20, the “Clean the vacuum HEPA filters day,” a day which I have never before reached in my 47+ years on this planet. It is also the day which my 14 year old begged me, with actual tears in her eyes, not to run through the house naked yelling about farts while she was on a Zoom call with her friends, a day which I think is also a first, but I’m not as confident about that as the vacuum filter thing. (She’s already in therapy, I might as well make it interesting.)

Besides the farting – hey, we’re a predominantly vegan family currently living off a large inventory of dried beans – and, worse from my perspective, the vacuuming, I’m doing ok. A number of you have been so thoughtful to check in, so I thought I’d go ahead and post an update. 

After a few days of paranoid phantom symptoms, I feel fine. I vacillate between loving my family to pieces and wanting to kill them, living in a pigsty and obsessively cleaning everything, preparing healthy meals and gorging on chocolate … so, basically status quo. 

As for the medical piece, my doctors tell me that my targeted therapy medication does not render me particularly immuno-compromised in the same way that traditional chemotherapy would. I do have a slightly depressed WBC from 6+ years of treatment, but it’s not too concerning. My lungs are a little scarred from the initial disease damage, and I do have a chronic issue with mild congestion. These things don’t raise my risk of contracting COVID-19, but they may elevate my risk for severe complications.

Here’s what weighs heavily on my mind right now: Like the author of this article (an MD who also has a Stage IV Lung cancer diagnosis), I worry that should I need hospital resources during a COVID-19 system overload, I would be determined to be lowest priority, denied care, and sent home to die. 

TLDR; this excerpt from the article sums it up: “Medical leaders in Washington state quietly debated a plan to decide who gets care when hospitals fill up. Not many details are out, but the arguments echo a similar discussion in Italy, where an intensive-care unit protocol withheld life-saving care from certain people. The rejected were those older than 80 or who had a Charlson comorbidity index of 5 or more. With my diagnosis of stage IV lung cancer, I score a 6.” Similarly, this Newsweek article details how “Some of the medical conditions [in the Alabama plan] that would be excluded from ventilator use include cardiac arrest, severe trauma, dementia, metastasized cancer, severe burns, AIDS and ‘severe mental retardation.’”

Oh, shit. Despite the fact that I’ve been doing well for 6+ years, working hard to help others with this disease, raising my family, and isolating like a mother-trucker, if I end up in an overcrowded hospital next to some shit-for-brains 20 year old Spring-breaker, I’m the one that’s going to get denied treatment. 

I’ve had to be painfully explicit about this potential deprivation of care situation with my teens, who desperately want to see their friends “who’ve also been isolating, Mom!” But, I can’t be sure if they really have, or if everyone in their household has, and I can’t take the risk. Because my risk is much greater than the risk in most families – not that I’ll get it, but that if I do, I am far more likely to get screwed by the system.

And, I’ve been in the hospital when I couldn’t stop coughing, struggled to breathe and needed O2. It was pretty terrifying WITH the full support of a well-resourced hospital. I shudder to think what that experience would be like without that support.

If you are one of the people who’s been staying home, please continue to do so. Even in places like California where we’re beginning to see the curve-flattening benefits of our quarantine, the coming weeks may be an inflection point, making isolation even more crucial. If you are one of the people who isn’t taking this seriously, bending the rules about leaving your house, defining “essential” activities more liberally than is necessary, resenting the restrictions, I beg you to please reconsider. Your actions jeopardize the lives of thousands of people who are going to get slotted behind you for scarce healthcare resources (as well as healthcare workers exposed on the front lines, whom you personally might need). In truth, very, very few of us have any essential work outside the home in the next several weeks. Besides, you wouldn’t want to miss out on some fantastic opportunities to clean your vacuums or torture your teens, would you? Please stay home. Thanks.