I’m Ok

By Harrison Reed, PA-C

When the world shut down, we made Old Fashioneds. One part bourbon, one part simple syrup. A dash of bitters. Served over one of those huge ice cubes they use in “modern speakeasies.” Natalie liked hers with an orange peel and a maraschino cherry. Sacrilege. I told her it’s supposed to be a cocktail, not an Edible Arrangement. She just laughed.

The virus had spread across the internet before it had spread across the city. Terrifying, sure, but still a little exciting. The risk felt theoretical. I signed up for extra shifts in the ICU and, to avoid human contact, rode my bicycle in to work past a century’s worth of war memorials. That must have been what those soldiers felt, too: a desire to see some action before the whole thing ended too soon.

But I remember the first patient, the one who arrived before we had tests or knew what this sickness really looked like up close. She hadn’t come from anywhere suspicious, didn’t look any different than me, gave us no reason to put on more than a pair of gloves. But her disease broke all the normal rules, ignored all of our interventions, just acted strange. She died so fast.

***

Natalie and I had nowhere to go, so on date nights, we stayed at home. She wore fancy dresses, put swirls of white and silver makeup around her eyes, and clicked around my apartment in high heels. She deserved something classy, so we made negronis: 1 part Campari, 1 part gin, one part sweet red vermouth. It’s a bitter drink, a taste your mouth initially rejects but, with sip after acclimating sip, becomes something you crave.

For dinner, we made pupusas with ingredients from her parents’ now-empty restaurant. We pretended we were hosting a cooking show in my kitchen in front of an imaginary studio audience.

Now, Natalie, tell us: Is this how a pupusa is supposed to look?

Not exactly. But, folks at home, it’s important to remember that something can still be wonderful and delicious on the inside even if the outside is, um, charred.

***

That first wave of infections split the city in half: those who could transform their spare bedrooms into offices and those who had to venture from their homes to keep the machinery of society grinding forward. Our charge nurse, scanning the growing list of ICU admissions, said the only risk factor that seemed to matter was a name ending in “z.” Like Gonzalez or Rodriquez. They were the ones with three generations under one roof, the ones still showing up to drive rideshares or cook food or clean hospital rooms.

As the weeks dragged on and their savings dwindled, Natalie’s parents decided to re-open the restaurant.

***

On the first warm day of the year, we made Moscow Mules. Fill a cup with ice, dump in some vodka, and top it off with ginger beer. Slice up a lime—the ones you washed with soap and water as soon as you left the grocery store—and squeeze a few wedges into the mix. It’s properly served in a copper mug but, if you’re leaving the house, you can pour it into a metal thermos for the same effect.

The parks were closed so we brought blankets to the grassy medians of an empty office building parking lot. We drank and baked in the sun while Natalie’s dog, Eddie, sniffed at every unfamiliar shrub. By the third Mule, if I closed my eyes and laid back into the grass, I could almost hear waves crashing on a beach a thousand miles away. Natalie rested her head on my chest and I wondered if she could hear my heart thudding with a slow, creeping panic no drink could sedate.

***

I no longer recognized the ICU; the patients there were a funhouse mirror of human physiology. They perched on a ledge between disaster and catastrophe. Lungs ravaged beyond recognition struggled to extract each molecule of oxygen from the air while their other organs somehow soldiered on until they fell, one by one, casualties in a brutal war of attrition.

There was no more rulebook. The sturdiest patients died in a blink while the sickliest dangled above the abyss for weeks, teasing us as their vitals plummeted only to stabilize before we had even donned our plastic protection. It was like practicing medicine on another planet. Gravity itself felt different.

***

Natalie helped at her parents’ restaurant as carry-out orders grew from a trickle to a constant stream. By day, she managed multi-million-dollar government contracts; by night, she poured to-go margaritas. To limit their exposure, we created a system of pseudo-quarantine based on the wild guesses of experts and calibrated to our loneliness. After each shift in the ICU, I counted the days and waited for some fever or cough to develop. When none did, we planned a date at home: horror movie marathons, wine and watercolors, do-it-yourself spa nights sitting on the bathroom counter.

But weeks could pass before a perfect, safe window opened. I pretended to rage against the injustice of it, but part of me had already adapted to the isolation. Even craved it. The idea of people had become repulsive. Our hardwired social instinct, our evolved closeness that had once ensured our survival, was killing us. Now, if someone dared to set foot on an elevator at the same time as me, he was a threat. I pictured my fist flying toward the side of his face before I blinked the image away.

Most nights I just lay on my couch, unable to move. Every cell in my brain was lead.

***

That summer, a Black man was killed by a police officer. The weight of that death—just heavy enough on just the right pressure points—broke open the country. Protests, fueled by centuries of injustice, moral rot that had long been plastered over and ignored by those in power, rang out across the city. We didn’t know what to do—barely understood the pain echoing around us—so we joined our friends to shake our fists at government buildings. We wanted an enemy we could finally see, one we could scream at, one we could hurt.

But the afternoon sun caramelized our outrage into a lazy defiance and, when the rubber bullets and tear gas flew our way, we scattered. We were just part-time activists with the privilege to come and go from the public discourse as we pleased. And since our dedication to the cause kept regular business hours, we were able to clock out by happy hour.

The Dark and Stormy: a few ounces of dark rum over ice, topped off with ginger beer and garnished with a lime wedge. You can also make a Layover—take a mini airplane bottle of the rum, pull off the cap, and jam it upside down through the hole at the top of the can of ginger beer—if you have places to be. We didn’t.

***

I stopped running. It was too hot outside and, most days, my jogs devolved into aimless wandering while my mind raced through anxious avenues and back alleys of despair. The gyms were still closed, too and, like most people, I got fat. Natalie still wanted to spend time with me, for some reason. But the prospect of prolonged social interaction began to feel like a grueling obstacle course. Each day, I weighed the options and chose the acute disappointment of canceling plans over the slow suffocation of spending hours of time as an actor, playing the role of a functional human in a healthy relationship. Every time I hit “send,” I pictured her standing in her parents’ house, purse in hand, summer dress and heels on, eye makeup perfect, texting back: “what the hell?”

***

Two pregnant women arrived in the ICU, lungs ravaged. Both of them lost their babies.

***

Natalie and I finally made plans to get away. We found a house at the top of a mountain, isolated by several hours of winding road that snaked through the Appalachians. It had a back porch that overlooked a valley where the sun would set each evening over the distant mountain range. We could sit there with our coffees in the mornings and our wine glasses in the evenings. We could chase Eddie as he scrambled along hiking trails and barked at strange birds. We could sleep in and forget about hospital beds and broken lungs and emails and margaritas to-go.

Natalie bought a week’s worth of groceries and drove with Eddie to pick me up for the trip. She found me on my couch, staring at the ceiling, with no bags packed. I expected her to be angry, to cross her arms and scold me, to yell or scream. But she just sat down next to me on the couch and cried.

“I know it’s over,” she finally said through sniffles, “but I just don’t want to leave.”

I wrapped my arms around her and squeezed her, said “I’m sorry” until the words sounded funny in my ears. The guilt that slid up from my chest and sat in my throat was the first thing I could remember feeling in weeks. I walked her to the door, kissed her on the forehead, and said goodbye.

“You’re a good person,” she said. “I hope you get the help you need.”

The door clicked shut behind her.

***

A third mother arrived in the ICU, this one just weeks from her due date. Her oxygen saturation dropped and her blood pressure plummeted and the OB/GYNs performed an emergency C-section. Her belly bled for days as she gasped for air. When the numbers were lower than any of us could stomach, we decided to put her on ECMO—a bedside contraption that sucked blood from her body, ran it through a whirling oxygenator, and swept away the carbon dioxide before pumping it right back into her veins.

She was awake when we put in the cannulas, garden hose-sized tubes that we jammed into her jugular and femoral veins. She stared at the ceiling the entire time and whispered dios, dios, dios until the pink foam from her lungs filled her mouth and muffled the words. In that moment, as I sweat under layers of protective gowns and fluorescent lights, all I could see in the young woman’s face was Natalie. Maybe it was because they were the same age or had the same nose. Or maybe because her eyes were so full of pain.

I later heard that the baby had survived. But after weeks of blood vessel-constricting medications and invasive procedures, the young mother had her feet and both of her hands amputated.

***

It’s funny how the framing of a situation can change it entirely. You can live in a luxury penthouse apartment in a downtown high-rise, young and experimental, enjoying the best of the bachelor life. Or you can be a fool who paid a small fortune to live at the top of a jam-packed concrete petri dish, spending the prime of your life all alone, running from invisible monsters.

After Natalie left, I made Old Fashioneds. I didn’t need orange peels or maraschino cherries anymore. The fancy ice cube: take it or leave it. I’d even forget the sugar; I wanted the burn of the bourbon to linger on my throat like a constipated sob that won’t come up. I wanted to feel something like the night Natalie left.

I made friends with the owner of the liquor store on the corner and he ensured my brand was always in stock. I made a deal with myself that I wouldn’t let the level in the bottle drop more than one-fourth on any given night. Or maybe a third. Definitely not more than a third. But I had to be sure I always had something to drink at home before the stores closed.

I read an article that said the pandemic had ushered in the return of the cocktail hour, a forgotten institution that officially marked the end of the workday and the start of the evening. It became my only real marker of time, the only part of the clock that mattered.

***

Whatever reprieve the summer had brought to our hospital was over. The leaves outside changed and sick patients surged back into our ICU. But our fighting spirit just wasn’t there to meet it. Inside the unit, our beds filled while outside its walls, the world debated if the disease—and the deaths and suffering it brought—was even real. They accused us of lying, of perpetrating a hoax. We had gone from heroes to heretics.

***

News of a vaccine began to circulate and the hospital chattered with rumors: who would be first in line, who was in charge of the distribution, how soon we could save ourselves. “I am so ready to be done with this,” one of my coworkers said. “You can jam it straight into my eyeball.”

And sure enough, like some bizarre Hallmark Channel movie, the vaccine arrived at our hospital’s doors just in time for Christmas.

“How do you feel?” the tech asked me after she pulled the needle from my arm.

“I’m just glad this is finally over,” I said.

“Me too.”

***

My arm was still sore when I decided to finally make a pilgrimage home to see my mother. A trip that normally occurred every few months had been postponed for over a year. I dared not pack into an airplane while the virus still swirled around us and most of the people I cared about still couldn’t get a vaccine. So I borrowed a friend’s car to drive the 13 hours home.

I tried to clean up my apartment before I left. I put all of the old liquor bottles into a trash bag to take to our recycling center. But the bag was almost too heavy to lift and when I hoisted it over my shoulder, the bottom tore open and the bottles crashed to the floor. I left them there, in a pile in the middle of my kitchen, like a fallen, noxious chandelier.

***

It is now the waning hours of the drive and my car’s headlights cut through the darkness ahead of me like a photonic snowplow. I hunch forward and wrap my arms around the steering wheel as a dull pain gnaws at the center of my torso. I wonder if the months of drinking have finally sent my pancreas into a tailspin. Or if heartache was never really a metaphor.

Along the sides of the highway, at the edges of my headlights, the shrubbery shifts to the familiar foliage of my childhood. As I near my hometown, landmarks and street signs come into focus. They’re recognizable but not quite the same, like deepening creases on the face of a long-lost friend. Those last few miles, I don’t need directions or GPS. I just lean deeper into the steering wheel and let the car glide to my destination.

I pull into the driveway and turn off the headlights. I kill the engine and listen to it pop and click as it cools in the midnight air. The dark silhouette of my mother’s home sits in front of me, smaller and more fragile than I remember. I crack open the car door and step into the night. I walk the several steps to the front door of the house on cement feet.

The door opens before I knock, and my mom stands in the entryway. She looks at me and offers something between a smile and a cringe and I wonder how much of her son she still recognizes. She beckons me inside and says: “How are you, honey?”

I want to launch myself forward, to wrap my arms around her and bury my face in her shoulder. I want to open my mouth and let out all the trapped sorrow in one feral howl. I want to retch and gag until I have expelled all over her floor every ounce of pain I had drowned in every liquor bottle. I want my eyes to stream until the tears have left me bone dry, leathery, mummified. I want to fall to my knees and let gravity push me into a shaking, quivering pile on the cold tile. I want to scream until my own eardrums shatter, squeeze my fists until every bone in my hands is dust, and then reach deep into the cavern of my chest and excise the throbbing, aching, festering mass and hold it in my bloodied hands for all the world to see.

Instead, I just smile and reply:

“I’m OK.”

Epilogue with Harrison Reed

Harrison, thank you so much for your vulnerability and honesty in sharing your experiences on the frontlines of COVID. How are you doing today?

Something I’m reflecting on since reading your narrative is the loneliness and isolation that COVID invited in but still exists today for many without social or emotional support. We know that loneliness poses health risks. In fact, Surgeon General Vivek Murthy called loneliness an epidemic. How do you see this show up in your current work and what are your thoughts on how healthcare professionals can make small changes to help?

What would you say to healthcare professionals who are still hurting and need healing from their own experiences and traumas of being on the frontlines of COVID?

This newsletter is rooted in helping us remember our shared humanity through the stories and experiences of others, so as we close this chapter, what dose of humanity do you want to leave readers with today?

About Harrison

Harrison Reed is a physician assistant who practices critical care medicine in Washington, D.C. He is the clinical editor of The Journal of the American Academy of PAs (JAAPA) and the recipient of the 2022 AAPA Publishing Award. He is the creator and curator of HarrisonReedWriting.com.

🔗 To connect with Harrison, find more of his writing, and learn more about his courses and tips for clinicians interested in medical writing:

LinkedIn | Twitter | Instagram | YouTube | Harrison Reed Writing | The Contralateral