The family super-spreader event: thoughts on a COVID-19 Thanksgiving

It was Black Friday, and as I held her hand, I knew that she would be dead within the hour.

My breath was stale inside my N95. The yellow isolation gown was moist and clingy, and the fogged-up goggles gave me that feeling that I was on an extended deep-sea expedition. Mrs. Carson was still occupying her bed, but really she was already gone. I had watched the respiratory rate creep up, and the oxygen drop despite the high flow cannula. Her tumors were suitable for immunotherapy, and she might have had a chance for more time with her family, but this was a different time, a different year.

As I walked down the lonely hallway, I was beginning to feel sorry for myself as my COVID Thanksgiving was dragging on. My stomach clenched as I felt my phone ring in the pocket of my baby blue scrubs.

“Hey lady, what’s up?” I said to my sister.

“We just made gumbo, and everyone is great. We miss you,” She said.

I was missing another holiday. As a hospitalist, I know the routine. Life goes on, but this was 2020, and nothing was normal.

“What are you guys doing tomorrow?” I asked, though I already knew the answer.

“The boys will hunt, and the girls will go shopping,” she said, “Just like any other year.”

I love my family. But as I thought about them crisscrossing the country to get together for the holiday meal, I felt something like anger. My mother just turned 70, and her husband has a good six years on her. My patient, Mrs. Carson, was only 60. For a second, I pictured my healthy, vibrant mother clawing at a BiPAP mask, seeing the light leave her eyes. As we spoke, I knew that they were all gathered together in my hometown, a mixing pot for contagion from Oklahoma, Colorado, Arkansas, and Utah.

Masks were a joke, a political intrusion. I knew that visitors from next door, neighbors popping in to say hello and giving a hug.

This year has been a strain. I had politely pleaded ignorance when my uncle explained how the hospitals were coding deaths due to Covid to boost their reimbursement. Yet I had seen six deaths in three days in the first wave, and they were real enough. I was lectured on the vagaries of the Death Registration System and comorbid conditions. Patients with multiple illnesses or advanced age were seen as a worthy sacrifice to maintain an economy. As if we were not all clods of the same earth! Warnings and pleas from doctors were made into political statements, a commentary on personal liberty, and the government’s intrusion. My occupation had become a family minefield, and I dared not but tread lightly.

As I spoke with my sister, I pictured my family together in the warmth of my father’s house. They were toasting one another and consuming vast quantities of delicious food—hugging and merry. But as I slung my stethoscope around my neck, the weight of the pandemic settled on my shoulders. My family was dancing on the train tracks. They were children playing with a revolver.

The heaviness of the situation, me in my world, her in hers, was too much to bear.