Friday, March 20, 2020

The Silver Linings Of COVID-19. The Life Choices We Surrender To A Virus.

There must be silver linings in the storms that life inevitably delivers. Lately I’m struggling to find them, identify them, and, keep a rosy eyed perspective as I attempt in earnest to magnify them.
It is the middle of March 2020 and the entire globe is focused on the pandemic looming around us called COVID-19. It is the fodder for previously produced thrillers too numerous to mention and the story is actively unfolding a little deeper and gloomier with each passing day. Everything that provides us our day to day normalcy is either under closure for safety reasons, or, threatened to become the next place shut down to ensure self- isolation to attempt to stop the spread of a tiny bug our immune systems won’t recognize and thereby might not respond to appropriately to save its host.

Fear based hysteria is influencing our very scientifically based safety precautions. The world has been our guinea pigs and we should remain thankful that we aren’t Italy, S. Korea, or China. There is some small saving grace in not being first country to start red dots that balloon into whole country-wide zones. You can learn a lot from the first guys mistakes, or misgivings. It isn’t a hoax, and this is our dress rehearsal. Fear is a great motivator and based on the grocery store brawls over toilet paper and sanitizers it can be the seasoning to remind us we have yet to evolve.


The COVID-19 mania is causing whole nations into forced quarantines. Communities are losing swaths of citizens and the novelty of a new big possibly highly virulent disease has scientists reeling over understanding it as fast as is humanly possible. We will have a vaccine for this faster than ever seen before in history. This will happen because we are so motivated to find it, and so practiced in the methods employed to do so. With each great advance comes an ever-increasing expectation. For me this virus is pure novel once in a lifetime science. Biology meets marvelous fragility. You cannot admire the incredible brilliance of microorganisms without conceding to their immense power. Take yourself out of the equation and the scales of survival are all pushed to equality. There is hope in mortality. Where one dies another survives. Without balance there is no beauty and humility. I know it sounds crazy to admire a virus, but we cannot convince ourselves we are so superior we forget to preserve the lives around us, can we? It is the silver lining to the once in a lifetime disease du jour.

Personally, for as much as I want to gawk and pine as the self-proclaimed science geek addicted to COVID-19 melodramas over the real-time emerging information and science of this new disease with the way it so effectively fertilizes its mark on the world, I have to take myself out of 30,000 foot view  and refocus on the other fish I have to fry. I have a hospital to oversee and a real fear that one disease for one species will strangle the ability for us to care for any other species. Every veterinarian I know went into vet medicine because we chose the other species over our own. The silver lining of unconditional love compelled us to serve one and allow the other to pay us for that. You learn fairly quickly that your heart may always lie with your furry patients, but your solidarity lies in the details of disease and its clear killing allegiance to its victims. There are times you must choose to protect the human at your adorable furred patients’ expense. I also have to brace myself for the lunacy of paranoia that people will abandon, or kill, their pets if the fake news starts concocting stories about that one 17 year old Pomeranian, who may, or may not, have or not had, we think it was two or three times tested? from a yet to be deemed credible internist in an otherwise yet to be relied upon country (China) who would rather control the news, their people, and their own reputation as being “powerful” than being honest and transparent. For now, your pets are safe. They won’t give it to you, get it from you, and they are still the best chance any of us will ever have at unconditional love as we are potentially put on house arrest.



My mom has been one of the billions of collateral victims held hostage by COVID-19. She was diagnosed with her stage 4 metastatic breast cancer at about the same time corona made its first victim. Her story of the duel between her body and its terminator started as COVID-19 patient zero found theirs. Her disease story started in December 2019. It has been a many months long process of finding her answers, providing her care, understanding her options with each choice and predicament, and uncovering resources and services to optimize an acceptable end of life plan. Its been a lot of shit to dig through while accepting the losses she never saw coming. For most of January and February she was in a hospital. She was released from that to her rehab facility early March. There was a choice here, but in retrospect it may have been the wrong one. At that time COVID didn’t exist on the radar. The choice was hers and the options were to go home, or, go to physician, nurse and therapist assisted 24/7 care? She wanted to go home. But she knew she couldn’t manage there in her current state. If she went home she had stairs to ascend and descend on her toothpick bones with lungs that wouldn’t propel her and an aluminum walker in her protective arsenal. She was now expected to be an 80-pound pack mule who couldn’t breathe. It wasn’t going to work. We, her family, the hospital staff, the social workers, everyone in her life, convinced her that a “short stay in rehab was her best chance at recovering some lost ground to be able to go home.” I put it plainly, “we are setting you up to fail, again, (this would be the third strike), at home. Your next stop, slip, bad card, etc. is hospice.” (Why I feel so compelled to tell her what no one else wants to say out loud to her has me facing the only regrets about this whole debacle that I expect. Personal notes; What the heck am I supposed to do? Lie? Purse my lips? Just live blissfully with the crowd in denial? I honestly don’t know. I do know that she prefers I shut up and act stupid. Just talk about the happy stuff” she pleads. I’m honestly trying).



My mom was transferred from the last 2-week hospital stay that proved fruitful in both diagnosing her and getting her indexed vocabulary of opioids in order to the rehab facility in Bel Air, MD. She was moved from an hour plus away hospital to a rehab facility within 30 minutes. We were hopeful that with her willing commitment to get a team approach to her muscle weakness, walker and oxygen dependency that she could go home stronger than the hospital bed, massive opioid slumber that pain eradication costs you.  She has nurses who provide a never-ending list of medication options on a daily rotation. She is now an expert on requesting and medicating the pain away. In vet med we caution every patient to find their “lowest effective dose.” That combination and frequency that permits the smallest amount of medications to produce the most tolerable degree of comfort without the sedation, if at all possible. My mom just wants pills delivered and pain eradicated no matter the consequence. There are lots of consequences. Desire to ambulate, breathing, and constipation rank amongst the greatest victors in the exchange. She also has lost the ability to manage these on her own and going home as such is going to be a real challenge.



It is hard for a fighter within me with no white flag in my wardrobe to concede. I cannot find a silver lining with all of her decisions. And yet she is holed away in confinement and I cannot meddle. Maybe that is both of our silver linings?

I call her daily. Dig for little tidbits of information. The interrogator in the room with civil rights and a fifth amendment defense strategy. She knows I dig. She attempts to pull the parent card, I usually remind myself to bow, she has the reaper to bargain with, why waste energy on me? There is her silver lining in having a common enemy and an hour glass with sand slipping away.

When we first went to visit her in the rehab facility I was taken back by the residents all lined up in their wheel chairs in the hallway outside their rooms. Some looked up at you, few smiled, almost none interacted if you said “hello.” They were the institutionalized form of ‘stoopers,’ the term we use in Baltimore City for the people who sit on their front steps and watch the city pass them by. When I was at the Academy we had “fall out.” We would all rush out of our rooms and line up like little soldiers, head bowed, cap covering our eyes (you are only a real person if you have eyes, I think was the point?). Shoulders pressed back, hands plastered to our sides, pushing the wall back into our rooms awaiting the next shouted directive to remind us that we had no place in the world and no one to save us. It was shit. I don’t know why I had no rational cognition of the person I was shaping myself to be under anyone’s command. Yet all these came flooding back to me as I walked those halls the first time all the while thinking, these people must be lifers?




I called her yesterday.
“Hey mom, what are you doing?”

“I’m in the hallway. I couldn’t stay in my room any longer, and I am not going to become one of those bed ridden people.” For her it is a simple step away from her worst-case scenario and not towards mine.

She is there. Locked away. Safe. And I am on the outside trying to not get swept away in the hysteria. Trying to understand all of the implications for all of my actions and decisions and knowing that little ferocious bug has me within my straw house in his favor.


At the finale of every long hard health battle beside the ones you love most there is a feeling of shedding the weight from your shoulders so heavy you couldn’t move out from under it until they passed. After yearlong battles with Jekyll, and before him Savannah, my beloved beagles I spent a year each fighting for and doting over, despite each day just being an accumulation of massive causalities that they gained along the way when they finally lost their battles there was this overwhelming feeling of relief. The burden, both emotional and physical, was now behind me. There was also immense guilt in that, but it was still true none the less. I can’t go see my mom and she can’t make me feel guilty, or neglectful, or even argumentative in my interventions as the over bearing guardian we swapped crowns for. Corona has taken these responsibilities off my plate. I cannot micromanage her, and, she has given up on that influencing her recovery. There is time passing between us that we don’t have. I can’t watch her with my calculating ever scrutinizing analytical medical eye. (As Diedra, my sister would me and say, I always have an agenda.” And she knows she is right). I am supposed to see what others don’t. I am supposed to be one step ahead of her next pitfall and help her side step it. And now remotely, my critiqued questions are blunted, and, or, more aptly ignored.


Her silver lining has been in the prisoners feeling of isolation and the oddly placed security that provides. She has people around her. She finds great comfort in that. Her self-imposed home isolation wouldn’t afford her that luxury. If she was at home she would not be able to have visitors. NOT ONE! She is the worst at risk patient there can be. She has precious limited time and she would be banished to spend those last days in solitude. At her rehab facility she has food delivered at her command, anything she requests, made to order and delivered without a tip required. She has people she can share her story with. For the first time in her 7-decade life she has learned what living with others is like. She never had a dorm, roommates in an apartment, or, anything where she had to share. She has never seen death, suffering, and disease cripple and control. It has been a lesson on humility, humanity, and empathy. She is enjoying exploring new experiences. Ones she would never had exposure too, and, honestly spent a whole lifetime avoiding.


I call her every day, at least twice a day. She is still her firing, pistol self. “So, mom have you met the people around you? Do you know the names of the people in the rooms adjacent to you?” I pick small sentences and direct questions. She is on elephant doses of opioids she can get lost in the sentence if it has too many curves. “Krista! Some of them can’t talk. I don’t have time for that.” And, the empathy recedes as the parent reprimands. I guess I am expecting too much. The vet in me wants to understand these people, and their conditions much more than the talking patients. Maybe that apple rolled too far from that tree?

The house is falling. The pain won’t win, but the body has lost its hope in walking independently. Stairs of any measure greater than one, and a tube in each nostril pushing atmospheric ether into her lungs that can’t muster the strength to tug on the diaphragm anymore. There are weak protests of pleas to let her “conserve her energy” which always sounds like handing the draw to the house. It is not a bluff but a fold.


I want her to know I am still sitting in the bleachers. Still rooting her on, and yet there is only the half-answered phone calls and the locked building that takes care packages at the front door. She is in there. Confined within her fear, and, passing precautions to me in the big scary germ filled freedom.
I know that if things get worse she will only have two options. Forced confinement if she is feared to be exposed or infected, and, home isolation if the bed she resides in gets too precious to permit her to stay in her already terminal state. How could it be worse? Die alone or die alone?

The veterinary clinic is being allowed to remain open, for now. The MD governor has us in his “essential personal” graces. We are rationing provisions, adapting protocols to minimize congregating of people, washing everything as obsessively as possible and trying to allow people, the staff most importantly, to do what they feel is best for them. They are able to take time off, stay home with their kids as all of the kids are out of school, and we will provide as much support as we can. There is no end date for a virus. Just curves charts and accumulated data compared against the previous days and weeks of data.



Life is a roulette game. Chance and luck, fate and frailty, and yet we are tiny specks in a timeline without boundaries. But she is my mom and her silver linings are fleeting locked up for her own good. I really only care how she chooses to spend her time. She has a team rooting for her while I cannot be seen or heard outside of her cell phone tucked away in her wheelchair. Her lifeline to the life she has on hold in the world of germs and equality irrespective of mass or intelligence scales.

Thank you for reading. If you would like to read more about my moms journey you can find it here.
Human vs Veterinary Medicine. My personal experience in dealing with both.

The Journey and The Pile of Regret Souvenirs.

For more blogs on subjects mentioned above see;

Terminal Mom. Losing my pups.

The Phantom Effect. Grieving the loss of your pet.

My Beloved Jekyll-pup. May you run through the fields forever.

Survivors Remorse.

The Distracted Hearts Recovering. Getting up and moving on after the loss of your pet.

I also host a free pet health network. If you have a pet related question you can find me there Pawbly.com.

I am also on YouTube, Facebook, and our clinic website JarrettsvilleVet.com

Be safe everyone, there is a virus out there.