Last night, a cable news host raised an anguished alarm about the crisis of the pandemic in America’s nursing homes. It resonated. As a physician, I have worked in those places across the U.S. From the pastoral rural to the gritty inner city. Faces of people and scenes inside those walls flashed before my eyes. Caregivers. They are the ones who ride the buses and subways or drive their decades-old vehicles to attend to the most vulnerable among us. There are no horns or bells. There are no cheers as they arrive for work at convalescent centers at 7 a.m. In the predawn hours, they arrive, often after working a shift in another facility. The patients, the oldest and most frail of all await them. They await them in the darkened rooms. They await them to open the shades, bid them good morning. They await them to turn them, to remove soiled diapers, to wipe behinds clean, to apply protective ointment. They await them to wheel them to the dayroom and set up a breakfast tray. They await them to spoon the oatmeal or Jell-O into their mouths crooked from strokes. The LVNs or R.N.s in those homes, many who have struggled to come to America for a better life, push med carts down the dimly lit hallways, patiently watching as trembling hands take the small medication cups and swallow each pill one by one. Stronger patients, their walkers clanking along the floor head to the dining room for a communal meal. At one bedside table, a faded photo of a handsome young smiling Asian man in a U.S. Army uniform, embracing a pretty dark-haired smiling young Asian woman, sits next to a small prayer card remembrance from a funeral. A wedding photo of a large blonde family hangs next to a bed where the hissing sound of oxygen feeds the nostrils of a tiny figure. Curled and stiff, she lies on her side, eyes open, unseeing. A large dark-skinned man in a baseball cap shuffles along in a wheelchair; a caregiver gently guides him. As COVID-19 bears down across the country with the terrifying speed of a silent hurricane, its winds filled with a sociopathic scourge, astutely targeting the most vulnerable, nursing homes become a welcome Petri dish for coronavirus feeding. If the measure of a society lies in how we treat our most vulnerable, by what scale and to what degree of adequacy, if not admiration, have we risen? The tiny woman with the Coke bottle glasses and an effervescent attitude, lifts her blouse. To a physician making rounds, auscultating her heart, the thick scars on her chest and abdomen, are visible. She had been living near Hiroshima in the mid-1940s. A young woman full of life, she loved to dance. In a brief moment, all was shattered. With a fiery explosion, a sister and countless others were gone. Now, with memory fading, she leans on the kindness of caregivers to help remind her when the music is playing in the dayroom. As COVID-19 intrudes into the safe space of the final homes for the most frail among us, those who went to war, the last of the greatest generation, the Korean conflict, Vietnam and younger folks crippled by the war of congenital disability, we must ask ourselves what the measure of our care is? As the workplaces of the ones who wash and feed and smile and greet the oldest and sickest for a paltry wage are infiltrated by an insidious killer, we must ask ourselves, how are we protecting them? Yet as COVID-19 leaks into the airspace of the nursing homes of our nation, stalking and killing with great suffering, only a lone reporter is alarmed. One news network reports. There is no unified program or outcry to what is coming as the angel of death to millions of our disabled peers, parents, grandparents, and those who care for them in this season of Passover and Easter. It’s seven pm. Still, there are no bells, no whistles, no thank you for the workers who toil in the shadows of the convalescent centers, the intermediate units, the skilled and custodial care wings. There are no cheers. Only a long silent howl from those that despair as the caregivers depart. We must not forget them or the ones they tend. Maureen A. Mavrinac is a family physician. Source
