And Then It All Changed

The blue gloves didn’t peel easily from Barbie’s sweaty hands. Neither did the rest of the personal protective equipment she was struggling out of in the middle of a cold heavy rain. She tried to stay bent under the trunk lid of her Subaru, while stripping off the jumpsuit, soggy shoe protectors, face mask, goggles, and hair protector but the wind was blowing hard enough to swirl the rain even under her makeshift shelter, soaking her. By the time she slammed the driver’s side door shut against the storm, she was wet, cold and miserable. With the heater on full blast, she contemplated whether she even wanted to finish this day. This was visit number one for the day. She had six more to go.

Home health used to be easy for Barbie. A twenty-five-year veteran of physical therapy, she used to be able to do this job in her sleep. She eased in and out of homes, chatting with her patients, visiting seven or more in a day and driving fifty or more miles before she ended her day.

But that was before the pandemic. Now she struggled to get through five visits and she was using brain cells that she never knew she had. From the pre-visit screening by phone for Covid-19 to the methodical temperature check the minute she walked into their home, she had to change the way she thought of, spoke to and treated her elderly patients.

The effort to be heard through her mask, left her feeling like she was screaming and left her with a hoarse voice every day. Her nose and face flaked and itched from the constant friction of the disposable mask against her fair skin.

She wondered if she had enough brain cells to keep this up much longer. She was having trouble thinking and planning her visits because every move now had to engage a thinking process to be sure she didn’t contaminate herself or her patients. Had she changed her gloves when she needed to? Did she use enough hand sanitizer? Did she touch her face? Did she wipe down her tablet? Her brain couldn’t keep up.  

She couldn’t socially distance from her patients; she was physical therapy. Her whole job was about touch. She had to touch them to teach them. How could she move a newly replaced knee or hip if she stayed six feet away? Although it all seemed crazy, she did her best and prayed she didn’t catch this virus. Refusal

And then there were the families. As many times as she screened for the virus, she knew that she got some false answers. Was it denial caused by a refusal to admit their own vulnerability to the virus? Did they think they couldn’t possibly catch it? Or was it because of the stigma of being untouchable, isolated if they had been exposed?  

Her tablet signaled an email. She opened the message.

Mr. Barnes tested positive for Covid-19 and is in the hospital. His sister died yesterday; she was positive also. 

Barbie’s heart fluttered. She had treated this man four days ago in a ten- by- ten bedroom, crammed with furniture, impossible to keep a distance from him distance from and no available protective equipment except a handmade mask and a pair of gloves. He lived with his sister.

The middle-aged therapist fought back the fear that suddenly left her feeling weak. Why hadn’t the family members told her that someone else in the home was sick? Apparently, the young woman died in her own bed. Had Barbie been exposed?

She called her supervisor and walked through the steps of her last visit with Mr. Barnes. According to guidelines, Angela decided that Barbie hadn’t been exposed because she was wearing a mask and gloves. It was a cloth mask, but at least it was a mask. There was no reportable exposure, no need to quarantine herself. At that moment, her trust evaporated. She felt unprotected and in the face of this virus, she was naked and vulnerable.        

There was an N-95 mask in her box in the office, Angela advised her. She could wear it if a patient was suspected of Covid-19. And if she didn’t know? Well then, she was shit- out of luck.  

As she drove, Barbie reflected on her career in physical therapy. There had been changes in the practice over the years but nothing like this pandemic had catapulted.  

The number of deaths in the small southern city where she worked was rising fast. The lady that ran the funeral home died last week and now her son was fighting for his life. A woman at the municipal building died, another family near the end of town got infected and lost a wife, a mother and a sister. Barbie was starting to lose track but was sure that the number of people she knew was over ten now. And none of them were over the age of sixty-five.

Barbie was sixty- two.

The day got worse. Her last patient of the day was curled up in bed when she walked into the dark bedroom. He complained of chills and she stuck the digital thermometer under his tongue. When it beeped, she backed away from the bed, staring at the number. His temperature was 101.4. Thermometer still in hand, she exited the home, fighting back the fear of yet another exposure. She called Angela again, this time from the driveway.

The rescue squad arrived ten minutes later and she watched from a distance as the elderly man was rolled out of the house on a gurney. She couldn’t erase that vision as she drove home that afternoon. She needed a steaming hot cleansing shower and the faster she got it, the better she would feel.  

She stripped her clothes off at the back door, next to the washing machine where she threw the infected clothing and hit the start button, filling the washer with scalding hot water. If there were any traces of the virus, they would be washed down the drain. In the shower, she scrubbed and scrubbed her body with scalding water and a bar of antibacterial soap to purge every single germ of Covid- 19 that might still be sticking to her. But on the way to the shower, she reached into the refrigerator and grabbed an unopened bottle of wine and carried a full glass with her to the bathroom.

As she brushed out her hair, she emptied the glass. She hadn’t really tasted it but she was already beginning to feel the effects of the alcohol on an empty stomach.

She picked up her cell phone and punched her oldest son’s number.   

“Hi Corey.” 

“Mom? What’s up?” His voice was full of suspicion.  

Barbie never called her kids during the week because she knew they were knee deep in their lives. She expected him to be suspicious of a Friday afternoon phone call.   

“Oh nothing.” She answered while pouring her second glass of wine.   

 “How is everything,” he probed.

There was enough alcohol in her blood stream to give her courage and she launched a recount of her day.   

“I sent my last patient to the ER this afternoon with a fever.”

Corey caught on immediately. “Did he have Covid?”

“I don’t know,” she replied honestly.

He was silent and Barbie moved on through her story.  

“I had another one a couple days ago that tested positive.” Barbie recounted what she had heard about the sister that died.                

“What the…?” She heard the frustration in his voice.  

The next gulp of alcohol caught in her throat and she choked. She sputtered and a sob escaped. The words were gone; all she could do was cry.  

Corey was quiet until the last sob faded away. Then he asked, “are you okay?”

She wasn’t. Not at all. And she didn’t pretend to be. She had to be honest here. How else could she survive this pandemic?

 That afternoon was a turning point for her. This was the moment that she realized her loss. This was the moment that she grieved what she had lost. Her career, once carefree and caring had been swept away with the current of pandemic. Now, she faced anxiety, stress, and near exhaustion, with a headache, a heart flutter and shortness of breath that was with her every waking moment. She was on the verge of a panic attack every time she opened the door and entered a different home. This had been too much.     

She longed for the day to return when she could practice therapy with the ease and comfort she once had.  Her job had changed dramatically and with it, her confidence. But one thing that had not changed was her love for the people she met every single day. For the hands she touched, for the lives she made better, it had to become easy again. Someday it had to. It just had to.