By Dora Anne Mills, MD, MPH. Originally posted December 16, 2020
I’ve not been able to post the last three weeks. My hours have been filled with work – on the surge as well as the vaccine planning efforts – and my head and heart have been empty. It’s December, the darkest month of the year. And this must be the darkest December in modern history.
A disease that did not have a name nor a record a year ago was the leading cause of death in this country last week. Maine has fortunately faired relatively well, but we are in the middle of a deadly surge, with ICUs filled, and people getting sick and dying at alarming rates. When someone dies unexpectedly, the first thing you think of is COVID. And there have been many unexpected deaths. All of us know people whom we’ve lost to this disease.
I’ve been trying to keep hunkered down to stay safe, but co-existing with COVID-19 is challenging during a surge, including when living with those who work on the frontlines or when one’s own work requires interactions. Colleagues working in hospital frontlines here in Maine and elsewhere text or email me daily about their emotional and physical exhaustion, often symbolized by the creases on their face from the tight-fitting N95 masks they must wear. Yet, in the middle of this dark scourge, voices of vitriolic rage lash out at science and public health, as if the science on viral transmission and edicts on masks are to blame for this pandemic.
Notable anniversaries have reminded me of how dark these times are. December 1st, World AIDS Day, reminded me of the first pandemic in my career, with some haunting similarities to our current pandemic. I remembered the friends from my youth whom we so tragically lost, some dying alone because they were ostracized or people feared catching the mysterious infection. I remembered the AIDS patients I cared for, especially one boy who died just after his 12th birthday. Other than his mother, no one in his family was allowed to know he had AIDS. I remembered the rage that people lashed on gay men and others suspected of causing the disease. Nearly 40 years after AIDS was detected, there is still no vaccine or easy cure. But now the AIDS pandemic has been eclipsed by another pandemic – COVID and its parallel pandemic of misinformation and anger.
December 7th, I remembered my parents. For a young couple emerging from the Great Depression that defined much of their teen and young adult lives, they took a leap of faith and married in June of 1941, embarking to build a quaint family life in a small town in rural Maine. But December 7th changed all that, and my father journeyed instead with the Navy for several years through the Pacific during WWII. Sunday afternoon December 7th was a defining moment in their lives, and they always paused on the anniversary to tell us their story of that day, and to honor those many lives lost. But on Pearl Harbor Day, 2020, we lost more Americans from the raging pandemic than from the attack in 1941.
Each of these days this year brought some sadness and emptiness. But despite the bleak darkness, I lit a Christmas tree. I placed my battery-powered menorah in the window in solidarity with Jewish friends (as my son jokingly asked me if the batteries would last eight days). These lights were a sign of faith, a faith that was hard to see or feel.
Then last Friday night news broke that the FDA issued authorization for the Pfizer vaccine. A group of us worked feverishly to incorporate the FDA’s language into all of our materials, forms, and protocols. Others worked on scheduling our care team members for vaccine and others to staff the clinics, using systems we spent several months building. Sunday, the CDC issued their recommendations, which again, meant reading them carefully and figuring out how to translate them into materials, forms, and protocols. As information continued to evolve federally, ripple effects meant we had to adjust and re-adjust. Even Tuesday morning we were revising the vaccine consent form to align with US CDC revisions published late Monday.
Yesterday morning at 7:30, we received word that the vaccine had arrived under police escort at Maine Medical Center, our tertiary care center with over 12,000 employees, many of whom have been caring for most of Maine’s sickest COVID-19 patients the last 10 months. By 9 am, several of our COVID-19 ICU nurses were receiving their vaccines. We felt the vaccine to be such an urgent matter, we made sure we could start vaccinating as soon as possible. The clinic ended at 10:30 pm.
I was sitting in my office late morning when the photo came across my email, of one of Maine’s top infectious disease physicians vaccinating a COVID-19 ICU nurse, our first COVID-19 vaccine administered, and the first vaccine in Maine. My eyes welled up with tears. In the midst of a dark December, there is light, and there is hope.
Last evening, I spent at the vaccine clinic at Maine Medical Center. It’s not my turn yet to get a vaccine, but as someone coordinating the efforts at MaineHealth, I am also working in the clinics to vaccinate and to help in other roles. Last evening, I also wanted to touch base and to witness. I am grateful I did. So many of my staff were there working, volunteering their time – Cassie, Naomi, Tina, Kristen, and others. What fun to see so many in person, a rarity since most are working remotely, so I only see them virtually. There were IT specialists making sure the laptops and the several medical records and vaccine information systems were working and interfacing. There were pharmacists thawing and reconstituting the vaccine. There was a retired physician and a retired nurse vaccinating. There were our emergency preparedness leaders ensuring all needs were met. There were food service workers bringing in dinner. It truly took a village (distanced, masked, and with eye protection and hand sanitizer) to make this all work!
A steady stream of nurses and other frontline heroes walked through to get vaccinated. They talked about the vaccine helping to lift a cloud of fear they’ve been living under – fear of bringing COVID home to their loved ones, fear of losing yet another patient, fear of getting sick themselves. They talked about the vaccine shining hope in addition to lifting the cloud.
Although COVID will continue to ravage and rage, and even years from now, it will likely surreptitiously slither across the globe, the vaccine is our ticket to more normalcy. Years ago, after treatments for AIDS evolved to keep the infection at bay, one Maine AIDS activist remarked that although the medications weren’t a cure, they allowed him to plant perennials rather than annuals. Indeed, the COVID vaccine is the bulb that will help us grow blossoms for months and years to come.
A couple of years ago, I found a fairly plain looking Bible with a black leather cover among my mother’s belongings. I opened it to find it was from my mother’s parents. My grandparents were potato farmers in northern Maine. They’d lost much of their farm during the Depression. But they never lost their optimistic spirit and their faith. The Bible was a gift to my parents, Christmas, 1941. A message of hope from another very dark December. Although it would be another five arduous years marked with untold sacrifices and well after the V Day celebrations (V-E Day and V-J Day) until my parents could return to their quaint lives in a small town in Maine, my grandparents and parents held and gave the gifts of faith and hope.
December 15th was a historic and monumental day in Maine. It was our V Day, Vaccine Day. Somehow now those recent anniversaries don’t seem so bleak. Even they convey to us some gifts from the past. Somewhere under my frozen garden, there are daffodils percolating. My home is lit with candles. I now clench some seeds of faith and hope.Dora Anne Mills, MD, MPH, FAAP, Chief Health Improvement Officer, MaineHealth