This I Am Convinced!

Blaring sirens and flashing streams of red lights have become a warning system in our culture. At first, one’s heart may race, but after decades, we have become desensitized to some degree, to the sound of that raging roar. Admittedly, when I hear a siren, feelings of anxiety compress in my chest for just a moment but soon, they too fade. Thoughts pass through my mind – it is a car accident? Did someone break in somewhere? Is there an altercation? I know that someone, somewhere, is experiencing a trauma of some kind. My years of training in insurance claims naturally brings me to a car accident. But first responders use sirens to warn the surrounding traffic they are in route, on the way, in fact, responding to a cry for help.

In Greek Mythology, a siren is a creature, half-bird, half-woman, who lured sailors to destruction by the sweetness of her song. In contemporary society, a siren is most recognizable as an device that electronically produces a penetrating warning sound.

I live around the corner from a fire station and across the street from the sheriff’s office and have heard the roar of a siren or watched a speeding police car, ambulance or fire truck go by. In my city of Littleton, we have had our share of tragedies and hypervigilant reactions to subsequent events that followed. But without notice, the sound of a siren and the sight of a first responder flashing by my back yard, or across an intersection, has brought new meaning as the COVID19 pandemic swept across our nation and our communities.

The city grew curiously quiet under the early days of the stay-at-home order. Traffic was uncharacteristically light and there was an obvious influx of people and pets walking the narrow pathways of our suburban neighborhood. So, when that familiar sound reverberated our neighborhood, it was distinct in a way it hadn’t been before. No longer did my subconscious drift to car accidents or criminal activity. Instead, a growing consciousness, perhaps an anxiety of sorts, of a pandemic gripping our nation, created a visceral reaction within me. Oh my gosh … here we go! As I looked up and glanced across to the first responder vehicles, each and every single time, inside, both men and women, swathed in white haz-mat suits. It was a jarring moment. Where are they going? The must be responding to a COVID call. Is there another outbreak? Where?

I don’t know how to describe the shift in my body or my sense by that sound, that vision. It was like it was out of the movie Outbreak. Paranoia? Fear? The unknown, all reasons for alarm – no pun intended. Where they afraid? Did the feel anxious or scared? Did they have enough protection? I’ve been thinking about these encounters for a couple months now but until now, unable to put it into words. In those spaces in between, I was still trying to integrate my own experiences as a Hospice Chaplain caring for COVID+ patients. Perhaps these glances were opportunities to name my feelings. Why was I anxious? If I was infected with COVID, chances are I’d be sick for a time and come out the other side just fine. But what would it mean for my patients, co-workers and family? What about the COVID patients I had seen? Touched? Was I careful enough? Our thoughts can consume us, and our time.

One day I was enjoying a day of staycation in my back yard. The sun was shining, the traffic noise was mild, the dog by my side. I was actually reading a book for pure joy, a book by P. Desai about finding our authentic soul through the many layers of experience, unhealed pain and societal programming. It was relaxing and I drifted in the pages of the book, lost in an insatiable desire to be transformed. And then I heard it, that familiar noise. I felt a momentary twinge but it was brief and disappeared, not like before. This time I became aware, heightened, but far less triggered. For just a moment I imagined those first responders seated in the front seat of the vehicles, donned in PPE and how hot and uncomfortable it must have been.

I wondered again about those heroes, those responding to anxious calls during the early days of the pandemic when most of us were tucked away at home. Paramedics, firefighters, law enforcement, but then I thought too about the doctors, nurses, hospital and heath care workers, maintenance crews, grocery store workers, gas attendants, social workers and yes, even chaplains. We were all responding to an unfamiliar threat, a potential killer and a highly contagious enemy that pervaded our communities.

I remember the training and preparation of ‘donning and doffing PPE’ – putting on and taking of personal protective equipment. We practiced and prepared, on paper and then we modeled the steps, asking clarifying questions, wondering what we were getting ourselves into. We read and studied, educating ourselves about low, moderate and high-risk exposures, and how they could potentially happen. We asked questions. We read bulletins from the Centers for Disease Control, the World Health Organization, state and local agencies and the National Hospice and Palliative Care Organization. With all the careful training and barrage of communication, protocols changing sometimes by the hour, I assumed we were in for a plethora of sick patients and more death. Fortunately, things didn’t evolve quite that way. Senior living facilities locked down to everyone, even sometimes the outside hospice and heath care nurses. Day to day the rules were different. Keeping up with the ever-changing landscape caused increased concern and anxiety.

Little by little I lost access to my patients. Debates at all the highest agencies were taking place: Is hospice care essential? Are support services essential? Massage therapists were furloughed. Administrative staff laid off. Chaplains and Social Workers eventually furloughed. The very intent of our work, to sit bedside with patients, was stripped away. Our focus shift toward supporting their families, our own staff, and the facility staff who had no access to those outside the doors of their facilities. This did not sit well with me at all. Patients who were not at death’s door were now dying, of loneliness, abandonment and neglect. Something felt morally wrong about all of it. My heart sank into my stomach and was twisted and bruised by stories of family members crying out, Will my Dad die alone? What if my Mom doesn’t remember me when it’s all over? How can they just cut us off? Holding space for others became a container I couldn’t escape, one by one, by telephone, Facetime, in emails and across parking lots.

And then came a notification across my phone, so-and-so was COVID+ and within 48 hours, actively dying. There were no roaring sirens or racing vehicles. This was my call to action. No one would know but me and a few others. “Can the Chaplain please visit our Mom and bless her? We understand if she can’t but we would like to say goodbye to our Mom.” I planned to meet our nurse for the visit and she had arranged for the family to join us on Zoom video the next morning, praying my patient still be alive.

There I stood, outside the quarantined room, curious, anxious, zoned in. We just donned our PPE: blue synthetic fabric encased shoe coverings, oddly-thin yellow paper-like gown strewn partially around my torso, skin tight clear latex gloves, a simple mask covered by an N95 mask. That’s it? I glanced over at my colleague, aware of her experience in ICU and with H1N1, the Swine Flu, TB, and accepted it must be.

This was my first COVID+ encounter. I took a picture of myself to capture the moment and to later use to help process the experience and integrate my feelings. The picture spoke a thousand words: I don’t have a face shield. My head and neck are exposed. My pant legs are not covered. If this is airborne, are all the things in the room contaminated? I need to get her prayer bead. The family asked that I use them. Can I touch them? Can I put them in her hand? Are they contaminated? What about the furniture, is it all infected? Where will I sit? How will we video this? Can I use my cell phone for the music? I’ve never done a blessing or lead a family through Buddhist rituals, dear God, I’m going in, help me! And then the move of the Divine swept through me. I was bedside. Present. Open! She was so frail and cachectic, helpless, lying in bed in what appeared to be a catatonic-like state. Her eyes remained closed most of the time, her eye lids reddish in color, like allergy eyes. She was lifeless, not characteristic of the active, feisty woman I once knew. I was filled with sadness, empathy, disbelief. I had visited her frequently over the past nine months, each time a new experience. Her short-term memory was obliterated but she could recall childhood stories in the internment camps. Sigh. At times I witnessed her frantically racing around the unit, searching for her little sister, agitated and afraid, remembering those awful days.

Moved to compassion, I sat on the bed across from her and scooted it closer to hers. I found her prayer beads in a small drawer in her shrine and I placed them around her left hand. I then played a Buddhist chant from my cell phone. The cadence of the sounds fill with space with a sense of peace and she opened her eyes for only a moment. I prayed silently for her comfort and peace. I prayed also, that her journey would end quickly, and without pain.

My colleague sat next to me, holding her laptop with images of the family on screen listening and watching through the video. I gave them a few moments to settle into the space, to find their center. As few moments later I began to read a Buddhist blessing, one that I had read with the patient on occasion. Feeling the enormity of the situation, I could feel myself choking up. I was overcome with emotion. This must be so hard for them not being here. Use me God, show me what to do. Almost empathically, acknowledging the family could not reach out and touch their Mother, Aunt, Grandmother, I placed my right hand on her head and began to pray. When I was finished, I gave the family time to express their thoughts. One by one, they struggled to get the words out. They cried.

When they finished, I returned to the ritual sounds of chanting. In those moments, something changed in her face; her facial muscles relaxed and her body sunk into the mattress. The family noticed this too, and expressed gratitude for the bedside blessing. The video call soon ended and my colleague and I took a moment of silence. Deep breath. We called another colleague who had worked closely with the patient and we let her say goodbye. Tears flowed …

The task was complete and now I had to figure out how to process everything I was feeling. Don’t touch your glasses Cheryl. What do I do with my phone? Do I remember the steps of doffing the PPE? God … help me remember this. Booties first? Wait, no, I’m still in the room. Booties last? Sigh!

We moved just outside the private room and began to doff our PPE. Carefully rolling the gown off, down and away, into a ball. Without allowing it to touch anything else, we place it in the trash bag along with our latex gloves. Sanitize hands. Next, the booties. Sanitize. Oh she’s (my colleague) is cleaning her cell phone, God, I’ve got to do that. I cleaned my cellphone with alcohol pads before placing it in my pocket. Check – toes to head – booties, gloves, gown, phone, mask, what do I do with this mask? Crap, I have to wear a mask out of there. Wait, I’ve got a surgical mask. I pulled off the N95 mask and gasped for air, then place it in a small brown paper bag, place inside a gallon size plastic bag and put that in a reusable grocery bag designated for COVID visits. Sanitize again. Ok I think I’m good.

My colleague and I checked in with the staff, then walked out of the unit. We found our way to the elevator and took it down two floors and before we could leave the lobby. To exit we had to have our temperature taken again. We signed out of the facility log, went out the front doors and walked to our cars, not a word spoken. Finally, I took a deep breath and exhaled loudly. “Thanks for walking with me through that,” I said to my colleague mentor, as I opened the trunk to my car. “I am happy I could,” she responded. It was a moment, I felt, where we bonded.

As I drove home, I attempted to make a mental list of what steps I needed to take before going in my house. Shoes off, sanitize and leave in the garage. I’ll just go ahead and take my shirt, socks and pants off as well and walk them straight to the washing machine. But what about the car? I have an N95 mask in the trunk of my car and I need to preserve it, in case I need it again. Sigh. I arrived home and parked in the drive way. I entered the garage and closed the garage door. It felt ominous. I took my shoes off and I sprayed them with disinfectant. I undressed and carried my clothes up the stairs and put them straight into the washing machine. Quickly, I grabbed a pair of shorts and a t-shirt and put them on and headed back down the stairs and out to the car.

I wiped every surface down on the inside of the car with a warm rag and then again with Clorox wipes. I hope this doesn’t ruin the leather. Oh well … it’s not important. This took nearly half an hour. I didn’t want to miss anything on the interior. Painstakingly, I washed, vacuumed and then sanitized again. And then I washed and dried the exterior, paying careful attention to the door handles and the trunk. When I was finally finished, I pulled the car inside, shut the garage door and stripped down again. I took the second set of clothing up the stairs and put them into the washing machine and started it.

I moved to the shower. In the shower I went over and over the steps in my head. Did I doff my PPE properly? Did I get clean the car good enough? I can just wash my clothes, I don’t have to burn them, right? Oh my God, I forgot to clean my glasses. Head to toe, I washed, not once but twice. Another half hour had passed. The water was therapeutic and relaxing. I stepped outside the shower and dried myself and immediately grabbed a bottle of rubbing alcohol. I cleaned my glasses diligently. Sigh. Ok, I think I’ve got it all.

Reaching inside the bathroom cabinet I grabbed another Clorox wipe for each hand and began to retrace my every step, making a mental note. Shower door. Bathroom door knob. Counter top. Dresser drawers. Washing machine. Stair railing. Screen door handle. Disinfectant bottle. Sigh. Deep breath. Ok! I’ve done all I can. It was now 90 minutes after I had arrived home. I went to the refrigerator, reached for a cold beer. Yes, I had a drink that afternoon as I sat down in my backyard in silence.

From a distance, I heard a faint but penetrating sound, perforating the sacredness of my backyard oasis.

As time has passed, the news of the pandemic has consumed me less and less. I’ve grown more focused on my work and how I can be fully present for others. Even as the virus infiltrated the security of my own family, the anxiety and fear slowly dissipated. What if I do get it? Well, I’ll likely live to tell about it.

It is a powerful metaphor, the siren. Its etymology suggests the impetus of luring something to its demise. That does not necessarily correlate to the outcome of those first responder calls. But what if we re-imagined this mythological figure, half-bird and half-woman, as a spiritual being? What if we reimagined her to be half-dove, half-feminine? What if this luring was the Spirit of Divine Presence, working in and through me?

This, I am convinced; the sound of the notification on my phone that day, was the Spirit of the Divine, luring me to lead another in their final moments, and in those moments I would reclaim a non-anxious presence.

In the midst of the pandemic, and its pervasive resurgence across our nation, and the world, I continue to visit my patients. I work diligently to ground myself and remain a non-anxious presence for my patients, my co-workers and colleagues, my CPE peers, my family and all whom I am in contact with. I continue to center myself and find my purpose, so that once again, when I am lured, I will be a non-anxious presence.