Vampires and Other Scapegoats

February 27, 2020

“You are so pig-headed,” my partner, Frith, said on the way to the airport. I was taking a morning flight from Seattle to San Jose with a stop in San Francisco. I had reserved a rental car to drive south to visit my mom in central California.

“You’re way too intense,“ I snapped back.

“Yet,” Frith finished my sentence. “It might already be here. It incubates. Think of how many people you will pass coming from other countries. Think of airport corridors, lobbies, and bathrooms — especially bathrooms. Then the whole sitting on a plane with stale air circulating, while crowded together with other people. There are so many possible places for disease transmission.”

Frith had just returned from a 6-week business trip to Japan.

“Wear the mask from the moment you step out of this car until you open all the rental car windows at the San Jose Airport,” she insisted, adding that I sanitize the steering wheel, radio buttons, seatbelts, and gearshift before starting the car.

“Use your other mask for the return flight to Seattle,” Frith commanded.

The Covid virus had not yet dominated the news in the US.

I said okay. I thought Frith was being obsessive. I repeated there were no cases in Washington. “We don’t even understand the virus, “I said.

“Precisely, “ Frith responded. “So take precautions. You have a really lousy immune system from all your cancer treatments.”

I did not sense imminent danger, but I wore a mask out of respect for Frith. As I walked through the airport corridors, I noticed several Asian college-aged students and a handful of older Asian adults wore masks. Passers-by stared. I felt self-conscious due to imagined scowling glances from fellow travelers.

The majority of people in the Seattle airport and on the plane were maskless. I lowered my mask down to my chin while I drank a cup of coffee, but otherwise covered my mouth and nose.

When I changed planes in San Francisco, only Asian people, once again, wore masks.

I bought a package of pretzels to eat in the lobby. I was sitting across and a few seats down from a young man who had a bad cold. He had taken out a handkerchief to blow his nose. Then he sneezed with great force.

I had a sudden, visceral dread. I stood up abruptly and moved away, tossing out my snack. From then on, anyone with or without a mask walking through the airport seemed potentially dangerous.

After years of living with stage 4-breast cancer, airports were already places I dreaded. Once while I was waiting for a flight, I experienced extended uncontrollable shaking in my right limbs. Before that, there were a few instances of my right leg shaking, but I had rationalized that phenomenon away as a symptom of neuropathy. I told my oncologist about the intensified shaking. She immediately ordered a brain MRI. The scan revealed 15 cancer lesions spread throughout my brain. Breast cancer cells had found fresh territory. After two weeks of brain radiology, the lesions shrank and did not return. Nor did my hair. I have bald patches and streaks left by the radiation.

In February 2020, I again experienced an airport as a place of danger.

When I got to the home of my 91-year old mother, she told me that the first Covid patient had been identified in Washington State. She remembered it was a man who had been traveling in China.

Mom was not particularly worried about the virus at that point or about my visit. She was still volunteering at a local hospital and playing Mahjong and dominoes with friends at the Elks Club. Mom and I went to a movie on that visit and ate out at restaurants.

On the day I returned to Seattle, media reports were intensifying about the virus outbreak in Washington.

I gladly wore the second mask on the flight back to Seattle. I noticed contagion anxiety in the airport passageways and the waiting areas this time. About 30 passengers of all ages and backgrounds wore masks on the flight home. Most people, including myself, did not know how to manage mask protocols. When the plane reached its cruising altitude, several people took off their masks and put them back on again as the plane descended into Seattle. I left mine on because I had promised Frith to be vigilant.

No direct orders from any national or state entity had been announced yet. At that point, most people were still separating themselves from the crises unfolding in Asia and Europe.

March 5, 2021

I started a new job at a different psychiatric hospital a few days after returning from California. There was some buzz about the virus. Staff waited for guidance.

At that point, Covid-19 seemed to be a disease that targeted older adults and people with existing health conditions like the seniors who had become sick at the Kirkland nursing facility.

Two weeks after our visit, Mom suspended her volunteering gig at her small-town hospital and stopped meeting friends for weekly games. She would remain isolated in her home for the following year. My brother and his family regularly brought groceries and visited with her in her garage. She remained optimistic, playing piano and trying to keep her mind sharp by focusing on puzzles.

At my job, rules started to get more specific: masks, social distancing, frequent hand washing, and cleaning surfaces were highly advised but not yet required. We were also instructed not to touch our faces.

After my third week on the job, Frith insisted that I call my oncologist to get her opinion about being at high risk for contracting the virus. The oncologist recommended a medical leave of absence from the hospital. It seemed like a hysterical suggestion, and it seemed unfair to my team to be absent from a job I had just started.

My oncologist said that I would likely have an intense inflammatory reaction if I did contract Covid-19. In response to that pronouncement, I had magical thoughts in which I saw myself as being more resilient than others because I was still alive. It was a hopeful theory, albeit naïve.

Reluctantly, I requested the leave and permission to keep receiving my salary by setting up a telehealth program for the outpatient programs.

I returned to work in early April. Telehealth launched soon after that. I was curious whether patients would embrace the new online platform. Initially, they did not. Only one man enrolled, a senior who lived two hours away from Seattle. Unfortunately, he had a broken printer, poor connectivity, and no tech support.

He stayed a distortion-filled two days, then dropped out. We continued to fine-tune the telehealth program. Most patients who enrolled in outpatient program groups preferred to participate in person. They often felt safer around other patients and away from home.

The hospital continued to update safety protocols because a handful of patients and staff throughout the hospital started to report disease symptoms. Corporate, national, and state rules became more specific. Medical providers wore N-95 masks, and the rest of us mostly wore surgical or cotton masks. Eventually, staff that had direct contact with patients wore N-95 masks and face shields. All entrances to the hospital were locked, except for one door near the lobby. Each morning, masked staff members filed in through that one door for screening.

Notices posted throughout the hospital urged staff to wash hands frequently, guard the distance between themselves and others, and clean contaminated surfaces. Still, cases of Covid-19 emerged because there was no way to control the status of everyone who entered the hospital, nor was it possible to control hospital staff interactions with people outside the facility,

Mostly, I was vigilant, but sometimes I slipped my mask down under my chin when I was in my office. Then, I would forget to pull it back up until I was reminded by another staff member with a gesture or the word, “mask.” I was called to task by a patient who had a vulnerable health condition. “Being absentminded is not an excuse,” she said. She was right. I was more cautious after that.

Every morning I screened patients for symptoms of Covid-19 as they entered the outpatient program. I sat beside Margie, who screened the substance use patients. She had been in the army and had a hard edge and a fantastic booming laugh that punctuated her stories.

She was in her early sixties with multiple medical conditions. She likely got the virus from a detox patient or from someone outside the hospital.

Her illness started with cold/flu symptoms. She coughed more often and complained of fatigue. When her symptoms increased, she stopped coming to work. We heard rumors that Margie was being intubated in a nearby ICU. We knew Margie had a strong will to live, so we expected her to return with a new set of stories, including ones about grappling with Covid-19.

Of course, that is not the way Margie’s illness unfolded. Another lung event occurred a few weeks into her ICU stay. This time the reaction was fatal. Her death left behind a husband who had been unemployed for years and several grandchildren. It took us all months to come to terms with her absence.

May 8, 2021

Each morning as I walked to my office, I passed sepia photographs taken when the hospital was called Riverton Sanitarium. It had been built for patients with (TB) in 1928 on 43 acres of rural forestland. The campus, which featured Swiss-chalet-style cottages, looked like a peaceful vacation spa. Patients benefitted from both the fresh air and the natural surroundings considered ideal for healing.

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My favorite uncle, Cal, had lived in a TB sanitarium in LA for several years as a teen during World War. II He survived several near-death episodes while staying at the sanitarium. When he completed treatment at age 20, he returned home to finish high school. Later he became a successful painter.

The antique sanitarium photos were a daily reminder that humans throughout history have faced epidemics and pandemics. As sophisticated as our understanding of immunity and disease might become, we will not likely escape the persistence and evolution of viruses that vex us. Nor will we sidestep such psychological side effects as despair, mass suspicions, and fears that get stimulated in a crisis.

People were dying from tuberculosis in Washington State in the 1930s and 40 when the Riverton photos were taken. I have learned that TB sanitariums came into existence because medical providers refused to allow TB patients into general and community hospitals. Doctors did not want to have too many patients on their caseloads dying. It might eradicate patient trust and tarnish their reputations.

It is equally interesting to note how suspicious, irrational beliefs and scapegoating dominated human thoughts and behaviors around major disease outbreaks historically and in modern times. The human mind seems to regress to primitive thinking patterns, such as finding ways to step away and vilify people who are considered others or outsiders. Some humans become terrified and lack access to more objective, rational patterns of thought and neutral media sources.

Without a foundation of reasoned and temperate knowledge, humans resort to mass hysteria, with, often, brutal results.

I come across a research article by Sarah A Lauer and associates that looked into the social impact of misconceptions regarding TB. During the 14th century in Poland, people with TB were forced into isolation, or else the community shunned them and had their property burned to the ground.

In the 19th century, tuberculosis — called “consumption”–-was romanticized and fetishized. It became fashionable, even glorified as a sign of artistic genius, to be suffering from lung issues. Writers such as John Keats and the Bronte sisters were all quite creative in their consumptive years.

In New England, some rural communities associated tuberculosis cases with vampires, and hysterical people ended up burning all or parts of dead bodies of vampiric consumptives. Henry David Thoreau, commenting on the vampire hysteria, noted: “the savage in man is never quite eradicated.” TB patients, also called “lungers” were forced to wear bells around their necks.

Viruses preceded us and will continue to be with us, adapting and evolving more quickly than our minds and behaviors can pivot. In this digital age wherein an abundance of information is generated and consumed without time or space set aside for reflection, truth is anyone’s bitch.

People value the voices of whoever adamantly offers simple equations and explanations that pretend to resolve complex issues. Vaccines are dangerous. Science is a conspiracy. We trust a voice that resonates with the imagined voices of our righteous ancestors who themselves were driven by fears and deep mistrust to scapegoat others.

I remember as I write that Uncle Cal faced experiences of being the other two times. First, he was banished to the sanitarium. Next, forty years later, at the height of the AIDS crisis in 1985, Cal was treated like a pariah at my brother’s wedding reception by his extended Swiss-Italian relatives. Cal’s aunts and cousins assumed that he had AIDS because he was gay. He had never come out to anyone in his family. His relatives responded to his reaching out toward them by retreating to the opposite side of the room. They made no effort to hide their disgust.

July 31, 2021

We continue to be faced with complex issues. We learn that the Covid-19 virus keeps mutating and adapting; the new Covid variant mainly infects people who have not been vaccinated. Apparently, it can also infect those of us who have been vaccinated. We can be vectors that spread the disease to the ones we most want to protect.

Last week, I started wearing masks in public spaces again. I watched a woman use her mask as a tissue to cover her nose and mouth after exiting a store when a young skateboarder rolled past her. She exhibited the raw anger and fear that exist in us that is possible to temper. We are all in this together, and yet, our feelings can shift to alienation and isolation.

My niece is getting married next weekend after having postponed her wedding for one year because of Covid. I am on the fence about going. My stepdaughter is the first to insist I avoid the event. Is it really a safe time to be gathering with 250 other guests in inside spaces? Will it be safe for my 92-year old mother? Some of the guests will not have been vaccinated. I ask several doctors and a friend who has cancer for their opinions. One doctor I ask answers in an existential manner. It is not really an answer at all. He muses, “I would not put my kids on a plane right now, but then I guess we have to get back to living at some point.” Every other medical provider I consult says: Do Not Go.

I listen to all of them measuring their words against what is bell-clear inside. When I text regrets to my niece, her response is gracious. Reflecting on the insights of my stepdaughter and my niece, I feel hope. I wonder if we could face the next phase of this evolving pandemic in a less contentious way.

I read about and hear on NPR that young adults who have often been as stubborn and resistant to the truth of Covid-19, as I was 18 months ago when Frith first offered caution and a mask, are the ones stepping up to be vaccinated now. They may also be the ones who lead us back to sanity, unity, and a restored sense of community.