Looking back at March of 2020 when all this began, for many it was a huge impact and for others it was the worst year ever. For me, it was sad and even uneasy.

At the end of 2020, a big decision had to be determined, the vaccines were available. "What do I do?" I asked myself. Many opinions, suggestions and doubt from colleagues to even the news on television, I felt unsure, whether to get this newly created vaccine into my body.

People around me -- coworkers, friends, church folks -- began to get the vaccine, but I was still doubtful.

I lost my dad in 2020. It was not not COVID related, but with all that was going on, it was hard on us all. My mom was now left by herself, elderly and fragile. I knew I had to make a decision.

I decided to place all of my doubts and insecurities aside and get the vaccine. I am glad that I am vaccinated and I now even have my booster. I no longer feel insecure or doubtful and I encourage others to also become fully vaccinated, so that family and friends can be safe as well as mine.

My dad was diagnosed with COVID-19 in December 2021. He is a physician who fell ill just days before the Pfizer vaccine would have been made available to him.

We were scared, angry, and nervous. My dad works with immunocompromised patients every day, yet he was reusing his N95 mask for several days, carefully storing it every night in a brown paper bag until he received a new one the following week.

Luckily, he was treated at the hospital where he works, surrounded by concerned colleagues who were able to check on him. Despite the efforts to reduce his anxiety, he continued to call my brother and I daily to teach us about finances and legal documents we would have to be in charge of in case he didn’t survive. This was bleak and felt unnecessary considering the fact that he was recovering as the days progressed. But as a child of Holocaust survivors, my father was taught to prepare for the worst. Always.

His rational tendencies during this time of extreme stress and anxiety were jarring, but he channeled all of his fear into assessing his lab results, oxygen saturation, and ensuring that his family’s future was protected. Becoming the patient was very confusing to him, even more so than it was to us.

I was so grateful when his treating physicians called me to explain what was going on and how he was when they saw him each day. Their objective assessments felt more real than those coming from my father-turned-patient. Their support was comforting during a time of such fear. Yet, not all patients have this luxury. This experience emphasized to me how much a quick call from a medical student, like myself, or provider could mean to a family, especially when they are unable to actually spend time with and physically support their loved one. On the other hand, I have seen first-hand how tired my dad is from providing great care to his patients. Where is the balance? How do we take care of ourselves as providers but also support our patients and families?

“I know you have a lot of patients, but he’s all I’ve got. Please take care of him like he’s one of yours.” The partner of my patient hospitalized with COVID-19 pleaded over the phone.

My mind flashed back immediately to a patient in a different hospital just a decade earlier. He had lain in his bed with monitors beeping in the background while his previously active body could do nothing more than open his eyes and whisper. He maintained a faint smile and a hopeful peace in his eyes. He was my father, and I was hopeful that he would recover.

My mother and my younger brother sat around him by me, and we spoke to him in our native language. We had immigrated to the United States only a few weeks earlier to face an uncertain future full of challenges.

I still remember the kindnesses and compassion the medical team had shown to my family, and how they so sensitively broke the news of his passing. Each gentle interaction they had with my family that day demonstrated their humanity, humility, and grace.

Facing a new pandemic where COVID-19 illness course is often uncertain has been a major stressor for patients and their families. Every day, some of my patients recover and leave the hospital while others never do.

My family’s life trajectory was forever altered by the death of our father, but it also inspired me to serve patients with the deepest compassion when they are at the darkest and uncertain moments in their lives. I care for patients who look like my father, and I support families who resemble my family, often anxious about dealing with uncertainty.

When I deliver bad news, I see my own family sitting there, hearing the unbearable news. I feel their losses as well, so when someone tells me to care for their loved one, who is all they’ve got, I fully understand.

I had been raised to believe that the hospital was a place of healing, but I had learned the hard way that this is not always the case. Sometimes the patient and family experience are what lasts in their memories, not the outcome.

I remember meeting progressively sick patients with a puzzling clinical picture

I remember how they became weaker, shorter of breath, and more frightened

I remember their names and their faces and the unforgettable sound of labored breathing

I remember looking at lab results that made my heart sink

I remember when nothing we tried seemed to change what was going to happen

I remember hospital floors dedicated to patients with a single diagnosis

I remember the haunted faces and trembling voices of brothers, sisters, parents, and friends

I remember the desperation, the prayers, and the tears

I remember weeping in the stairwell, after yet another family meeting

I remember breathing deeply before making the call that would change someone’s world forever

I remember feeling danger every time I walked into my place of work

I remember trying to reassure my parents and friends that I would be ok

I remember the tension, the pressure, the humor, the sadness, and the profound exhaustion

I remember Dr. Anthony Fauci being in the news

I remember intense public and private debates about “who”, “why”, “how”, “us”, and “them”

I remember our shared joy at small successes, new information, and learning how to stay safe

I remember witnessing miracles

I remember the first years with the terrible disease we learned was from HIV

I remember how long it took to stop reliving the worst moments in my thoughts and dreams

I remember hoping to never see another pandemic

I remember Boston, 1984

For interviewees, Covid-19 didn’t happen in a bubble, but in context of their existing life experiences with health and illness, and with healthcare. One interviewee, Deanna Day, shares the story of the many years it took to have her pain taken seriously and be diagnosed with endometriosis.

When she became sick with Covid, she didn’t have a PCP set up in her new city, in part because of past problematic experiences and the hesitancy that created. The start of her story can be viewed here.

Another, Jaipreet Virdi, lost her hearing at a young age, when her meningitis was repeatedly dismissed because of healthcare discrimination in the the Kuwaiti context where they lived at the time. She reflects on how these experiences shaped how she felt when she became sick with covid.

Third, an artist created illustrations for excerpts we share from a past research project looking at post-polio syndrome; here “Anne” shares her life story during the polio pandemic.

And kids’ reflections can be seen here.

I’m grateful for the connections in my life, thoughtful people each navigating as best they can, and for holding spaces for being with the depth of these experiences.

Exhibits and artwork can be viewed here.

Image credit: Jade Ramos

For the first six months of the Pandemic, I found myself dealing with a rather unique sequelae of a previous medical experience. In 1972, i.e., fifty years ago, I was hospitalized for 120 days at the Hospital of the University of Pennsylvania. A routine physical examination, done because of my then pregnant wife’s intuitive anxiety about my health (I felt fine) revealed an enlarged liver. The rudimentary workup available in that “dark-age” era, revealed what my surgeon, in never to be forgotten words, referred to as “a grapefruit-sized mass in the right lobe of your liver.” The working diagnosis was malignant hepatoma. The initial hemihepatectomy surgery went well, but was followed by myriad complications, including in chronologic order, weeks of post-op fever, a second surgery to find and drain the abscess in the remaining liver, sepsis, massive clotting in both legs and ARDS (Acute Respiratory Distress Syndrome) requiring five very difficult weeks on a respirator. During the latter, I had a series of ten pneumothoracies, each requiring a chest tube.

It was all very tough, and I had regarded every day since as a bonus, until “The Virus” came calling. Here was an illness that was doing to people’s lungs what the ARDS had already done to mine, i.e., producing inflammation and scarring of the membrane between the air sacs and the small blood vessels, thus preventing the diffusion of inhaled oxygen into the blood stream. I felt like the proverbial sitting duck, starting with a 20 percent normal diffusion capacity on a good day. I began having dreadful, interminable nights and exhausting insomnia, due to irrepressible thoughts, images and dreams about being back on a respirator again and of my family gathered tearfully around my casket. The coups de grace was the recurrence of the nightmares I had had fifty years ago, about my autopsy. Still alive, I was taken, as I commonly was for x-rays, etc., down into the basement of the hospital and into a large unidentified room with five tables. The middle one was empty, and I was told to climb over to it, whereupon the morgue attendant approached my head with the electric saw they use to get at a decedent’s brain. It was, in the words of that inimitable philosopher, baseball catcher Yogi Berra, “deja vu all over again!” Somewhat sheepishly, I must admit that I didn’t really appreciate what all this angst was about, until I mentioned it to my colleague, Dr. Fay Young, who pointed out that, obviously, all this was the manifestation of classic PTSD. Somehow, recognizing that helped greatly in dealing with it.

As the Pandemic has worn on, I am sleeping well again, and while awake, my ordinarily good resilience has helped me regain my usual optimistic view of life. However, I have pondered greatly the question of whether I would choose to go back on a respirator if the need arose. One of the major concerns, obviously, is whether I would be left unable to breathe after another insult to my lungs. However, while the concept is still abhorrent, I have decided that I would, because I want to see my ten wonderful grandchildren grow up further, because I dearly love my wife of nearly 53 years, and also importantly, because I still love my work and feel that I have more that I want to accomplish and contribute. In all of this, I know that I am a very lucky man, and one for whom every day is still a bonus.

I have been an Internist for 42 years. In that time there has never been a day at work that I could have predicted. I see that as exciting and I would not want the surprises to be ruined by knowing what that day would bring.

Then came COVID. Cases at Cooper rose rapidly. We were like the rest of the world – fighting a battle in the dark with few weapons. As an ethicist I was asked to be on various committees at the hospital and had the honor of working with amazing, courageous, and tireless people. What if we ran out of PPE? What if we ran out of ventilators? How do we stratify lives? When new medications became available in short supply, how do we ethically distribute them? When the vaccine becomes available, how do we decide who gets it first if there is not enough at the start? We have now had time to reflect and there has been a flood of information that was not available at the time all these decisions had to be made.

Of all the things I have been involved with in my life the one that took the most out of me emotionally was sitting on the Visitation Committee at Cooper during the beginning of this horrible pandemic. A group of us met twice daily and often on weekends to decide what family members could visit their loved ones. There were guidelines from the State, but like all such documents they are unable to provide direction in all situations. We had issues presented to us that will never leave my memory. I slept poorly due to the burden. We had to digest rapidly evolving scientific information and make quick decisions after hearing each horrific case.

Louise was a 46 y/o female requesting to see her mother on a ventilator in the ICU due to COVID to let her know that her husband, Louise’s father, had died that day of COVID. James was just notified that his father had died of COVID in the hospital and was requesting that he and his brother be able to see his father in our morgue because the funeral homes were not permitting visitors. Ellen was with her daughter in labor and delivery and wanted to have her husband present after hearing that there might be complications. There were many such situations every day. Our committee took the burden off the providers of telling families the decision, and we took that burden upon ourselves. It was terrible.

If I knew then what I know now about how the virus spreads, how masks really work, the true risks to others, how many would die, and that no end would be in clear sight for a long time, I might have voted to let some family members say goodbye to those they love. No one who experienced the stories we heard would dare speak negatively about the vaccine. We sadly did not have a crystal ball. We still need one in the fight against COVID.

I recall my first vaccine experience when I was 6 years old standing in line at my pediatrician, Dr. Marcelle’s office. I have a vivid memory of the smile on her face as she handed me a sugar cube on which she had just placed two drops of the polio vaccine. I swallowed the sweet sugar cube and lived to tell this story. Decades later, I found myself standing in line again to receive the Covid-19 vaccine that would be delivered this time by my medical student who was more nervous than I was, yet she had a beautiful smile on her face that reminded me of the joy that my pediatrician must have felt when she knew that she had just saved another patient from a terrible illness.

I have witnessed the devastating effect of both illnesses on my family and friends, and I cannot imagine what the consequences of having Polio back then or Covid 19 today would have been on my life. This thought has since crossed my mind each time I met with one of my patients recently diagnosed with cancer whether younger or older than myself. I wish they had a chance to prevent such a terrible disease with a tool as simple and accessible as I had with vaccine.