Week 18: Cancer in the time of COVID

July 28, 2020

Richard’s in the hospital again this afternoon, and honestly, it’s hard to think about anything else.

Richard is my mom’s boyfriend of 15 years. They met in 2004, and shortly after became bridge partners. He was a retired school teacher, a widower with no children of his own. She was a retired real estate agent, with two grown children and four grandchildren (now five — hello, Elle!). She was also still married to my dad — but as I can attest, it wasn’t going very well. She left my dad in October, and six months later, started dating Richard.

Given the history here, I was predisposed not to like her new paramour. But he turned out to be so likable — kind and friendly, easy-going, and difficult to rattle. My mom can run high-strung and stressed out; in him she found a partner who not only refuses to rise her level of anxiety, but who actually calms her down. “Now, Kris,” he often says, “that’s not a big a deal.” And pretty much always, it turns out it’s not.

(No worries about my father. My mother formally moved out in the morning, and he went on his first J-Date that evening. Two dates a day on the weekdays and three dates a day on the weekend, for two months straight, until he met Joyce in December. This past February, they celebrated their 14th wedding anniversary.)

Richard turns out to have two obsessions: bridge and politics. I don’t know too much about his bridge side, though my mother tells me he’s a great player. But I’m well acquainted with his political fixation. At 81 years old, he’s an old-school Democrat (think Biden, pre-pandemic). A measure of his intensity is that I did not notice a particular uptick in his news diet when Trump got elected. The way we’ve all become attuned to every twist and turn of the D.C. drama? That’s how he was about the Iraq War when I met him, and it hasn’t waned since.

But I don’t know if he’s been tracking the details of the Republicans’ latest coronavirus relief bill, or that Trump just claimed that much of the country is “corona free.” He may be too busy fighting to breathe.

A few years ago, Richard did a preventative scan, and to everyone’s surprise, they found cancer in one kidney. So they went in and took out the kidney and honestly, I barely even noticed there’d been a surgery. He just went on as before, as though nothing much had happened. Two or three years passed, and cancer turned up again, in an adrenal gland. Another surgery, another excision, another shrug, and he was back to his life of politics tracking, bridge with my mom, travel with my mom (sometimes bridge and travel together, when they went on bridge cruises) and walking their rescue dog, Sadie.

Then, in January, his back hurt badly enough that he had my mom take him to the ER. I’m picturing excruciating pain, because nothing less seems to catch his attention. It turned out the kidney cancer had metastasized to his spine and his lungs. That was a bad day, and the days have not gotten appreciably better since then.

There’s been immunotherapy. There’s been the side effects of immunotherapy. There’ve been scans and blood work and more scans. Earlier this month, there was a week in the hospital, followed by about 10 days in rehab, where they tried to increase his weight and strength. Then this morning, he could hardly breath. My mom drove him back to UCLA, where’s he supposed to spend the night. When he comes home tomorrow, it will be with a tank of oxygen.

There’s the hope that the oxygen will make it easier for him to breathe, and give him back some ease in his days. There’s the hope that the treatment the oncologist plans to start on Friday will be the magic bullet we’ve been seeking for the last six months.

Hope feels narrower and more tenuous each day, but — maybe — there’s enough still to clutch onto and try to hold fast.

What’s certain is that this is hard to watch. It’s hard to watch Richard suffer. It’s also hard to watch my mom struggle with his illness. She doesn’t whine and she’s been remarkably composed through these last few months. But Richard has made her happier than I’ve ever seen her in my life, and so I’m not surprised that this has been a brutal journey for her, too.

I’m not sure how to end this post. Sunshine does break through cloudy skies, right? Well, we’re all waiting on the sun.

Week 11: Quandary for our times

June 2, 2020

I’ve been thinking about rage.

There’s the rage on our streets, when people smash store windows and steal goods and destroy the livelihood of businesses already crippled by the pandemic.

Or when demonstrators throw firecrackers at police, screaming at them, daring them.

Or when police fire rubber bullets into crowds and smash into protesters — even peaceful ones, even journalists.

Or when no one throws anything or hits anyone. When the marches are “peaceful,” they are still full of rage. You don’t brave the threat of tear gas and pepper spray and coronavirus to march down crowded streets on a weekday if you’re not on fire with fury at the injustice all around you.

Within our homes, there’s rage too. I’ve spent the last three and a half years distraught at our national politics, but I’ve never been this angry.

Here in Los Angeles, we are going on our fourth night of curfew, with no end in sight. The city convulses and convulses again, like major cities all over this country. Yes, we’re horrified by the George Floyd murder. Yes, we’re appalled at the violence casually inflicted on black people at the hands of our authorities.

But here in L.A., we know that too many black people are homeless. Too many people are homeless, period. If we’re paying attention, we know that the COVID wards are filled with the poor and the underprivileged. Our city is a beautiful cauldron of inequity. I worry we’re seeing its contents bubble over.

The one person who is supposed to ease down the heat, our President, instead threatens to call the military on us, then has officers clearing protesters with tear gas and clubs so he can walk across a plaza to a church where he holds up a Bible.

The guns and the threats and the religious symbol — which for him is probably all it is — I defy him to describe even part of what’s inside those covers — it makes me feel as though I will explode, like those emojis with the top of the scalp blowing off. I don’t know what to do with this fury of mine, that’s both potent and noteworthy and completely insignificant, all at the same time.

I have a list of black-owned businesses I can frequent — check. I have and will continue to donate money to causes — check. Once I meet my work deadlines, if I feel well enough that day (still recovering from the virus, in fits and starts), and the protests are still ongoing, I may march.

I don’t know if any of it will matter. The forces arrayed against justice are formidable, and growing more so every day.

In conclusion… well, there are no suitable conclusions to this. Instead, here are two things people said to me that keep echoing in my head, and one story unique to early June, 2020

My mom today, on the phone: “I don’t think anyone is happy right now.”
My friend on Saturday, in reply to my text asking how she was doing because she lives near the rioting: “We are ok, just super sad for the state of our city and our country. Not sure how much more everyone can take.”

And finally, a story. Yesterday, Liam was trying to pick up a Chipotle burrito to join a friend for a socially distanced lunch. He’d made it from Mar Vista to Rancho Park when he realized that they’d given him the wrong order. He’d already driven past boarded up store fronts and stationed police cars and didn’t care to do it again. But he needed his order, so he grit his teeth and went back.

Rattled by … well, everything … he was pulling out of the parking lot when he swerved to avoid a pedestrian and scraped the side of my minivan against a pole. It didn’t look pretty and the bumper seemed to be dangling a bit. I asked him if he could pop it back into place, and he could, so I told him to go ahead, we’d deal with it later. What’s a scraped bumper amid rioting and a pandemic?

Then the President did his shenanigans and we all forgot all about the car.

Today, Liam and Eli drove the minivan down to Manhattan Beach for a protest. They walked five miles round trip during the peaceful rally. When they got back, Eli took the car out again to get groceries for my mother (because she’s in her 80s and remember? there’s still a virus out there). There was a long line in front of Ralphs; inside, the patrons were testy and the clerks were exhausted. When he offered to bag his own groceries, the cashier, an older African-American lady, thanked him and told him he had no idea what kind of a day it had been.

On the way home from dropping the groceries at my mom’s in Westwood, driving down the freeway, he heard a funny scraping noise. A guy in another car yelled at him that he’d better get off the highway and check out what’s going on.

And this is how my son ends up parked at the corner of Amherst and Pearl at 5:30 p.m. with a bumper half-dangling off his car and a curfew barreling his way in 30 minutes.

It turns out there is a unique flavor of panic to getting a call from your kid that a bumper is half off a car and he’s a half hour away from being arrested for breaking curfew. There is no guidebook or precedent that I know of for what you do in that situation.

What did he do? What do you think? He smashed that bumper back into place as best he could, and drove home as carefully as possible. Tomorrow, we will figure out how to get it fixed during a pandemic, skirting protests and riots.

I know this isn’t the fault of the Establishment, or the Bad Cops, or even Donald J. Trump. But it sure feels like it is.

Week 11: Ablaze

May 31, 2020

It’s late, and I should go to bed. But it’s hard to close my eyes on our burning nation.

Look, I’m a white lady from a white neighborhood. I’m not sure what right I have to my opinion, on the murder of George Floyd, on the protests, on the riots or the looting. And I’m not writing this because I believe what I think is important or necessary at this moment. There are so many more important and necessary voices than mine tonight.

But I’m confused. I’m shocked, and embarrassed that I’m shocked. And I’m appalled at myself, because I know by doing nothing so far to affect change, I’m complicit in perpetuating our racist system.

I also want to apologize to everyone who doesn’t enjoy my white privilege — apologize because I know I still don’t get it, and I’m sorrier than I can put into words.

I’m almost always someone who gets almost all her news from print. But today seemed like it demanded video, so I watched my local CBS station and then CNN, for about an hour, until my stomach hurt and I turned it off. I saw so much yelling. So many menacing officers marching forward (though I’m sure, underneath those helmets and bulletproof vests, many of them are terrified). I watched things burn.

First I watched it in L.A. Then Long Beach. Then Santa Monica. Then Philadelphia. Then Washington, D.C. Then New York City. It seemed like our nation itself was on fire.

But the head of our national fire department? Our Commander in Chief? Where was he? Where were the calm words? The call to our better nature?

Nope. Except for an occasional rage tweet, he was quiet.

I’ve lived through national crises before. But we’ve always had a leader who believed he answered to all Americans. I don’t know how a leaderless nation stops convulsing once it starts. I’m scared to find out.

P.S. Here’s a video I watched on Twitter tonight. It brought me to tears. I just had to share it.

my god this is powerful. sound up. pic.twitter.com/IbdsfyyA4U
— shauna (@goldengateblond) May 31, 2020

Day 39: Normal

May 5, 2020

I’m writing today, as I have every day lately, from my dining room table. Behind me is a window twice my size, that looks out onto a world I more observe than inhabit.

But the opening is coming! So I read in the papers. So I see in the news. We’ll get back to business, our President promises. “Normal” will return again.

“Normal,” hand in hand with the coronavirus. Whatever that looks like.

I have no idea what the right path forward is. California’s governor is inching us into more economic activity, and that may be a good thing. As I wrote yesterday, I don’t know that we can live like this forever.

But here’s the conversation so many of us aren’t having: what are we willing to accept in exchange for a paycheck? In a swap for profits?

I just read an op-ed in the New York Times that wonders if our response to the continuing pandemic will come to resemble our reaction to gun violence fatalities.

“The coronavirus scenario I can’t stop thinking about,” wrote Charlie Warzel in the Times, “is the one where we simply get used to all the dying.”

It’s not such a fantastical scenario. The Times reported today that the Trump administration is discussing winding down the White House Coronavirus Task Force; as Trump himself toured a mask manufacturing plant in Phoenix, wearing safety goggles but no mask (like his VP, when he toured the Mayo clinic last week); and where he responded to a reporter’s question about the task force’s possible demise by saying, “”I think we are looking at Phase 2, and we are looking at other phases” of the pandemic.

Of course, Trump is only leading the way. From Florida to Georgia to Iowa, states are lifting quarantine orders. There’s also a cresting frustration in conservative swaths of this state. On Friday, a 24-hour fitness studio called the Gym, in Victorville, Calif., opened for business in defiance of the state’s mandate, with an 8-foot by 10-foot printout of the Constitution posted by the front door.

“This virus is political,” the Gym’s owner, Jacob D. Lewis, told the Los Angeles Times. “It comes down to our civil rights. There’s one thing that people in power forget, one thing that makes us all the same, and that’s the Constitution.

“They can’t force us to shut our doors,” he continued. “We did it voluntarily in the beginning because they hyped it so much, but guess what? They lied to us.”

Meanwhile, the number of COVID-19 cases nationwide continued to climb. And Riverside County, which contains Victorville, has the second-highest caseload in the state. At 4,354, it’s a fraction of the 28,000-plus cases in Los Angeles County, but more than double the 1,760 cases in San Francisco.

I can imagine an alternative path, one in which we continue to expand testing and demand people wear masks in public while staying home, in private spaces, as much as they can. Meanwhile, we ramp up our contact tracing abilities and invest in a great antibody test, like the one produced by Roche. Once our case numbers come down to a level officials deem acceptable, then we open up, slowly, testing for antibodies so we know who is safe to wander about, while continuing to test for new infections, and then tracing down and quarantining those who came in contact with the ill person.

It’s not a perfect solution, not by a long shot. Even if we have the best antibody test possible, we still don’t know what those antibodies mean. Do they confer immunity? If so, for how long? Also, we’ve burnt up so much precious time this winter and spring not investing in testing, not producing enough masks or hand sanitizer or PPE or any of the other items we need to prevent virus transmission, that we arrived in May hobbled by an economic crisis unlike any I’ve seen before in my lifetime, while here in LA and around most of the nation, more and more people are falling ill. I don’t fault our mayor or our governor, who did the best they could with the tools they had. But it’s also true that the people have been patient, and thanks to bungling at the highest levels, we don’t have enough progress to show for our sacrifices.

I realize I may be ruffling feathers here, and I’m sorry for anyone I’ve upset. But my husband is a doctor, and if we as a nation decide we’re not going to worry about the coronavirus, well, he won’t have that luxury. It’ll be in his exam room and in the ER and in the hospital. He will be exposed to it again and again and again, in a way he’s so far avoided thanks to the quick and decisive actions of our state and local leaders.

And anyway, I don’t know if any of us have that luxury. I just read today about a Ralph’s supermarket in Hollywood where 21 of the 158 employees have tested positive for the virus. I don’t know about you, but I wouldn’t be in much of a hurry to shop there now. If we loose our controls, if we turn our backs on this virus, return to life as we used to live it, the virus won’t just creep away. It will creep inside us. That’s what viruses do. And then where will we be? And how will we function?

Day 22: Letters of Transit

April 16, 2020

Last night, we sat down with our kids to see “Casablanca.” Not all three kids — the middle one took a pass. He often takes a pass. This is how he missed seeing “Come From Away” at the Ahmanson two Decembers ago, a theatrical experience the other four of us still gush about with wonder.

But I digress.

So there we were, me and the 16-year-old and the 21-year-old curled up on the couch, my possibly-COVID husband relegated to another option (he vacillated between the floor and an ottoman). And maybe it was because we kept pausing the movie to explain plot details to the 16-year-old (while her older brother rolled his eyes and threatened, “If she needs to stop one more time, I’m leaving” — but she did, and he didn’t). Or maybe I’ve finally seen this thing so many times that I can get beyond wondering what Ingrid Bergman would’ve looked like without soft focus, and sighing over the tragedy of thwarted love.

But for the first time, I understood in a visceral way the relief those characters must have felt to land in Casablanca, and yet, the burning desire, even need, they had to leave.

Until this virus landed in my community, I’d never been stalked by an enemy before. I thought my dreams of Nazis chasing me sort of counted. I thought the fear I felt the night of September 11, 2001, looking up into a Los Angeles sky brightened only by starlight, wondering if my city would be next — I thought that counted.

No, it didn’t. Not for me, anyway. But now I know what it’s like to find my society up against something implacable and potentially lethal. To make a rough correlation, the outside is Vichy France. My home is Casablanca. It’s safe — for now. I can afford to stay here — for now. There are adequate provisions — for now. But I want — we all want — to get to safety.

That war, when it caught you in its crosshairs, was so much deadlier than this virus. But it was ungainlier, couldn’t travel with the same smooth, voracious ease.

President Trump wants to open up the nation as soon as possible — May 1st, or even earlier for some locales, he reportedly told governors on a phone call today. I confess, I am usually knee-jerk negative on all things Trump. And of course, this nation remains woefully unprepared to confront this pandemic, short as we are on testing, and ventilators, and ICU beds, and ill-equipped as we are to do proper contact tracing.

But what is our alternative? Here in California, we are what’s considered a raging COVID success story. “State’s scariest virus scenarios finally yield to ray of optimism,” read the headline in this morning’s LA Times. “Coronavirus cases in California may be peaking, models show, provided we stick with social distancing.” (italics are mine)

That means everything — so many lives saved — and nothing. I don’t understand how we keep doing this. I see friends posting on Facebook that neither they nor their spouse have had any income for a month. Two, three, four months like this seems unsustainable.

In such moments, I turn to my younger brother, who loves numbers. When he was a kid, he’d grab the sports section each morning and lie on his stomach on the den carpet, the paper spread out before him to the stats section, chewing up the numbers in his head, breaking them down. Today, with business in the doldrums, he fills his time scouring the internet for COVID-19 spread data. Sometimes he sends me what he finds. (Sometimes he makes graphs of infection rates by region, country or state. I’m trying to get him to make a few that I can share here, but so far, he’s a no go.)

Yesterday, he sent me this link. As of today, the New York state infection rate is 11,530 per one million people. California’s is 704. Sure, we can re-open this state, but whether we inch forward, or throw ourselves a big “return to normalcy” party, we still must grapple with the intractable fact that most of us remain unexposed to the virus and don’t have immunity.

But are New Yorkers much better off? Definitely, there are a lot more people in the five boroughs that have survived COVID-19 than in Los Angeles. But we still don’t know what that hard-won exposure is worth in immunity. I came across a study in Science Magazine the other day that sent chills down my spine. The authors — Harvard University professors — explained that viral immunity could be anywhere from five years or more to a handful of months. We just don’t know. And, they added, what’s going on now may not be the worst we’re going to see. I’m just going to quote from their paper here, because they explain it better than me:

One-time social distancing efforts may push the SARS-CoV-2 epidemic peak into the autumn, potentially exacerbating the load on critical care resources if there is increased wintertime transmissibility. Intermittent social distancing might maintain critical care demand within current thresholds, but widespread surveillance will be required to time the distancing measures correctly and avoid overshooting critical care capacity. New therapeutics, vaccines, or other interventions such as aggressive contact tracing and quarantine – impractical now in many places but more practical once case numbers have been reduced and testing scaled up (43) – could alleviate the need for stringent social distancing to maintain control of the epidemic. In the absence of such interventions, surveillance and intermittent distancing (or sustained distancing if it is highly effective) may need to be maintained into 2022, which would present a substantial social and economic burden.
“Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period,” Science Magazine, April 14, 2020

In other words, if this doesn’t work out right, we could be asked to do this for two more years. But we can’t. Can we? People who had solid lives will lose their homes. People won’t have money for food. And will the food even be there? What of our vaunted supply chains, when the virus keeps striking and striking, and we keep shutting down in response?

Just like Victor Laszlo and his soft-focus Ilsa, we all just want safety. We sit here on uncomfortable bar stools in Casablanca, throwing back our cocktails, trying to figure out how to get letters of transit so we can leave this beautiful hellhole.

Remember, in “Casablanca,” security was only an illusion. It was a free French territory, but the Germans kept finding ways to convert life to death. And so we wait in our homes, while the economy crumbles, and we’re “safe” — maybe from the virus, probably not from the economic damage being wrought all around us.

We want safe passage. But maybe there’s no entirely safe passage through this thing.

Day 5: Tests

Today, our president told governors on a phone call that he “hasn’t heard about testing in weeks,” presumably because lack of tests and delivery of test results is no longer a problem.

As with so many things over these last three, excruciatingly long years, Mr. President, you are wrong again. Only this time, for me, it’s not theoretical. My family and I live every day with the consequences of this administration’s dilly-dallying and cavalier attitude towards mapping and diagnosing coronavirus infections.

As I’ve written before, I got tested for the coronavirus on Monday, March 23. Eight days later, I still don’t have a result. The latest word I heard is 10 days out from testing, which would have the answer landing in my inbox on Wednesday. But then again, I just heard of a guy who tested in mid-March, and is still awaiting results.

Meanwhile, I’m getting better. By the time I actually hear whether I had COVID-19 on March 23, 2020, I may be completely healed and back to my online Bar Method workouts and two mile dog walks. But still, it matters.

It matters because I’ve spent the last week and a half going, Do I have it? Don’t I have it? Inspecting my symptoms. Second-guessing myself.

It matters because at first it seemed so implausible that I was sick with this famed illness that, even after I tested, my family and I took the notion half-seriously. I mostly stayed in my room. I mostly wore a mask when I ventured into the rest of the house. My daughter lay down next to me on the bed and rolled her eyes when I ordered her to get up. My husband continued to sleep next to me until my coughing at midnight sufficiently freaked him out enough to switch rooms.

Then on Saturday, our daughter and younger son both got sick, her with a hacking cough and minor fever, him with dizziness, coughing, fatigue and vomiting. Even the oldest kid had a sore throat. By today, 48 hours later, the younger two are healing and the oldest completed a 27-mile bike ride. Only my husband has remained symptom-free — and freaked out, wondering if it’s still coming for him, and if so, how badly?

My husband got tested the day after me, and received his negative result 16 hours later, because as a healthcare worker, he went to the front of the line. But that only means he didn’t have it on March 24.

If my test result was back, and I tested negative, then he would know I hadn’t exposed him to the coronavirus. If the test wasn’t so precious, and the kids could get tested, too, then we’d know whether we’ve all had the same thing, or one or more of us has yet to face down COVID-19.

It’s not much. Only peace of mind. Thanks to the bungling of this administration, it’s not to be had around here.