On the front lines

Writer tells his personal tale of covering
the COVID-19 pandemic — and the illness that followed.  

Story by Tom Chiarella

It was a sunny March day in Omaha, Nebraska, which now reads in my mind like some postcard from another world. It’s a dim memory to me, though as I write this it was only five weeks ago. After I returned from Omaha, I didn’t feel well. More than a month would pass before I felt like myself again. The sunny day in Omaha? It would be forgotten without my notes. Most things from that time would be. These days, a month can shred a lot of memories.

I was in Omaha visiting the National Quarantine Center — the largest of its kind in the United States — which sits in the middle of the campus of the University of Nebraska Medical Center. I was there to do research for a magazine story, to observe the work of staff members in the Biocontainment Unit, which at that moment housed a number of the nation’s first confirmed COVID-19 patients.

testingsite
Testing site

 Among many other requests I made, I’d asked to speak to a nurse who worked in the Quarantine Center. I waited for her in an ordinary hospital hallway. The woman who agreed to speak with me got off the elevator carrying a bag of IV medication and a sheaf of patient files under her arm. ID card clipped to her waist. Blue-gray scrubs. Newish white shoes. A watch. Smart haircut. A single ring. 

I noted all those details. I used an exclamation point. “Nurse!” I wrote at the top of a page.  

She had 11 minutes. “OK, call it 12,” she allowed. “This is the middle of my work. I have to be precise.” I thanked her for the time. She thought I meant the work. “Everybody here works,” she said. “This is my job. No need to thank me for showing up to work.”

OK. No need to argue. I shrugged and started up with the questions. At the time, I figured she might be right.


In that hallway, outside the staff entrance to the Biocontainment Unit, two federal marshals monitored the ins and outs. The day before, I’d interviewed the medical center CEO, two physicians, an epidemiologist and a lab researcher. I caught them on the move — between meetings, standing in front of a vending machine, walking to or from their cars, standing in a spare conference room. They were fairly patient, but they never paused in their work. They were tired, but they made time to tell me what they had learned.    

marshals
Federal marshals outside the Biocontainment Unit

Between interviews, I sometimes stood in that unadorned carpeted corridor outside the staff entrance to the Biocontainment Unit and observed the comings and goings of those who worked inside. The marshals wouldn’t talk, not even to confirm they were marshals. (They were.) But it wasn’t difficult to get a word in with the medical staff when they queued up at the marshal’s table after clocking in. Nurses. Doctors. Respiratory therapists. As they paused at the door for an ID check, they often gave a thumbs-up, or an affirming nod. They smiled as they moved toward their work, their patients. They didn’t have much time to tell stories. One nurse spoke about his weekend lacrosse game. Another described the process of teaching her son to ice skate. Mostly they looked at the plain, wooden door and spoke about what was beyond it, in preparation for the work ahead.   

Consider: women and men, headed into a “hot zone” of viral containment, a worrisome pinch-point in the possible spread of a dangerous novel virus. This, in the days before social distancing was introduced to the world. Early March of this year. Most of them had been training — periodically, repeatedly — for years to work in the Biocontainment Unit. The first of its kind in the country, the unit opened at UNMC in 2004 and was first used during an Ebola outbreak in 2014. The veteran employees had learned to trust the work then, when this facility was the only unit on U.S. soil that dealt with active Ebola patients. Serious, important, and yes, dangerous work.  

And no one seemed afraid.

“The work obviously matters, to the country and to the world. So it’s something you naturally want to be a part of.”

We’ve all seen movies about epidemics. It was not a cinematic location. There was nothing dire or dramatic in the attitude of the people who worked there. The atmosphere felt nothing like a movie about a global pandemic. It was simply a scene from inside a real one. I saw no measure of fear in their faces. There was a pervasive calm and a sense of the ordinary.   No one in the hall wore hazmat suits. No buzzers or flashing lights. No one wavered when they talked about their work. They had no doubt. This is Nebraska. This is health care. These people simply wanted to get to work.  

Once inside, they would don a full set of top-grade personal protective equipment — a process carried out with a partner, involving 12 to 15 minutes of long, memorized checklists and vetting procedures. Redundant masks and face screens, triple-redundant gloves, layers of gowns, aprons, dozens of seals and cinchings. All of it double-checked by the partner, rechecked against posted lists. This laborious process is repeated upon every entry, by every individual admitted to the unit. 

do not enter

With the donning process complete, they proceeded to a nurses’ station, where they were updated on patient status before finally moving to greet the patients behind another set of doors. The space is reverse pressurized to allow for a full exchange of air several times an hour. This is biocontainment.  

They have learned not to fear it. Trained. It shows as they sign in to go work that day. No one is excited, however, or cavalier about the undertaking. 

Nor do they appear anxious. At least it doesn’t show. They are eager. Uniformly.   

“I just want to see my patients,” said one nurse, a 28-year-old father of two who normally worked in the transplant unit. “Same as any other day, really. Virus or no virus. The people are the best part of the job. In the containment unit, there’s just some work you have to do to get to them.”

Another nurse was standing at the dawn of her third-consecutive day working a 12-hour shift. She was 48, with a husband and teenage daughter at home.

“No one is pushing me in the door,” she said. “This kind of work is why I chose nursing. I want a job where I have to concentrate in every minute of the thing. Time goes by quickly when everything you do matters.”


When I couldn’t get time with the staff as they worked, I stopped people in the street. Were they aware of the work being done in the Biocontainment Unit? Did they know about the emergent novel coronavirus? Did it worry them to have this work going on in their city? At breakfast one morning, I spoke with six nurses from the maternity ward, sitting together at a clamshell table. They knew about the Biocontainment Unit and the Quarantine Center. They had friends training to work there. They expressed admiration for the work. Pride that it goes on in Omaha.

“I’m a labor and delivery nurse,” one of them told me. “I love what I do. I chose this career. But I grew up in Nebraska. We’re used to this. They had Ebola there in 2014, and they handled it.”  

“I was in high school then,” said another, “and I couldn’t stop reading the newspaper. My parents were worried it was in Omaha. I just figured this is what we do.”

She paused, thinking back on the time between the two viruses. A mere six years. She can see a legacy already. “A lot of my friends became nurses because of that time, with all the news coverage,” she said. “The work obviously matters, to the country and to the world. So it’s something you naturally want to be a part of.”


At some point, I asked to speak to someone who worked with the patients in the Quarantine Center, which is in a different building from the Biocontainment Unit. A nurse volunteered. Same one who had emerged from the elevator, said bye to her friends over her shoulder and approached me carrying all that stuff. In my notes, I scratched out an inventory of what she carried. Same list you read at the beginning of this article.

I’m glad I have those notes. 

Days later, after returning home, I developed a fever and a painful cough. Exhaustion took hold of me. I started hearing my own breathing at night.

By now, you’ve heard the stories of quarantine and isolation with COVID-19 patients. I was told to ride out the flu-like symptoms, to get a test when it became available and to stay in touch with my physician. The illness might last four to eight days, and then I’d be able to leave isolation after being symptom-free for three consecutive days.   

But for me, it has been a very different story.

I followed the directions given by the Centers for Disease Control and the state of Indiana where I live. I’ve had a low-grade fever every day. Exhaustion creeps up on me every waking moment. I’ve had so many varieties of cough and sore throat that I have given them names. They sound like birds. The woodland cough. The sandpaper throat. The kick-me lung warbler.

This is Day 32.

I filed the magazine story before I went into isolation. So my work in Omaha was over. But I think about UNMC often, and the people I met in Omaha. Because I went into isolation almost directly after my return from Omaha, my most recent memories of the world outside are stacked up around the people I met there, in and around the medical center. People I remember more for their jobs than for their names. Those nurses. An X-ray tech. A phlebotomist. A hospital shuttle driver. A sanitation worker. A facility manager. An HVAC tech. A purchaser for a retail food chain. A TSA agent. A teacher. A retired Green Beret medic. Every one and each, on their way to work, or returning from there.   

“This kind of work is why I chose nursing. I want a job where I have to concentrate in every minute of the thing. Time goes by quickly when everything you do matters.”

They got the news from the world just like everybody else these days — on the radio, on the way to work, on their phone or in strips running along the bottom of a distant television screen. And all of them were aware of the dangerous work going on with the virus in their very own city, in the nearby medical center.   

No one showed fear. Without fail, they expressed pride in the city where they lived and worked. “It’s a tough job,” the Green Beret medic said, leaning against a counter in an espresso bar. “Makes you appreciate the people you meet walking around here. Omaha’s cool like that. Anybody could be saving the world. Or just going to work, I guess.”

I don’t list them that way — without their names — to make them any less human. I have notes. I can access the names. To the contrary, I don’t need the notes to remember the way they claimed their work as some proud part of who they are. Same as the nurses and doctors at the medical center.


Iam remembering all this after more than a month in isolation, sitting behind the tall windows of a second-floor apartment in a 19th century mercantile building, facing the courthouse square in a little town in Indiana. The terms of the world out there have changed. It’s a time of lockdown and social distancing. Jobs have been lost. Many people can’t go to work. The ones who can — the nurses, doctors, orderlies, the janitors and cooks and supermarket cashiers — just seem brave for being willing.

Days ago, I was in an emergency room in suburban Indianapolis, waiting to get yet another chest X-ray. The radiologist came in wearing a full suit of personal protection equipment. I could hear the rasp of the respirator clipped to her waistband. And right then, for the first time, I was scared.   

She worked away. Eventually, feeling somewhat lonely and overwhelmed, I spoke. 

“Thank you,” I said, “for coming to work.” 

She looked at me through her redundant protections, her glasses and facemask, and nodded. “It’s my job,” she told me, as if that were enough. 

I ignored that and thanked her again. For showing up. For her work. Thank you. 

It mattered, and this time I knew it needed to be said.


thumbnail_IMG_0045

Tom Chiarella was writer-at-large for Esquire Magazine for more than a decade.  He’s been a contributor to Popular Mechanics, The New Yorker, Golf Digest, O: the Oprah Magazine, Chicago Magazine, Euroman, Men’s Style, Fashion (Canada) and many others. He lives in Bainbridge, Indiana, and serves as an Emeritus Professor of English at DePauw University.


This story originally appeared in the June/July 2020 issue of Kiwanis magazine.

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