I’m not proud to admit this, but I’m terrified of getting Covid-19. Specifically, I’m terrified of getting it and dying in the hospital on a ventilator.
I’m not proud of this terror because, rationally speaking, it’s misplaced. I’m not in a group at elevated risk of dying from it. I’m healthy and relatively young. Given all the people who have a legitimate right to fear serious disease, my anxiety feels self-indulgent to the point of being offensive. I try not to mention it to my elderly friends and neighbors when I check in with them, but there I am, obsessing about the errant cough and monitoring my breathing for any trace of wheeze. The reason is that I know it’s possible to go from being healthy to being gravely ill in a matter of days. I know firsthand what it’s like to think you have the flu, land in an intensive care unit, and nearly die.
Almost 10 years ago, after feeling run-down for a day or so, I suddenly developed a fever. I’ll never forget the moment it descended upon me. I was an opinion writer for the Los Angeles Times and had just hit “send” on my laptop, filing my latest column with my editor. It was as if the illness had been waiting for me to finish the piece before completely overtaking my body. Though I lived in L.A., I was in New York at the time, staying at a friend’s place in Brooklyn while she and her family were out of town. It was early evening and, amid shivers and body aches, I rummaged through the cabinets looking for aspirin or some sort of fever reducer. Not finding any, I made my way to a neighborhood pharmacy and bought some Tylenol. I was in bed by 8 p.m.
These days, unless my mind is otherwise occupied, I can easily convince myself that the tickle in my throat will soon turn into a dry cough.
The next day the fever was slightly down but the aches were worse. I canceled all of my plans and appointments and returned to the pharmacy, asking the man behind the counter what he suggested for my symptoms. I remember him telling me I probably had allergies. That sounded wrong, but I went along with it because I was so unaccustomed to being sick that allergies were pretty much my only point of contact with illness. In fact, I was so unaccustomed to being sick that I didn’t even have a primary care physician at home. I bought some Benadryl and went back to bed. I didn’t get out of bed until the next day.
The next day I felt somewhat better, enough so that I forced myself to go for a run in the park, thinking I’d sweat out the remainder of whatever was ailing me. I resumed my remaining travel plans to take the train to Boston, where I would meet my then-husband and drive to New Hampshire to visit old friends of his from college. The friends were a family of four; the wife was a family physician. By the time we arrived at their house, I was too sick to even sit at the dinner table, so I went to bed and stayed there for the next day or so. The physician wife checked on me regularly but surmised I just had a nasty bug and told me to keep taking Tylenol.
I flew back to L.A. with my husband and threw up in the lavatory of the plane. I also became so intolerably warm that, despite mounting physical weakness, I yanked a suitcase out of the overhead bin in search of one of his T-shirts to change into. The morning after we got home, I went to an urgent care clinic. I was given IV fluids and then sent home with the assurance that I had the flu and would start to feel better soon.
The next morning, I woke up weaker than I’d ever been in my life. I was also thirsty in a way that I didn’t think was possible. The whites of my eyes had turned yellow and my urine was as dark as tea. My husband took me back to the clinic, where I was given more fluids until a doctor finally decided I should be taken to an emergency room because I probably had hepatitis. I said that was fine as long as I didn’t have to move my body in any way. I was too weak at that point to lift my arm. I was transported by ambulance five blocks to the local hospital, where I was evaluated and eventually admitted. The last thing I remember was slurring my speech as I tried to answer the questions of an infectious disease doctor. Had I traveled anywhere exotic? Had I been exposed to any strange chemicals? Who was the president of the United States? Hard as I tried, I could not get the words in my mouth to match the words in my brain. I remember being worried that the doctor thought I was drunk.
The events of the ensuing several days I only know secondhand, since they were either erased from my memory or took place while I was under sedation. The first thing that happened, I’m told, is that even though I was clearly getting sicker even as I lay in the hospital bed, it took my husband raising a fuss in order to get anyone to pay proper attention. Apparently I was speaking incoherently, babbling about leaving laundry in the dryer or forgetting to lock the door. The nurses said I was just tired. My husband insisted that the doctor be called in the middle of the night, and eventually, the doctor came. I was moved into a step-up unit and, sometime later, the critical care unit. Eventually, I was placed in a medical coma with a breathing tube and a feeding tube. By then I had liver and kidney failure and meningoencephalitis, a swelling of the brain and its lining.
The doctors suspected that it had been a virus that had set all of this off, possibly something like West Nile virus. Still, they were giving me constant infusions of four kinds of antibiotics, just in case it was something else. I also received platelet transfusions, a blood transfusion, three EEGs, three MRIs, two CT scans, and a spinal tap. I developed a condition called DIC, or Disseminated Intravascular Coagulation, which is when reduced platelets mean your blood can’t clot and you risk spontaneous internal bleeding. A healthy platelet count is supposed to be somewhere around 200,000. Mine at one point was 14,000.
As you may be guessing by now, I survived this ordeal. (In a testament to the tyranny of the life of a newspaper columnist, the first thing I asked for when I came out of the coma was for someone to call my editor and tell her I’d be filing the next column late.) The cause of the illness turned out to be bacterial rather than viral, an infection caused by a vector-borne disease called murine typhus (you can read more about it here if you want the disgusting details). Other than tinnitus and mild hearing loss, I made a complete recovery, which is pretty miraculous given that my family had been warned at points that I might suffer permanent brain damage if I survived at all. But one of the lingering effects, other than having difficulty hearing people in loud restaurants, is that I’m a lot more afraid of getting sick than I used to be. Specifically, I’m afraid of getting very ill very suddenly.
There is nothing about what happened to me 10 years ago that makes me more vulnerable to Covid-19. In fact, I’ve been so healthy since then that I don’t think I’ve even run a fever since (though you better believe I have a general practice doctor). Still, the threat taps right into my deepest fears. These days, unless my mind is otherwise occupied, I can easily convince myself that the tickle in my throat will soon turn into a dry cough and who knows what calamities will cascade from there. Climbing stairs, I wonder if I’m winded in an expected way or if I have the shortness of breath associated with this new virus. On a logical level, I know this is overkill. But given my experience, the logic is pure. I’ve seen how easy it is for even medical professionals to mistake grave illness for common cold symptoms. I’ve seen how a disease process isn’t just about what happens in the body but about the chain of events that happens in a patient’s life as she grows far sicker than she realizes.
Even a decade later, when I think about my illness, the thing that freaks me out most is how any number of steps taken or not taken could have changed the situation entirely — for better or for worse. What would have happened if I’d gone to a doctor when I began having symptoms rather than consulted with a pharmacist? What if I hadn’t tried to barrel through my illness by proceeding with my travel plans? (I wonder if my husband’s doctor friend, who had no way of knowing at that point how sick I was getting, remained unalarmed in part because I’d elected to make the trip rather than going straight home from New York?) What if, once doctors decided that I really was seriously ill, the nearest ER had been at a small community medical center rather than a world-class hospital? What if, once in the hospital, my husband hadn’t been such a bulldog about making sure I was cared for properly?
The answers are, of course, unknowable, just as is almost everything at this point about the Covid-19 situation. The questions, however, represent micro versions of the mélange of variables that will affect every individual coronavirus case. For all the talk about risk factors like age and “underlying health issues,” for all the emphasis on self-quarantine and social distancing, for all the hope that the key to stemming the crisis lies in the testing facilities that supposedly are about to sprout up in parking lots across America, we haven’t heard much about the role of chance.
I’ve seen how a disease process isn’t just about what happens in the body but about the chain of events that happens in a patient’s life as she grows far sicker than she realizes.
A haunting article in the New York Times on March 13 told the story of two Chinese women, both healthy 29-year-olds working in the medical field, who came down with severe coronavirus. Both had similar symptoms, received similar care in the hospitals they worked in, and had similar levels of family support. Both were near death at different points. One survived and the other didn’t.
For all the coronavirus news I’ve consumed by now (too much), this story grabbed me like none other. My heart broke for the woman who died, a doctor whose two-year-old son, we’re told at the end of the article, thinks his mom is still at work at the hospital. But it also reminded me all over again that even though I received excellent care and recovered from my illness, I could just as easily have received excellent care and died. It forced me to reckon with the fact that the whole ordeal was a wild card. And that is almost too scary to face.
We know all about large-scale chaos being wrought by the Covid-19 pandemic — the quarantines, school shutdowns, empty store shelves, the collapse of both day-to-day commerce and the global economy. But it’s easy to overlook the internal chaos this kind of thing can inflict, the paranoia and the self-monitoring — not to mention the self-admonition that can come from thinking you’re overreacting.
I scoff at myself for letting my mind entertain phantom symptoms every time I have a moment to spare. I know it’s more than a little narcissistic for a healthy person to fret constantly about winding up on a ventilator when there are so many elderly, chronically ill, or otherwise immune-compromised people out there with greater reason to worry. But I also know that even if my fears are unlikely to be realized, they’re not baseless. Though people under age 50 rarely die of Covid-19, they can still become critically ill with the pneumonia it causes. There are undoubtedly people lying in hospital beds right now who, up until a few days ago, had gone through life assuming they were invulnerable to something like this — maybe even invulnerable to just about everything. I suspect that in the coming weeks and months we’re going to be hearing more stories about people like them and the two young women in China. They’ll be taking place at medical units both far away from us and down the street. And even though no two stories will be alike, each will have only two possible endings.