PROVIDENCE, R.I. — The COVID-19 pandemic is exacting a heavy toll on families, isolating its victims from loved ones, while medical professionals run the race to save lives, all from a disease medical science cannot yet grasp.
The Catholics working in the country’s hospitals are witnesses to both life and death, serving as witnesses to life and hope.
“The most difficult day is taking care of a middle-aged man whose spouse has been admitted to the hospital and was also doing quite poorly,” Dr. Timothy Flanigan told the Register.
“He’s being overwhelmed with the thought that not only was he ill with pneumonia, but his spouse is even more ill,” he said. “And that … that was just … it was hard to carry. That was a lot, and difficult.”
Flanigan is an infectious disease specialist from Brown University’s medical school, as well as a Catholic deacon. For the past three weeks, the deacon and doctor’s life have nearly become one and the same. For all practical purposes, the hospital has become his parish so long as he is treating COVID-19 patients. So he no longer vests in the deacon’s alb, cincture and stole, but in PPE, “personal protective equipment,” consisting of a gown, gloves, masks and face shields.
Pastoral planning meetings give way to an 8am daily consultation with fellow infectious-disease specialists fighting COVID-19 and healing people. At their last meeting, they discussed some hopeful signs. Even over the past few months, they have learned a great deal in how to battle the virus.
All in all, for deacon and doctor, the mission from Jesus Christ is the same: “I am come that they might have life, and that they might have it more abundantly” (John 10:10).
Flanigan makes his rounds to patient bedsides. He said patients understand that they are not in control — the battle could go either way. Even though the odds are with them, perfectly healthy people sometimes are struck down and die. The doctors do not have the tools they are used to having; the illusion of control is stripped away, except for the realization that “every day is a gift from God.”
“Some of us pray out loud, and others pray quietly deeply inside,” he said. “I think God hears both just as well.”
And yet, the doctor sees the presence of God in the hospital rooms and corridors. He said, despite the isolation, people realize they’re not truly alone in this illness. And some others literally feel not alone even in the isolation unit. One Catholic patient told him he felt Jesus and Mary were with him.
“Even at two in the morning,” he said.
‘Heaven Will Be Full of Nurses’
The presence of God in the hospital is seen shining in the witness of its nurses, explained Flanigan. One of the reasons the hospital system has not buckled and broken is because the country’s nurses heroically rose to the occasion and refused to abandon patients in their darkest hour.
“I’m convinced that heaven will be full of nurses,” he said.
Across the country, hospitals have cut elective surgeries and transformed their facilities to absorb the influx of COVID-19 patients. The hospitals are hurting financially, but nurses and other medical professionals who provide key roles in hospital support have run to the battle.
Like a modern-day Joan of Arc, Celeste Jones (not her real name due to her hospital’s media restrictions), a nurse at a New York hospital, describes the armor she puts on to battle COVID-19 in the hospital. The Catholic nurse wears a variant of the 3M N95 mask, combined with a huge, heavy shield that covers her face all the way down the neck. The rest of her armor against the airborne menace consists of a medical head covering, disposable isolation gown, double gloves and disposable shoe-covering medical booties.
“We have to wear hospital-issued scrubs underneath all of this, which are tossed into the hospital laundry at the end of our shift,” she said.
The scent of battle in the hospital is the overwhelming amount of disinfectant diligently applied by the hospital maintenance staff, who, like the medical professionals, share in the risks.
“Our sinuses and lungs seem to burn a little from all the bleach we are using to constantly disinfectant everything,” she said.
Jones notes the horrible isolation of this disease. Unlike other diseases, where loved ones and visitors can console the suffering victim, COVID-19 is devastating for the solitude it demands.
“No visitors whatsoever,” she said. “Unless it is a parent or guardian of an infant or a child. No volunteers or students allowed.”
The only companions in the fight for life, or in death, are the medical professionals at their side who enter the isolated ICUs. It is something that Flanigan notes, as well: Encouragement for patients is key in successfully fighting COVID-19.
Jones said she sees God’s presence in “the consideration and kindness in all of our staff, who don’t always get along together during other times.”
“There is a type of quiet deliberation, peace and conscious effort to remain calm for each other’s sake and for the patients’ sakes,” she said.
Even most of the patients, she said, have made an effort to treat the nurses more kindly — it underscores how the gravity of battle permeates the very air.
The biggest question on her mind right now is “How long?”
“How long will this be going on, and when will we see the curve flattening?”
Furloughed and Fighting
While U.S. hospitals are absorbing the pandemic enough to save lives, they face an existential challenge: The health-care sector pays the bills for emergency care with elective surgeries and procedures. Even as Americans grow restive with the economic cost of the lockdowns, the reality is the transformation of operating rooms and re- and post- anesthesia care units (PACUs) that are helping medical professionals keep COVID’s death toll down is killing hospitals financially.
In Texas, Gov. Greg Abbott has announced plans for a phased restart of the economy. Part of that includes issuing an executive order allowing hospitals to allow a limited number of elective surgeries, so long as hospitals dedicate 25% capacity to treat COVID-19 patients and will not be depleted of PPE stocks. New York’s governor has likewise allowed hospitals outside of New York City and its suburbs to restart some elective procedures along similar lines in order to stave off financial collapse.
Mary Doe (also not her real name due to her hospital’s media restrictions), told the Register that her Houston hospital up to this point had canceled all elective surgeries to treat COVID-19 patients. Like others, her hospitals is now running out of money and has to furlough staff.
“For a lot of people, this has led to little or no pay,” she said. Hospital staff are going on voluntary furloughs, allowing them to keep benefits. As a hospital scrub technician, Doe is used to the operating room. Now she is working 10-hour to 12-hour floor shifts on an as-needed basis. She is also on call for emergencies where there is difficulty in keeping a patient’s airways open.
“Everybody is struggling,” she said. However, she was very happy that the doctors at her hospital required that the doctors, nurses and staff all be protected with appropriate PPE.
As a Catholic, Doe said one of the spiritual challenges is having to go to work in the hospital without being able to physically attend Mass. One consolation is the sacramentals: Her husband anoints her and the rest of their family with holy oil, asking God’s protection on them every day through this crisis.
However, she is glad that her hospital has made an effort to get patients the last rites and any spiritual care they need.
“Patients need both the physician for the body and the physician for souls,” she said.
In the fight against COVID-19, the ventilator is the final redoubt, manned by a respiratory therapist, against the onslaught of a disease that makes human beings drown in the fluid of their own lungs. And John Stevenson’s job as a respiratory therapist is to keep the lungs breathing and getting oxygen until the body’s immune system has enough time to rally and beat the disease.
“All I do is ventilators,” Stevenson (not his real name owing to media restrictions) told the Register. “We’re definitely on the front lines of COVID.”
At the Missouri hospital where the Catholic respiratory therapist works, it feels like the calm before the storm. While the disease has pushed hospitals in New York City to the brink, Stevenson said Missouri hospitals have had much longer to prepare and implement what is being learned elsewhere in how to fight the disease.
The main thing now is trying to get people on oxygen and help them to fight the disease at home, instead of in the hospital.
Stevenson said two things are critical to their safety: having enough PPE and not falling victim to fatigue.
“My face can get as close as 6 inches away from the face of a patient with COVID,” he said.
Fatigue is dangerous to medical professionals, Stevenson explained, not simply because it weakens the immune system; fatigue is when mistakes are made, such as taking off one’s PPE in the wrong order.
“It’s a real danger that we face,” he said.
Even if the country could manufacture ventilators en masse, like the effort during World War II to manufacture planes by converted factories, there is another problem in play: One cannot mass produce operators. Training takes time — at least two years, in the case of respiratory therapists, according to Stevenson.
Stevenson said the ventilators for COVID-19 patients are complex machines. A respiratory therapist generally operates three to four ventilators, or in a very busy situation, five to six.
“And in a nightmare scenario, as much as 10,” he said. In such a survival scenario, that would allow him to do nothing else than operate the ventilators to keep people alive.
Even though Missouri is in an area known as the Bible Belt, Stevenson said up to now the reality has been that God isn’t really much discussed within the hospital. But now COVID-19 is opening up those conversations, and more people are coming up to him asking for prayer.
“Everyone at the hospital knows I’m an active Catholic,” he said. Stevenson tries to show them how to pray meditatively using prayer beads like the rosary, the Orthodox prayer rope or even the Jesus Prayer: “Lord Jesus Christ, Son of God, have mercy on me, a sinner.”
Stevenson sees COVID-19 as waking people up to their mortality and where God is in their lives.
He said, “I think a lot more people are responding to that.”
Peter Jesserer Smith is a Register staff reporter.