Grief During Quarantine
My brother, Adam, tested positive for COVID-19 on March 22, 2020 and ten days later he was pronounced dead in a major hospital in New York.
As of today, April 5, 2020, there are more than 113,000 (which is up from 105,000 when I started writing this article 16 hours ago) confirmed cases of COVID-19 and a report of over 3,560 deaths in New York alone. The United States has reported 321,350 confirmed cases of coronavirus and over 9,110 confirmed deaths, an increase of 1,300 deaths from the previous day.
Why do I keep refreshing my screen every few hours to check on these numbers? What do they mean to the entire mental health community? The speed at which these numbers continue to grow impacts all of us.
Individually and collectively we are all part of a growing shadow of grief, loss and anxiety cast by the coronavirus pandemic. Writing helps me, and my hope is that my experience will help other clinicians as they work with this nebulous, complex grief in their clients. A grief that has no normal trajectory and may not be easy to articulate, especially in a time when isolation, self-quarantine and social distance are the measures we must all take to stay safe.
Adam was one of the vulnerable ones. He lived in a skilled nursing facility in Merrick, NY, where he received nutrition support through a peg in his abdomen and he needed a ventilator for at least half of the day to regulate his breathing. Of course, I knew that pneumonia or some other illness could take his life at any moment. Over the last 18 months, I was, in fact, preparing for (and dreading) the possibility of the news of his passing.
What I was not prepared for was the way that the last month of his life would unfold. I was not prepared for the way the coronavirus would do more than take my brother’s life, it would transform the world around us, day by day, and force us, like many other families to leave our loved and most vulnerable relatives alone at the end. No goodbye. No prayers. Just news and statistics.
Brené Brown (in her Unlocking Us Podcast posted on March 27, 2020) talks about “normalizing the adrenaline surge that arises during a moment of crisis.” She mentions how people come together, go to the funeral and ask what they can do. But that can’t happen in this crisis. Even the “normal rhythm” of attending a funeral, coming together as a family and observing traditional rites and rituals are not possible.
Since we don’t know enough about the transmission or containment of this virus, not even a glimpse of his body (other than by a photograph taken at the morgue) was safe or even possible. COVID-19 has robbed us all. We are not mourning as an extended family or close knit community. We now mourn in isolation and quarantine.
My 72 year old father used to visit my brother every day. They would talk about my brother’s progress (he was starting to read again and even requested the new Taylor Swift CD-is thateven a thing anymore?), weaning off the vent someday (he was up to 15 hours off the assisted mechanical breathing machine by that time) and maybe do a few hand strengthening exercises while discussing the news. On some days I’d even receive a bedside phone call and get to speak with both of them. But during the second week of March everything changed. We were told that the nursing home could no longer allow visitors as the dangers of the spread of coronavirus were increasing. Over the next 13 days, while Adam was still being routinely attended to by warm, helpful and professional caregivers, he was prohibited from having in person visits with my father, the only constant source of connection in his life.
At 5:30 pm on the 20th of March things got worse. The nursing home called to say that Adam was being taken by ambulance to a nearby emergency room in Oceanside, NY, because he had spiked a fever of 102 degrees. Fears and panic about the rapid spread of coronavirus were increasing, especially in NY. On March 21st, he was admitted to the hospital and his fever apparently went down, but they tested for COVID-19 and his positive test results were disclosed to us on Sunday, March 22th.
Adam was given the best care possible at both the nursing home and at Mt Sinai Hospital: he was administered the most current and powerful treatments available at this time- hydroxychloroquine, believed to be helpful in the treatment of COVID-19; he was given a private room; his nurse and doctor communicated with us as often as possible, which given the situation and an exhausted staff working beyond capacity, I will forever be grateful. Despite these efforts, on the night of April 1, at 1:00 am his heart flatlined. Yes, it all happened that fast.
I am writing this as a way to work with my experience, normalize it, if you will. The best I can come up with is now I know why they bring the bodies home after a war. Families need to come together to put the remains of those they love to rest in some way, to grieve and talk, and look at old photos or tell stories. My family, like many families, could not be with my brother in his last days and hours, nor can we be together now.
This is another layer of the incompleteness of our collective grief. I miss him already, meaning his absence is palpable to my entire family. Who knew that could happen so fast? And as we all struggle through these uncertain times, I am closer to indescribable isolation that I had not known before his death and the days of COVID-19.