By Lori Daniels Krummen

I don’t generally consider myself an anxious person – but to my surprise, I found myself unable to sleep especially during those first few weeks.  And then there was that new dry cough – was that COVID, or all that Lysol everywhere? What about that heart pounding for a bit longer than it should after I raced up the stairs, late for yet another COVID planning meeting? Was it too much caffeine today? (I asked for half caff – they wrote “1-2 caff” on my cup. I think they gave me a double shot instead!)  Is that why my heart is pounding and I’m sweating? I had been in the hospital daily, around nurse managers and housestaff who later spiked fevers (but tested negative!)  Like most around me in the hospital, every symptom that would barely register under normal times was now a potential COVID diagnosis.

 I had just finished a half-month block attending on the inpatient cardiology service, which meant I wouldn’t be leading daily rounds again for at least a month (assuming no surge…), and though I was still seeing clinic patients, mostly remotely, and was working daily on our Division and ICU COVID plans and protocols, I found myself wanting to do more.  Twitter feeds about the SARS-CoV2 use of the ACE2 receptor pointed me toward preliminary studies out of China, and more reading, which led me to develop a collaboration between colleagues at our 4 sister University of California Medical Centers. It started with a 9pm Friday night phone call to our Chief Medical and Informatics Officer, which led to a connection with data analysts and a weekend of meetings and spreadsheets.  By Monday at 8am I had IRB approval and a (deidentified) working dataset of all UCSD patients tested for COVID, and their relevant medical data.  Record time.

 For me, that weekend epitomizes the good of what COVID is bringing out in us.  Our community is becoming stronger.  I saw how eager everyone is to pitch in and help, in whatever way they can. The answer, from everyone, was “yes”. Weekend meetings, working early morning and late-night hours, writing proposals, getting approvals, joining forces, going above and beyond – yes, yes, and yes.  We are all pulling together.

 On a personal level, with no sport or science Olympiad teams to coach, no school lunches to pack, no girl scout meetings or drama clubs or practices of any sort to shuttle the kids to – I suddenly have time to not only dive into research, but also to be with my family.  We go on bike rides. We made a family movie about the lockdown.  I cook (sorry, kids! And yes, a non-COVID reason to have GI distress).  And now, though I am back on service in the hospital, the long clinical hours combined with the research keeps me motivated and hopeful.  I still think and worry about those in cities hit much harder than ours, and wish I could do more to help. But the small part that I am doing, and the joint effort that others are freely giving around me, provide me with something to focus on – and now I barely even notice my dry cough anymore.

Lori Daniels Krummen, MD is a cardiologist and Medical Director of the Cardiovascular Critical Care Unit at UC San Diego. She also runs the Biomarker Research Center.

By Chuck Fox, MD

I am on day 14 of self-imposed isolation from the Coronavirus given my underlying moderately severe lung disease.

You may remember from a prior post that I’m a physician, but I have not been to the office since March 12th. It’s the longest I’ve ever not gone to work in my 14+ year career at my practice.

My four (all non-CF, of course) partners have been covering for me in the office and the hospital — they were so gracious about making sure that I protected myself given my pre-existing condition.

I am doing all that I can from my house including taking all phone calls from the hospital doctors consulting our service, joining conference calls about the hospital and practice response to the pandemic, and setting up a telemedicine program for our patients to continue to receive medical care.

Yet, I have tremendous guilt about the fact that my partners are essentially risking their lives to cover for me and ensure that I reduce my risk of contracting COVD-19, and also extreme anxiety regarding the possibility of one of my partners getting sick or even dying from the virus.  As most of us know by now, the virus does not discriminate based on age, and there have been plenty of reports of young (under age 50) people getting pneumonia and dying from the disease.

I have reached out to my partners, had multiple group chats with them, have sent them each a hand-written thank you note, and my wife and I sent each of their families a gift basket on-line with all kinds of snacks and other goodies.

I am maintaining my “productivity,” essentially doing FaceTime Telehealth visits for approximately 6-7 patients per day over the past week from the comfort of my own home. The patients have been so appreciative, patient, and kind. The vast majority of them are doing quite well thus far, maintaining social distancing, and following the guidelines regarding protecting oneself from the microorganism.

Personally, I have a weird feeling of being like an outsider in this whole situation, because I am not going to the hospital or office to meet and examine patients. Rationally, of course I realize that I have no choice, that — if I were to contract COVID, I would almost certainly get pneumonia, possibly wind up on a ventilator and taking up an ICU bed — and even if I were to survive it, would put myself at risk for worsening lung function long-term and increasing the rapidity with which I might someday need a lung transplant.  That, if anything, I have a duty to my family and my community to stay healthy and not make this situation worse.

However, because I am not “out there” in the medical community actively taking care of patients, when I see or hear all these tributes on-line or on the news acknowledging and praising the doctors on the front lines, I do experience a bit of sadness inside.  I am different because of my CF, and this is one of those situations that really shines the light on that.

I have risked my life to care for patients over the years.  As a third year medical student, in 1997, I got HIV+ blood in my eye in the Mass General emergency room.  I have rounded in the hospital and seen in the office innumerable patients with respiratory illnesses such as the common cold, the flu, tuberculosis, etc., to which I could have easily been exposed and contracted.  Yet, in this situation, because of the extreme transmissibility of this disease and its predilection to cause pneumonia, I am relegated to the sidelines.  I would be lying if I said it doesn’t hurt to sit this one out.

But I must power on.  One of my best friends once gave me some amazing advice that I try and remember almost daily: “Don’t focus on what you’re NOT doing, focus on what you ARE doing.”  So I’m going to do that.  I am going to do everything I can virtually for my patients, my partners, and my practice.  I am going to help out my local community, place of worship, and CF Foundation Chapter.  And I’m going to keep in mind that there are many millions of others around the world — sick, food or shelter insecure, and/or unemployed — that are much worse off than my family and I are right now.  I will spend the next few (weeks? months?) appreciative of what I have, keeping a positive attitude, and helping those in need.

Fellow CF’ers and family members and friends — stay safe, make smart choices, and be healthy.

 Chuck Fox, MD is a gastroenterologist in Atlanta, GA

 Republished with permission from “Navigating COVID-19 as a CF’er Who Is Also a Healthcare Provider” by Dr. Chuck Fox, 2020. Cystic-Fibrosis.com, March 30, 2020, https://cystic-fibrosis.com/living/covid-healthcare-provider/. ©2020 by Health Union, LLC.

Read more from Provider Voices: COVID-19 here.

By Annie Brewster, MD

Suddenly everything is different. The quiet is a mix of unsettling and lovely. The chaos and constant motion I have grown used to are gone. No more frenzied efforts to get kids up and out of the house for school in the mornings. No more packing the dreaded school lunches. No more feeling like a taxi driver as I shuttle my kids from sporting event to sporting event, shivering in hockey rinks and on lacrosse sidelines, the sports mom I swore I would never become. And yet I miss all of this. The structure was comforting, or at least predictable. We are all working to create new structure. I hate board games, but we are playing them at night, because my thirteen-year-old forces us to. This is what her friend’s families are doing, apparently. Move it along, please. It was Mrs. Peacock in the Ballroom with the wrench, I guess prematurely. We are striving for normalcy.

Thank god for online school, and for the fact that my kids are old enough to manage their own learning. It helps my anxiety, and theirs, to have “classes” scheduled. There is so much that is unknown. Anything predictable is helpful. I feel grateful that I can put on my scrubs and go to the hospital for my scheduled shifts. It gives me purpose. It makes me feel useful. I am grateful for this. I hear my son telling his ninth-grade classmates during a zoom class that his mom is working in the hospital, seeing patients with COVID. His voice is strong and confident when he says this. He feels proud, and it gives him purpose, too. Yes, I am grateful.

I have never been a germaphobe and I’ll admit, I sort of poo-pooed this whole COVID thing at the beginning. During flu season each year, while many of my colleagues wipe down their entire exam room with Clorax after each visit and wear masks while they see flu + patients, I do not. The mask makes me feel too separate. We will be fine, I kept telling people has COVID started to creep into our realities. Relax. Eat a little dirt once in a while and you will be better for it. My invincibility complex rearing its head. I was so wrong.

Now, I read an “in memoriam” list of healthcare providers who have died from COVID that pops up on my news feed. I am overwhelmed, fixated on their names and ages. Okay, I’m scared. I am a patient and a doctor. I have MS and am on a medication that is messing with my immune system. Does this put me at increased risk? My neurologist says no, as long as my white blood cell count remains normal. Does he really know? I’m not sure. When I stop to reflect, I realize that my long-held shield of invincibility is ridiculous, a defense to protect me from the fact that I am actually already broken, as I guess we all are. How is it that I think I am unstoppable even though I already have a degenerative neurologic condition with no cure? It is almost humorous. Today, my shield has a crack in it. I worry about leaving my children without a mother, fleetingly. Regardless, I want to go to work. I am staffing one of the new RICs, or Respiratory Illness Clinics, at my hospital. We are seeing some very sick patients, because you can’t even get in the door unless you have symptoms suggestive of COVID and are somehow high risk—old, frail, otherwise sick. But weirdly I feel safe. I have on my mask and my goggles, my gown and my gloves. We have protocols. We have awareness and fear, and this fear is helping to keep us safe. But it feels weird to be afraid of my patients. I internally cringe when one of them takes off his mask to blow his nose. Don’t look in their throats, I am told! If you think they might have strep throat, give them an antibiotic. Everything is upside down and backwards.

But I still feel somehow sheltered from the truth of this pandemic. Boston has not yet been hit by the surge. I am not seeing the patients who are intubated in the ED. I am not seeing patients extubated in the ICU, often alone, when continued treatment becomes futile. I am not seeing the bodies. I have not yet been personally touched. No one I love has died. Yet. I am still standing on the sidelines to some extent, even though I am not. This makes me feel a little guilty, like I should be feeling the piercing pain.

I can no longer say I am not a germaphobe. I came as close as I ever have to a panic attack the other day in the supermarket. I was in New. Hampshire, which is behind Boston in terms of COVID awareness. I walk in unprepared. No one seems aware of the rules. No hand sanitizer anywhere. No crowd control or distancing. No wipes to clean the handles of the carts. Even the bathroom is out of order so I can’t wash my hands. I have to touch the food, the credit card reader, my credit card, the cart, the bags, the steering wheel of my car. My hands are contaminated, the enemy, and I wonder if I can trust them. I want to get away from myself, but I can’t.

Annie Brewster,MD is an internal medicine physician in Boston. She is the founder and executive director of Health Story Collaborative.

Read more from Provider Voices: COVID-19 here.

By Craig Norquist, MD

I have to admit, my military background kicked into gear as soon as there was concern that this was a pandemic that we needed “all hands on deck” in order to be successful. As an ED doctor who has active non-Hodgkins Lymphoma, i was torn on wanting to work in the department as a provider and leader, thinking i could provide some sense of calm and leadership in the face of unknown.

My ‘other role’ in healthcare is the CMIO (Chief Medical Information Officer) for our hospital network. We have 5 hospitals, one freestanding ED, and some 50 clinics that i oversee in regards to the EMR and all things digital. I have been working at least 12 hours per day behind the computer, in meetings, and one on ones to optimize the EMR to make it as helpful as possible. Early in the course of this it was helping to create and optimize alerting systems for those patients suspected of having the virus due to travel and symptoms. We also had to create order and resulting systems for testing and tie alerts to the results etc.. My time is hopefully productive in keeping the physicians protected from excessive clicking or documenting as well as optimizing their time on the computer.

I have been scheduled to work a couple of shifts but have been called off due to low work load as our volumes are currently down due to the social (physical) distancing as well as people being afraid of coming to the hospital and getting infected. This makes my wife happy, but honestly it makes me feel as though I am ‘hiding behind the computer.’ I am reassured by my ED colleagues, other doctors in the system, as well as the IT personnel who I work with that my time spent as CMIO is invaluable to more people than if i was working a clinical shift. Someone in IT told me that “there are lots of people who can be ED doctors, but far fewer who can be CMIO.” I have to admit that did help me reconcile my guilt with the long hours i am putting in with informatics.

It bothers me deeply that there are physicians and healthcare workers who are ‘on the front lines’ are sometimes putting themselves in a precarious position due to limited PPE. We are doing everything from trialing a video visit platform to minimize exposure time, to coordinating with our state health information exchange a way to get discrete data feeds of COVID test results as soon as a patient registers for a visit or in the ED.

Each day brings new issues and hurdles, but it is exactly in times like these that we earn our trust and mettle amongst our colleagues. And on another, perhaps realistic but warped way to look at it, i might still be available as a second wave of providers that might be needed to care both the providers who become ill or the second surge of patients.

Either way, I have never been more proud to be a physician and hope that we can continue to keep the wave of support and recognition going in order to regain the love and joy of caring for so many of the doctors who have lost it and become burned out.

Craig Norquist, MD is an Emergency Medicine physician in Scottsdale, Arizona.

Read more from Provider Voices: COVID-19 here.

By James Beckerman, M.D. 

(Twitter format)

1/n Doctors are experts in building walls.

2/n We’re not trained to compartmentalize, but it happens with experience. I don’t know if any of us completely avoid it.

3/n We are active witnesses to death, tragedy, injustice, and inequity every day. This defines the social and biological construct we call disease, and our mission to change it defines us as physicians.

4/n But it hurts. And so we learn to pretend that we are somehow separate from it.

5/n We can even compartmentalize moments of joy, which is tragic. Because there’s always the next patient, the next moment to face without prejudice, with the illusion of a clean slate.

6/n I remember running a code on an older gentleman as a resident. He was intubated, compressed, shocked and lined by our team of twenty-somethings. He didn’t survive.

7/n Afterwards as I walked down the stairs toward noon conference, I realized I was hungry. My co-resident noted that it was pizza day. We high-fived.

8/n I immediately felt sick to my stomach. I was ashamed. Because I knew that I was changing. And because I believed that change was necessary to do this, to see this, to be this.

9/n It’s twenty years later. I’m 48. I’m a happy husband and proud dad. And I love being a doctor. But I always remember that day so many years ago. I want to undo it. I feel guilty about my weakness, my fake bravado that I mistook for strength.

10/n I wonder if I truly needed to build those walls. Sometimes building walls is easier, but that doesn’t make it right.

11/n People are understandably looking for something good to come out of this disaster. It’s hard to sometimes. Many physicians are too drained and wounded to even start that process.

12/n But I’ve had the privilege of having some time to reflect. And some time to really listen, more than I normally do. To my colleagues. And to my patients.

13/n One of the striking features of this pandemic is that we are all experiencing it together. Separately, but together. There’s an irony that the very act of creating distance is making us closer.

14/n I feel closer to my family. I feel closer to my partners. I feel closer to my community. I feel closer to every healthcare worker anywhere. And I feel closer to my patients.

15/n I share your fear. I share your vulnerability. And I also share your gratitude.

16/n A storm is here. And it isn’t going away anytime soon. But it’s washing some things away.

17/n Walls are becoming clearer. People are seeing each other. Sometimes through masks.

18/18 And sometimes through tears. Thanks to all the helpers, everywhere. We see you. All of you.

 Jamie Beckerman, MD is a cardiologist in Portland, Oregon.

Read more from Provider Voices: COVID-19 here.

By John Miller, MD

I feel very fortunate.  I am staying one step ahead of viral transmission. With my career in transition, I have worked in three settings over the past three months.  

I volunteered in Zambia for three months at a rural clinic near South Luangwa National Park.  The infection had started to spread from China by the time I left, but there was hardly an inkling of what was to come at that point.  Two months after my departure, Zambia shut down and many of the expatriate workers returned home.  The clinic where I worked had very limited testing capabilities (Hgb, glucose, urinalysis, malaria, HIV, and a send out test for TB).  They make do working with limited information.  They also trust authority and abide by the government, both of which will help control viral transmission.  For a country dependent on tourism and foreign aid, how long until things get back to normal?

A month ago, I was working in the urgent care in Zuni, New Mexico. It was very busy with a lot of patients with cold and flu symptoms.  The hospital had started separating sick from well and asking patients with symptoms to wear masks.  I remember feeling thankful for that.  I saw a patient with cough and body aches who I would have liked to test for COVID-19.  He had recently traveled to Oklahoma to California and back trading feathers, but did not have an adequate fever for us to get one of the limited tests from the state lab.  The first three positive test results in New Mexico came the day after we left.  Several cases in the area then came out of a church revival in the Pinehill area on the Navajo reservation near Zuni.  

 The risks of infection are much higher on reservations than in other parts of the country.  There is a huge burden of chronic disease as well as chronic underfunding and staffing shortages in the Indian Health Services.  In addition, households are multigenerational and extended families are inter-reliant to meet basic needs. Despite this and having positive tests among Zuni tribal members, religious leaders controversially decided to hold their traditional night dances last weekend before imposing a curfew two weeks after the statewide stay at home order by New Mexico’s governor. Zuni’s first death from COVID-19 was reported today.  How many cases and deaths in Zuni will there be in a week?

 I am now working in the ED on the Blackfeet Indian Reservation in Browning, Montana.  There are no known cases on this reservation, and we have been testing.  There was a nursing home outbreak that led to three deaths in a neighboring county to the east, but now there are no new cases in three days.  To the west, a more populous county continues to have new cases.  I read that the statewide stay at home order is seen by some as an infringement of their constitutional rights.  Should church services and the right to assemble for any reason be considered essential?  “Will our country ever be the same?”

I was a bit slow to accept the need for social and physical distancing.  Our spring break ski road trip with another family was only cut short when all of the resorts closed.  As I write this though, I am on a break in the ED, wearing mask and goggles as I do at all times.  With no COVID-19 cases and the hospital encouraging people to stay away, the ED has been slow.  Most of the ED cases have been patients who need emergent evaluation.  It has been nice.  It leaves time to reflect and try to prepare for what is coming.

I know it is coming, even to one of the most remote counties in the country.  I am told that there is a flow of methamphetamines from Seattle to Spokane to Browning.  It seems like just a matter of time.  I am healthy, adaptable and flexible so know I will get through this.  As an introvert, I am actually enjoying the additional time to myself and with my family.  That part has been really great.

I am challenged, though, to accept those who denied this was coming, and who are still denying it.  Even more disturbing are those who know it is coming but still want to assemble, to grandstand shouting “Give me liberty or give me death!” through some grandiose view of themselves and their struggles.  This is not the revolutionary war.  It’s not except for a small number of anti-government folks who are actually not that far from main stream in the mountain west. 

This comes up from time to time, living on a blue island in a sea of red. That is Missoula in western Montana.  One former physician colleague is still comparing the number of flu deaths last year to the number of COVID-19 deaths.  He is not alone in these parts, and they get to have it both ways.  Oppose the current mitigation as unnecessary and then tout the results of it as evidence that denial was justified all along.  They might say it is just their “personal, educated opinion” but it seems their concern for their beleaguered President’s reelection chances exceed their concern for the health of their neighbors and patients.  

I guess it shouldn’t bother me so much, but I guess I expect more, at least at a time like this.  Can’t we all just put politics aside?  “Will our country ever be the same again?” We can only hope that some things change.

 John Miller, MD is a family medicine doctor in Missoula, MT. 

Read more from Provider Voices: COVID-19 here.

By Carolyn Payne

Solace is found on a peak at sunrise. The silence, the pristine air, and the beams of light reflecting off fresh snow melt away my anxiety. My body moves into rhythmic carving, and I feel my skis float more with each breath. Memories flow through me: my first kiss, my best and longest friendships, and my greatest sense of resilience after recovering from injury.

People often ask how I have time as a doctor-in-training to be outside. For me, the outdoors has always provided refuge and renewal. Today was no different. After a week of devastating news stories and overwhelming changes, skiing gave me a few hours where it was as if the coronavirus didn’t exist.

Skiing in Vermont: as if the coronavirus didn’t exist.

Health is not merely the absence of disease, according to the World Health Organization. I’ve been thinking about this a lot while self-isolating in Vermont. I’m alone in a small space, far away from loved ones. My neighbors blast their TVs and drink alcohol all day. The small town has limited health resources. Yet, the state is rapidly filling with affluent city dwellers retreating to their vacation homes, and I get it.

I’ve lived in dense cities. Dogs poop on sidewalks and sniff trash in the bushes. Roads are filled with angry drivers. Despite all the people, city residents seem to feel just as isolated and disconnected as those who live in rural areas. I am concerned that American cities have limited access to the outdoors, and we are significantly migrating to them.

This matters. We evolved to live outside together, but people across the nation are spending unprecedented amounts of time sitting inside alone. It is no coincidence that we are increasingly unhealthy. Americans are more obese than ever before. Close to half have at least one chronic disease. Suicide, opioid fatalities, and other “deaths of despair” are rising. Despite our country’s wealth and medical advances, American life expectancy is dropping.

A young man sitting inside alone at night.

As the pandemic changes the world as we know it, it is time for Americans to reconnect with the outdoors. Watching loved ones get sick or die and having daily life transformed by emergency orders is traumatic. I, along with many Vermonters, are finding relief in the outdoors. Other Americans should too.

Research shows that the outdoors improves health. Being in green spaces for as little as 10 minutes is associated with better mental health, including higher happiness scores. Spending time in the outdoors is also correlated with lower cortisol, stroke incidence, and mortality.

Even imagining being outside can improve your health now and after the pandemic, but nothing is better than real outdoor activity. Most of us are physically able and legally allowed to be outside. You can go alone or with your quarantine buddy, just stay in local areas and six feet from others. You can literally put your cell phone down right now and go for a walk or even a ski if you’re lucky enough to live somewhere that still has snow. Don’t tell me you don’t have time! If you commit to moving outside, you will feel less overwhelmed, down, or isolated. Your mind will be present, blood pressure will drop, and calories will burn.

Consider the stories of Phillip Stinis and Karla Amador. Phillip lost 80 pounds and healed his chronic back pain by becoming a mountaineer (without the gym). After a devastating emotional time, Karla said, “I went for a hike, and for the first time in a year and a half, I felt hope.” They shared their goal of hiking once a week for a year, which started a movement called 52 Hike Challenge. People everywhere have been putting their cell phones, stresses, and insecurities aside to climb mountains and reconnect with what it means to be human. You can join them.

Being outside will impact your identity and make you part of a community that transcends classes and borders. Amy Roberts, executive director of the Outdoor Industry Association, says, “When I talk with somebody about the outdoors…They all say, ‘I’m a skier; I’m a climber; I’m a runner.’” The outdoors creates purpose and much-needed community, motivating the pursuit of physical, mental, and social health everywhere.

If we connect with the outdoors during this pandemic, great things will happen. We will appreciate the importance of being healthy. We will be reminded that, as just one small part of the universe, we cannot control everything. Most importantly, we will be grateful for life and each other, motivating us to support and love people in our community, country, and world. We can finally act together to move away from our sedentary, materialistic “hustle culture” and even take on bigger challenges like healing our environment and limiting climate change.

As we go through one of the most devastating health crises in history, the outdoors can help. Sit by a flower, take a walk, or go for a ski. It will do wonders. Others will do the same, and America will come out of the next few months healthier and stronger because of it.

Go outside.

Carolyn Payne is an avid skier, hiker, and climber. She recently graduated as a Master of Public Health from Harvard University and an MD from University of Vermont. Carolyn will begin family medicine residency in June.

Originally published in Less Cancer Journal on Medium.com (April 4, 2020).

By Charley Rosenberry

I was in quite an awful wreck in 1986, involving a flatbed semi truck that swerved into oncoming traffic hitting me head on. The first responding police officer called me in as a fatality. When fire and paramedics arrived, a paramedic got as close as he could to me to determine I was alive. However, the first fire rigs on scene didn’t have the equipment to extract me, so called for another station to bring the necessary equipment. While they waited, the paramedic kept encouraging me to “hang in there.” Mind you, I thankfully don’t remember any of the wreck and these details. I only heard them later.

I remember regaining consciousness several days after the wreck. 

Once I stabilized in the hospital, that paramedic came to visit me regularly. Our relationship continued after I was released from the hospital. When I progressed to mobility out of the wheelchair, I went to the fire station and spent an hour or so with the firefighters and paramedics who responded. Quite a memorable visit. I regretted losing contact with the paramedic over the years. 

Now, 34 years later, my wife, Lanora, works for the fire department. Since she was appointed MSO (Medical Services Officer) by Pierce County Fire District 13, she has mentioned a Commissioner in the Department who has been especially supportive of her and served as a valuable mentor. I was glad for that, of course. Then, several months ago, I went with Lanora to her Chief’s retirement party. Her Chief was highly respected throughout Pierce County, so there were lots of Fire Department brass from Pierce County, including Tacoma Fire & Rescue in attendance. When we entered the banquet hall, Lanora pointed out various people she’d mentioned over the years, including the supportive Commissioner who was across the room. I hoped I’d have a chance to meet and thank him that night for supporting Lanora. 

At the celebration, I got into a conversation with the MSO of the Tacoma Fire Department. During it, I told him that I owed my life to his Department. He was interested to hear the details.  I told him about the paramedic mentioned above, how he visited me and had to leave one afternoon after getting called to another emergency that was rather unique on the Narrows Bridge. When I mentioned the other call, the MSO nodded towards the Commissioner that Lanora had pointed out. The MSO said, “That’s him.” 

I went over to the Commissioner. I introduced myself as Lanora’s husband. I said, “And we’ve met before.” In over 30 years as a paramedic with Tacoma Fire, he remembered the wreck vividly. Time, location, circumstances… After we were both a little choked up, he regained his tough guy paramedic composure and said, “Yeah, I remember we told Dispatch, ‘We have an AFU.’ That’s All Fucked Up.” 

Since that reunion, the Commissioner and Lanora have become even closer. He could be her biggest supporter – not that she hasn’t fully earned his support and that of her entire Department. Lanora and I have spent some good times with this Commissioner and his wife at various Department events, and I suspect we’ll have more good times to come.

This story lifts my spirits any time and certainly in these times. It reminds me that it is possible that we can make it through the tough times, and that amazing things can happen on down the trail.