• Dr. Kemia

Only This Moment

Updated: Apr 10

Dear everyone:

Oct. 20, 2014, at age 13, my eldest son was diagnosed with high risk, acute lymphoblastic leukemia.

Leukemia is a medical emergency, the kind that turns your world instantly inside out and takes your kid from a regular Monday in the 8th grade to the pediatric ICU in a blink. Suddenly, my long-haired, free spirited boy was trapped in a bed, surrounded by worried physicians and nurses as he endured, in rapid succession, a lumbar puncture, bone marrow biopsy, PICC line placement, numerous blood draws and the starting of powerful antibiotics, high-dose steroids and several different chemotherapeutic agents. His world turned inside out, and he went from big plans for big adventure – including the early stages of planning a dogsledding expedition to the North Pole with his dad and brothers – to the words, “3.5 years of daily chemotherapy…no travel during the first year…going to lose his hair…no school…”

Normal life to medical emergency to long-haul chemo-prison. In retrospect, it felt a lot like this.

One of my most acute memories from that day is of watching Joseph simultaneously vomit and cry as the chemo hit his system and the fear hit his brain. I stood there, frozen in the terror of it all before remembering that I Am The Mother. Shaking myself out of the stupor, I climbed into the bed with him, gathered his hair out of the puke pan and said sternly, as I have a thousand times in his life, “Joseph, look at my face. Breathe with me, son… again… Look at my face. I know you are scared but I need you to hear me: this is NOT your life. This is just this moment in time. It won’t always be like this. Keep looking at me. I promise. This is only THIS MOMENT. It will not always feel like this. Breathe, buddy. Nice and slow. Keep breathing.”

Interestingly, if you talk to Joseph today about that time in his life, he has very minimal negative emotion attached to those years. What he remembers is the family and the friends and the laughter and the work he started, that continues to this day, to protect the Boundary Waters.

He remembers the family. The friends. The laughter. The meaningful work. #Resiliency __________________________________________________

Things right now are hard and frightening on many, many levels. The number of sick keeps climbing, the number of people who have died is mounting, and the physicians and nurses and other providers on the frontlines in hot zones are exhausted. Everyone is hanging out in limbo, waiting desperately for that “end date” because we need to get back to work, to catch up on bills, to search for a new job, to put the pieces of business and life back together. Teachers miss their kids, kids miss their teachers, and families and friends miss each other. We are watching as Passover and Easter come and go. We are watching winter turn to spring. We are watching and watching and holding our breath.


It is not always going to be like this. This is our reality, for now; it will not be our forever. It will not always be this way. It will not always feel this way. I promise. ______________________________________________

What we are DOING now, though, changes things for all of us. Those who are practicing #RadicalSocialDistancing to #FlattenTheCurve do so not only to protect our own health, but to protect the health of our families, our friends, our community and, ultimately, our country. The more aggressive we are NOW, the more quickly this part of the danger passes. The more quickly we start to rebuild and reconnect.

And HEY YOU DISOBEDIENT OLD PEOPLE: knock it off. Stop acting like rowdy teenagers. We are trying to keep you alive – this is for your own good and it hurts us more than it hurts you. Stop going to the store. Stop making “quick runs” to the hardware store for that bolt you just have to have. You know how to use the phone – call a young person for your groceries, and get real: you don’t need that bolt.

Frankly, Boomer, you’re fooling no one with your feigned technological incompetence – you know how to use Instacart or Shipt: do it.

We love you, obdurate dears. But you're making us crazy, and we have quite enough going on trying to #homeschool our brood while we "work" from the kitchen table. We apologize once and for all for Everything. Now just. stay. home. ______________________________________________

The update re: #COVID19 is a mixed bag, but I think there are some bright spots in the dark.

1) The “hotspots” are really hot this week, and the modelling suggests that other areas will heat up in the near future. But, on the balance, we are accomplishing what we set out to do – Buy Time – and every single day we come closer to a point where resources match up with the projected need. Hospitals have expanded capacity, are gathering resources, and are putting contingencies in place. Doctors and healthcare providers are sharing updated information on best practices real time, multiple drug trials are running simultaneously, and the race for a vaccine is well underway (though still many, many months out).

2) The CDC has started national antibody surveillance (looking for evidence of prior infection). This is great news because we’ve been waiting and hoping for a highly specific (and sensitive) antibody test that will tell us who falls into that coveted “recovered-now-immune” group. This will happen first in the hotspots, then more widely.

Antibody testing helps in several ways: a) It helps us get an handle on the extent of community transmission; b) it will help guide those “epidemic peak” projections; c) it tells us who can safely return to work/school/society; d) it will help us in determining when “herd immunity” is reached by e) helping us get a grip on the denominator in this pandemic.

Remember, we think the prevalence is much (by at least an order of magnitude) higher than the “positive case” numbers would indicate, in large part because of a number of asymptomatic or mildly symptomatic cases who are contributing to community transmission, but never become ill – or ill enough - to seek medical attention.

3) Several new high-quality serology tests should be coming out this week. Again, it is hard to accurately interpret the data or model what is coming when we can’t get a handle on the true number of cases. We are woefully under-testing. The reasons for that are multi-fold: not enough test kits, not enough reagent to do the viral amplification needed, not enough labs, not enough people in the labs… The backlog has been 7+ days in many places across the country. More, faster testing will help correct that over the next month.

4) While it is really, really hard to look at New York and see a bright spot, one is starting to appear out of the pain. Over the weekend, for the first time, we saw a decrease in each of the three indices of transmission: confirmed cases, hospitalizations and death. This *could* mean that our denominator count (number of infected) was off by so much due to under-testing that even the best modeling (which tried to take this into account) missed by a few days and that they are going to experience an earlier peak. _________________________________________________

Last week I wrote a “tough love” post in which I warned that the next two weeks would be hard to watch. We are riding the curve up, nationally, but this IS a curve. There will be a down-slope.

Keep at it with your #PatrioticIntroversion. Your efforts have saved lives and will continue to do so. I am a big believer in the power of reframing. Stay focused on how many we saved, and the opportunities that are coming to rebuild something stronger, more equitable, sustainable and better able to withstand stress-testing.

This is temporary. It will not always feel like this. It will not always BE like this. Stay the course, America. It isn’t over, but dawn is coming, and we can fix anything but dead.

First the pain, then the rising.

Keep being brave, generous and kind, always

More soon. K

#Resilience #FlattenTheCurve #Suppression #CareinthetimeofCovid #PatrioticIntroversion #America #TrustDoctors #TrustTeachers #Covid19


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