Thankful, redux (or: Thanksgiving in the ICU)

I've been thinking a lot about all the people who will be spending this Thanksgiving in the ICU.

Unlike most people, I've already had the experience of seeing a loved one spend Thanksgiving in the ICU. Seeing a loved one spend Thanksgiving in the ICU while on supplemental oxygen, at that.

In November 2013, my wife Cara, who three months earlier had been diagnosed with stage 4 lung cancer at the age of 34, had a sudden downturn in her health after her first treatment failed the week of Thanksgiving. Two days before Thanksgiving, having noticed an increasingly distressing deterioration of her respiratory function, she went to the hospital, was admitted, and soon found herself in an ICU bed.

I wrote about the whole experience four years ago in a post called Thankful so I won't recount the story in detail this time. The title of that post was taken from a post Cara herself wrote just days before her hospital admission called Thankful in which she reflected on how much she had to be grateful for despite her lung cancer diagnosis. She wrote the post before she realized her health was suddenly worsening again. That's a reminder to me about how precious our lives and good health are and how we should never take those things for granted.

Cara hated being in the ICU. I remember well how much she hated it. The crowded conditions, the lack of privacy, all the beeping of hospital machines and all the other noises that made it so difficult to get any restful sleep. She was very glad when she got to move to a room in the cancer center later that week, before the surgery she had the following week. But on Thanksgiving Day, she was still in the ICU.

A picture Cara posted from her ICU bed: "That bag looks like a turkey, right? Is it?? #adventuresoftheICU"

Every year since Cara had moved to Cleveland, we had traveled to Columbus together for Thanksgiving dinner with my family. I would make applesauce. Cara would make rolls. We would enjoy a delicious feast and quality time with loved ones. Despite Cara's recent cancer diagnosis, that was again our plan in 2013. Obviously, the plan changed. But Cara and I did still get to share Thanksgiving dinner with family. Her parents came up to Cleveland and together they and I, with Cara's father doing most of the cooking, prepared a feast just as scrumptious as any we'd had in the past, and we took the food in to the hospital to share with Cara.

(I fondly remember how much our cat Mitters loved to munch on pieces of leftover turkey. She went crazy for that stuff.)

It was not the ideal way to enjoy a Thanksgiving dinner. But we were all glad that we could at least do what we did. Looking back from the vantage point of November 2020? I'm even more grateful.

As much as Cara hated being in the ICU, her accommodations and the fact that she was able to share a Thanksgiving dinner with her husband and her parents were absolutely luxurious compared to what things are like for someone in an ICU during the raging COVID pandemic. An ICU patient now would likely only be permitted a single visitor, if even that. Certainly not three. And sharing a meal with a visitor would be out of the question due to the exposure risk.

For someone who is intubated, as many COVID ICU patients are, the simple act of eating food would be beyond their capacity. Something they could only dream of hopefully being able to do again in the future, if their condition improves.

And then there are all the nurses and doctors and other health care workers toiling away in those ICUs instead of having a relaxing holiday at home with their families. They've already sacrificed so much all year, and now they're being asked to sacrifice even more as the pandemic reaches its worst levels yet in most of the country.

As much as it breaks my heart to think of all the people spending this Thanksgiving in ICUs across the country, I fear that Christmas next month could be even worse.

In all likelihood, it will be even worse, if enough people decide to have their usual Thanksgiving gatherings this week.

So I beg you, think of all those overwhelmed health care workers, and think of all those ICU patients, and think of all those potential future ICU patients whose illnesses could be prevented if we all decide to stay safe this week. Think of those people when you decide how you're going to celebrate this Thanksgiving. And even if you've already decided to avoid risky gatherings, perhaps someone you know has other plans. Perhaps by politely urging that person to reconsider, you could make a difference - a difference that could (although you'll never know it) save someone's life.

If my writing this post stops just one person from getting sick with COVID, it will have been a success.

I know how exhausted everyone is from this horrible pandemic. I know we all want it to be over and to be able to go back to doing all the things we miss so much from our normal lives. It's very understandable to just want to have a normal Thanksgiving right now.

The bad news is, this week the pandemic is worse than it ever has been, and it is less safe than ever to hold such a gathering.

Why, then, am I thankful at this dark point in time?

Because the good news is that the end is in sight.

We have recently gotten amazing news about vaccines that have been developed in record time.

When I wrote my previous post about Thanksgiving in the ICU, and about being thankful, the reason I was thankful was this: when Cara was in the ICU that Thanksgiving, it looked like her life was near its end, but thanks to amazing advances in cancer treatments and to the heroic work of scientists and doctors, she got to have another 17 months of life, and during that time we made so many wonderful memories together. And now I am thankful for similar reasons.

It borders on miraculous that we are getting these vaccines this quickly. And think about the past, before these marvelous advances in science and medicine had occurred. Think about what it was like before there were vaccines. The Black Plague killed a third or more of the people in Europe in the mid-1300s. The 1918 influenza pandemic killed about 50 million people worldwide.

If we were not able to develop a vaccine, we might have to eventually settle for just letting the virus run its course through the population while doing our best to protect more vulnerable people (efforts that so far are failing rather horribly here in the United States). Think about that. In New York City, about 3 out of every 1000 residents has been killed by COVID. Extrapolate that death rate to the entire US and it would be about one million deaths. And cases have started rising again in New York, showing that as much as some people would like to tell you otherwise, "herd immunity" has not been achieved.

Who can say how long it would take and how many people would have to die for the pandemic to run its course without vaccines? Not to mention the even larger number of people left with long-lasting reduced quality of life by their infections? It's horrific to contemplate.

We should all be so, so thankful for these advances in medical science, and for all the people whose hard work has made them possible.

Now is not the time to gather with people from outside your household for a Thanksgiving dinner. But it is a good time to reflect on reasons to be thankful.

In the coming months, people will start getting vaccinated. Over time, more and more of the population will be protected against the virus. In the spring, weather will start getting warmer again and more suitable for spending time outdoors, further driving infections down. By the summer, we could very well be back to something like normal.

I'm going to be so incredibly thankful when I can safely hang out with a group of friends, have a normal dinner with my family, go to concerts again. Probably about as thankful as I've ever been for anything in my life. Just imagine what that's going to feel like. And keep those thoughts with you through these dark winter months.

Next year, let's have the best Thanksgiving ever.