Covid-19: aftermath

I am thinking about the roaring twenties a lot. I think people went a little nuts, not because of the war, but because they had difficulty being emotionally honest about the influenza pandemic. I think we humans will do it again to forget the deaths, to go into denial, to refuse to grieve.

Yes, that is my prediction.

Be very quiet, I am hunting wabbits.

Be careful in our future roaring twenties. Money will flow like honey and people will go nuts. Hold fast, hunker down, don’t go out without your macintosh, wear clean underwear. Remember what your mother told you, remember what your father tells you. Because that was followed by the Depression and that is one risk.

I don’t know if it will start this spring or next spring. Ok, I AM hoping that my son and future daughter-in-law can get married in early May, since they’ve put it off for two years. But. The 1918-19 influenza was really three years, not two. It tailed off. Half the people in the world got it. In Samoa, half the adults died, or was it 70%? They had little exposure to infection but a ship brought it. They KNEW they were high risk, but a sailor didn’t know he was sick yet.

Why a roaring twenties? Because we want to forget this pandemic, as the last one was forgotten. Our history books say that the Roaring Twenties was about the end of World War I. We teach lots about that. We barely mention the influenza world pandemic. I am reading a book about the 1918-19 influenza pandemic published in 2018. The author says that it is only now, 100 years later, that we are starting to really tell the stories of that pandemic. She gathers stories from all over the world, including stores of different infection control strategies in two cities. One guessed right and one guessed wrong, and in the wrong one, way more people died.

I read about that 1918-19 pandemic after influenza nearly killed me in 2003. I was 42, healthy, a physician, a mother, an athlete. I had NO risk factors except stress. Now it looks like it was a PANS reaction, but at the time, neither my doctor nor I could figure out why I was short of breath and tachycardic walking across a room for two months. Fatigue, chest pain, tachycardia, shortness of breath. Hmmm, what does that sound like? My partners thought I was faking and I was so sick that I could barely communicate. The stresses were my mother dying of ovarian cancer in May 2000 and my marriage being pretty on the rocks and me working way too hard. My psychiatrist said I should take time off. I said, I can’t. He said, you’d better. Then I got flu. “See?” he said. The body decides, not the conscious brain. He was correct, damn him.

The book I read in 2004 looked dry and medical from the outside. It had pages and pages of footnotes. It had photographs of Los Angeles. They knew the influenza was coming towards them like a wave and they tried to get ready. Bodies under sheets were stacked five deep in the hallways of the hospitals. It hit that fast. People, usually age 20-50, turned blue and fell over dead. WHY? It was the immune response. The 20-50 year olds had a better immune response than the 50 and older and their lungs would swell until there was no airspace left. Even then, that pandemic death rate was only 1-2 % in the US. But it was so fast and spread so quickly that everything was disrupted because it was the workers that were deathly ill and at home and there was no one to work.

People wore masks in public, except for the mask refusers, but not in their homes. So entire families would get ill. I don’t think they had figured out viral loads yet. If you are the last one standing, and you are trying to take care of a spouse and six children, you were high risk from viral load and exhaustion.

The Roaring Twenties WAS a way to grieve, it’s just a dysfunctional one. The stages of grief: denial, bargaining, anger, grief and acceptance. My sister said that acting out and revenge ought to be added as stages of grief. She died of breast cancer after fighting it for 8 years. Roaring is denial and bargaining and acting out and revenge, all at once. Everyone grieves differently, remember that. There is not an order to the stages of grief and you don’t do them once. You do them over and over and over.

I am a Cheerful Charlie, right?

War is one way to forget/deny/act out. Let’s not do that. Let’s not have a civil war of forgetfulness and denial.

Let us remember clearly and lean on each other.

Playing for change: lean on me

I think this fits the Ragtag Daily Prompt: inflammable.

My sister’s blog: . She died on March 29, 2012. The start of the blog is here: .



I got Cheerful Charlie from Pogo comics: read the Albert Alligator section.
More recently, Downton Abby used Cheerful Charlie.

war doors

For Norm2.0’s Thursday Doors.

I went for a walk at Fort Worden this week and did not walk on the beach. I was wearing work shoes not suitable for sand. I went up the bluff to the bunkers instead. The bunkers are so quiet in the winter, without all the tourists.

It was very dark yesterday by 3:00 pm. We are so close to the solstice now.

dish prayer

Beloved, thank you for these dirty dishes.
Thank you that I have hands to wash the dishes.
Thank you that I have water, clean water, hot water and soap.
Thank you that I have a sponge and a sink.
Thank you that I have a home, that it has not burned or flooded or been destroyed by war.
Thank you that I had food to feed my family and my self, to dirty these dishes.
Thank you that I have food to put on clean dishes today and tomorrow.
Please, Beloved, help me bring food to those who need it, clean water, soap, dishes, homes.
Please, Beloved, open our hearts to others in need.
Thank you, Beloved, for these dirty dishes that now are clean and for the circle of life they represent, clean to dirty to clean again.


The Olympic Peninsula only has one wild fire currently, but the sunset last night was lit by smoke.

death in childbirth

When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”

We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….

Preeclampsia? No. Not that common. Eclampsia? Ditto.

“What if a woman is in labor and the baby is stuck? What do they die of?”

Ick. “Bleeding?”

“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”

We were all silent.

When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.

We would like to think this is in the past, but it isn’t. It still is going on, right now, in  poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…

When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….


The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.


sing for the girls

Sing for the girls who grow up in war zones.
Sing for the girls who grow up scared.
Sing for the girls who grow up abused.
Sing for the girls unprepared.

Sing for the girls who grow up with alcohol.
Sing for the girls who grow in broken homes.
Sing for the girls who don’t tell anyone.
Sing for the girls alone.

Sing for the girls who grow up beaten.
Sing for the girls who grow up raped.
Sing for the girls who care for siblings.
Sing for the girls who learn to hate.

Sing for the women who now look frozen.
Sing for the women who now look old.
Sing for the women who survived it anyway.
Sing for the women who told.

Sing for the girls who grow up broken.
Sing for the girls who break everything.
Sing for the girls who break the silence.
We are broken and breaking: sing.

I took the photograph at the US Synchronized Swimming Nationals in 2012.

PTSD and The Singing Tree

The Singing Tree by Kate Seredy, 1939, is a children’s book that illustrated PTSD for me long before I went to medical school. The Singing Tree is the sequel to The Good Master, and describes the survival of a Hungarian family and farm during World War I.

The good master is Marton Nagy, and he is called up as a Corporal, leaving the farm to be cared for by his wife, son, niece and workers. The farm suffers because so many men are called up. They are getting behind on the work and then find a diary from Marton, which gives suggestions and instructions for the year round work on the farm. One of the instructions is “to make out an application for Russian prisoners if necessary.”

They do. They apply and take 6 Russian prisoners, homesick farmers, who don’t speak Hungarian. Jansi and his cousin Kate take the chains off them and the prisoners quickly become part of the family. “Comrade, eh? Friend?” says one of the prisoners. And they are. They are also excellent workers and homesick.

As the prisoners are taken home in the wagon, they also take Peter, a deserter from the Hungarian army. He has panicked about his wife and new baby. He is crazy with worry. He is hidden under the six Russians, who sympathize. After seeing the baby he returns to his regiment. But Peter is angry and expresses his rage at Jews, even though it is Uncle Moses, the Jewish shopkeeper, who has helped hide him.

    Mother took Jancsi’s arm then and they left he room. They didn’t speak; what was there to say? Something, somebody had poisoned Peter’s soul against those who had been good to him all his life. Into Jancsi’s mind flashed the words Father had said: “The stampede… the mad whirlwind that sucks in men…and spits out crippled wrecks.” Crippled in body and soul, Jansci thought then, with an understanding far beyond his years.
    “Poor Peter,” he said aloud. Mother pressed his arm. “I knew you would see it that way, Son. I only hope the war ends before this poison has spread too far.” p 163.

Marton is missing and they have not heard from him. Jansci and Kate make the wagon trek to bring back their grandparents, because the front is now too close for them to be safe. Kate and Lily smuggle the cat along. The cat gets “sick” and the girls insist at stopping at a hospital. The sickness is kittens. The nurses laugh at the girls, but then let them help on the wards. Injured soldiers who are healing.

    “Almost an hour passed before all the patients had been fed. “There was only one asleep,” Lily said, coming back with the empty bowls; “he even had the sheet pulled over his face.” The nurse followed Lily’s pointing finger with her eyes. “Oh, the amnesia case. He sleeps most of the time.”

    “Whats am-amnesia?” Kate wanted to know.

    “Loss of memory. They forget who they are and have to begin life all over again; like babies.” “Does it hurt?”
    “No,” smiled the nurse. “It comes from a shock; like a big scare, you know.” She looked toward the bed again. “He is such a nice man too, poor fellow. He tries so hard to remember. if we could find out who he is, find something to remind of his home, he might remember. You wan tto see him?” she asked as Kate kept staring at the bed. “Come on then, but be quiet.”
    “No. 54, Amnesia,” was written on the headboard. The nurse gently lifted the sheet. Pandemonium broke loose immediately. Kate, with her famous tin-whistle scream gong at full blast, threw herself on the bed. “UNCLE MARTON! UNCLE MAAARTON! IT’S KATE. Can’t you….? UNCLE MARTO-O-O-ON!”

    Every patient was sitting bolt upright. Doctors and nurses were running in, Lily joined Kate, tugging at Uncle Marton’s hands. “Say something…you know us, don’t you? Say something.”

    “Kate, if you don’t stop that infamous yelling this minute, I’ll take Milky away from…Say! Where am I? Who are these people?” Uncle Marton was looking around dazedly.

    “Never mind them,” sobbed Kate, laughing at the same time. “You know who you are now, don’t you?”

    “Why shouldn’t I? Let me out of this bed!” Uncle Marton cried, trying to peel Kate and Lily off his chest.
    “Take it easy, take it easy,” said a doctor who stepped up. “What is your name?” “Lieutenant Marton Nagy of the Seventh Infantry,” snapped Uncle Marton, glaring at him. “Seventh Infantry… Seventh…oh…”His eyes clouded.
    “Now it all comes back, doesn’t it? You’ll be all right now, Lieutenant Nagy. Don’t think about that now. Tell me who this…this calliope is. That scream was the best I ever heard.” The doctor sat down on the bed, smiling at Kate. “I wish we could produce for each amnesia case we get; we wouldn’t have any.” pp 186-189

He gets to go home.

    “From Corporal to Lieutenant in a year. Pretty good, Lieutenant Nagy,” an officer with a lot of gold braid all over him said to Father. “And a handful of medals to catch up with you, as I heard. What did you do?”
    Father looked him straight in the eye. The muscles in his jaws were working. “I don’t know sir. I would rather not try to remember.”

    The officer sighed. “Go home, Lieutenant. Forget, if you can. I wish I could.”

And will he have to return?

    “Then Father went to report to the hospital and this time Mother and Jansci went with him. The doctors found that in body he was sound, but only time, long months or even years, could make him forget the things he never spoke about.
    “There are none braver than he is,” the doctor told Mother, “but the human mind can stand just so much of horror and no more. We dare not tke the risk of sending him back to war.”
    “Thank God!” Mother had exclaimed, and the doctor smiled very sadly.
    “I hear that every day now. Wives, mothers thanking the Lord for an injury their beloved ones have received. A broken bone, a brave mind darkened with nameless fear, anything that takes a long time to heal, has become a blessing, a gift. They are safe for a little while longer.”

And Jansci talks to one of the Russian prisoners.

    “Big boss come home…maybe war over?” Grigori wanted to know when they had come with Father. Jansci tried to explain and he thought that Grigori didn’t understand because for a long while he didn’t say anything. Then he sighed: “Grigori know. Hear, Jansci. Bad man, stupid man, he go kill and laugh. Good man, man with good heart, good head, no can kill and laugh. He cry inside. Baby cry with big noise. Man cry–no noise, but it hurt very bad. Me know….me know.” p. 203

Death affects the village.

    “More white envelopes were coming to the village now than ever since the war started. The hands of Uncle Moses began to tremble and he seemed to grow smaller, more bent. Aunt Sarah was like a silent little wraith, going from house to house to comfort, to help, or just sit, holding the hand of a woman who would never wait for the mail again because there was no one left to writ to her. Often she and priest met in one of the houses and the priest would bow deeply to her Once he told Father: “She seems to give more comfort, more strength to these poor women than I can.” pp 203-204

I wish that we had the sense expressed in this book about PTSD and the effects of war. When I worked at Madigan Army Hospital, some soldiers were getting ready for their fourth or fifth tour of duty. If we as a country are going to continue these wars, we must take more responsibility and have more care for the damage done. When people talk about “curing” PTSD or keeping it from happening: if we didn’t respond with PTSD as a species with horror for the evils of war, we don’t deserve to survive. We will be the Bad People, the Stupid People, who Kill and Laugh. We need to stop. This book was written in 1939 and clearly they knew the effects of PTSD. It’s been almost 80 years since Kate Seredy’s book was published: and still we question PTSD?
Civilians too:

illustration from p. 187