Olaf Kroneman
2014 was a bad year for birding. An avian virus infected and sickened birds. Hundreds collapsed and fell from tree branches as if they’d been shot by what Dr. Albright refused to call “sportsmen.” Dead birds littered the floor of the forest. That year the Doctor and his wife did not drive ten hours to Michigan to look for the Kirtland’s Warbler; it would be too heartbreaking.
When Dr. Lucas Albright was a medical student, he recalled some very old doctors talk of the 1918 flu epidemic. “It was a unique respiratory virus, and we didn’t know what a virus was until decades later. It killed healthy young people, especially infants, in less than twenty-four hours. It spread horrifyingly fast.”
Dr. Albright had been in the practice of medicine for over forty years and was grateful he escaped the catastrophe of a viral pandemic.
But along came COVID-19.
Lucas was now a very old doctor. He heard his younger colleagues say that this was 2020, and infectious diseases had been tamed. MERS, SARS, EBOLA, HIV were controlled. Covid was another panic producing false alarm.
Lucas was a student of medical history. He reviewed black and white pictures of doctors from 1918, all were masked. The only visible facial features were exhausted and terrified eyes. The brave physicians of 1918, though of the ages, were not stupid;they must have known something, so he put on a surgical mask.
Administration confronted him and told him not to wear a mask; it would frighten the patients and increase the likelihood of spread. He persisted. “But they wore them during the Spanish flu. They lived and died emersed in a pandemic. We should learn from their experience,” he said.
They were unmoved and told him that if he did not remove the mask security would escort him from the hospital.
He had seen doctors marched out of the hospital by uniformed security guards. The targeted doctors looked like political prisoners being marched for reeducation. It was humiliating but effective for a heartless administration.
He complied.
By March of 2020 people were dying. Infected patients collapsed and fell on their way to the hospital. It was as if the avian virus of 2014 now infected humans. The cardiac arrest alarm sounded over the hospital intercom three to four times an hour when previously the norm was once or twice a day, max. Initially hydroxychloroquine was administered. Six weeks later the CDC reported it was useless and could be harmful. Now they had nothing.
During his career Lucas managed patients with tuberculosis, HIV, pre-vaccine hepatitis, Legionnaires’ disease, and many other infectious diseases but was never afraid until Covid-19. Lucas imagined it would be how nuclear fallout killed.
In a way he thought that the virus was more frightening than nuclear fallout. You could use seismic detectors to locate an atomic threat and seek leaded shelter. This virus saturated the environment with invisible submicroscopic killer-drone like particles that silently invaded and destroyed the infected. From this virus you could run but you couldn’t hide. You didn’t even know where to run, where to hide. It was everywhere.
Doctors had to attend to patients. Electronic medical records and telemedicine were used to observe patients remotely. Lucas trained when the time-honored tradition of the laying on of hands was thought to be part of the healing process. HIV made gloves universal, but he still touched the patient.
With the coronavirus, even gloved hands rarely touched a patient. Masks were now mandatory.
Older doctors were advised not to come to the hospital but to assign their patients to younger physicians. He declined. He’d been their doctor for too long to abandon them during a frightening pandemic. He would take care of his patients in the right way.
Lucas dressed in scrubs, a gown, a surgical mask, gloves, a face shield and physically entered the patient’s room. He had to do it. It was what doctors did since antiquity.
Families could not visit, so a familiar face, his, though heavily sealed and concealed, should provide comfort to a frightened and dying patient. The patients took Dr. Albrights’ gloved hand, the last familiar hand many would touch.
A young physician, Dr. Samantha Kline, approached Lucas.
“I’ve got a bad Covid case,” she said.
“Aren’t they all bad?” Lucas asked.
“The patient’s a young woman, twenty-four years old.”
“She’s young,” Lucas said. “She should be okay.”
“She’s pregnant.”
“That’s a problem.”
“Read this text.”
Lucas read:
–My wife is in with COVID Please help her
–I will do what I can.
–They r going to put her on a ventilator
–She is in excellent hands
–They won’t let me b with her She doesn’t like to b alone
–I’m sorry
–Is there any medication that might help?
–She is on a strong steroid She should turn around
– hydroxychloroquine?
–It doesn’t work
– There are reports that it does She is so sick, and nobody is doing anything. I can’t
imagine living without her
–We r not allowed to use it
–God bless you, I know you’ll do what you can
“She’s on the ventilator?” Lucas asked. “What about the baby?”
“Baby’s thirty-four weeks. They may do a C-section. Save one rather than lose two.” She lost her composure and her voice. She choked out, “I didn’t sign up for this.”
“Nor did I,” Lucas said. “This is the worst thing I’ve seen in my career.”
“You should have stayed out of the hospital like the other older doctors.”
“Probably.”
Lucas handed her his handkerchief for her tears. He had another one for himself.
The next day she showed Lucas more texts.
–Doctor, good morning. Can we get my wife monoclonal antibodies? It appears the
Covid is still in her system.
–The monoclonal antibodies are only for outpatients. Doctors are not allowed to use
them for hospitalized patients
–Do monoclonal antibodies make sense to you?
– I will ask the infectious disease doctors. Call me anytime, day or night.
–hydroxychloroquine?
–They say it doesn’t work
–Can it harm her?
–Unlikely
–Thank you God bless you Doctor
“It’s tough,” she said. “A dying pregnant wife and he can’t be with her. They will let him join her when they take her off the ventilator so he can comfort her while she dies.”
“Horrible,” Lucas said. “Just horrible.”
The next day Dr. Kline approached Lucas.
“More texts?” Lucas asked.
“Yes.”
–Doctor, is there anything I can do to advocate for her? To get the monoclonal
antibodies or the hydroxychloroquine should I call a lawyer?
– Stay the course
–Thank you again. God bless you.
Lucas returned home to his wife.
He told her about the pregnant woman infected with COVID.
“Would giving her the hydroxychloroquine hurt her?”
“No.”
“It’s worth a chance.”
“Not in the hospital. They will kick you off the staff if you use it.”
“And shave your head and march you out?” she asked.
“They won’t shave my head. They are too civilized.”
“You used to fight them. Your tried to save those twenty-three patients. You tried to help other doctors of like mind.”
“But got nowhere. The more lives a I tried to save the more trouble I brought on us. I should have left long ago. But this was my hometown. I felt an obligation. I finally learned after forty years you can’t fight them. They have too much money and too many lawyers.”
“And not enough doctors like you.”
“I’m tired. I’m old. The pandemic has drained the fight out of me.”
The next day Dr. Kline was waiting for him at the doctors’ entrance. She handed Lucas her phone.
–Good morning, Doctor They won’t let me see my wife. I have not seen her for 2 weeks. I saw her on an iPad, and we had a prayer session They told us it looks bad. Thank you for the hydroxychloroquine?
–Don’t tell anybody
Lucas was worried.
“You administered hydroxychloroquine?”
“Lucas, if she dies, and she’s going to, and I didn’t give her that drug, even though it won’t help, that man will have doubts and think we held back something that could have saved her life.”
“You could have told him you gave it but didn’t”
“I couldn’t do that.”
“Me neither,” Lucas said. “If the hospital finds out you gave her the hydroxychloroquine, you will be removed from the hospital. The governor could take your license.”
“Let’s hope nobody finds out.”
Days later, more texts.
–Good morning, Doctor. She’s in critical condition. The oxygen is at 100 percent. She is on something called PEEP. The ICU team decided to put her in a coma. They are going to do a Caesarean section and remove the baby. I won’t give them permission. My beautiful wife needs all the strength she has. The operation will make her weaker.
“I need to talk with him. He must allow the baby to be born.”
Lucas nodded.
They did a C-section in the intensive care unit.
–Good morning, Doctor. I trust you. I’ve seen pictures of the baby. It was worth it.
–I will do anything I can.
“Good work, Dr. Kline,” Lucas said. “The child was born. Something good may come from all this.”
–Good morning, Doctor. Really good news. The ventilator is down to 90 percent. We are very happy. Keep praying.
– Doctor. Her oxygen requirements have decreased once again.
–Doctor. They took her off the ventilator, she’s going to live. God bless you and thank you for being so good to me
–You r welcome
–Thank you.
The woman got better.
“Do you think it was the hydroxychloroquine?” Lucas asked.
“No, but I’m glad I used it.”
“Don’t let anybody find out.”
“Too late, I have to meet with Dr. Fowler.”
“What happened?”
“One of our colleagues found out and reported me to administration.”
“A nurse?”
“No, a doctor. The assistant Chief of Medicine, Dr. Herbert.”
“That ambitious bastard. He wants to suck up to Fowler.”
“When are you going to meet Fowler?”
“At the end of the week, Friday.”
Dr. Albright went home and told his wife about the jam Dr. Kline found herself in.
“How did the doctors and administrators become such enemies? It wasn’t always like that.”
“No, remember when we arrived at the University of Virginia and you were pregnant, I was an intern? We got a bill for seven hundred dollars. I had to go meet with the hospital administrator and explain that we couldn’t pay the bill.”
“I was so sick. I was so pregnant, and Virginia in July was so hot.”
“He said to me, ‘Son, we don’t take money from our interns and physicians in training. You do so much for us.’ He ripped up the hospital bill.”
She smiled.
“Today they would have taken our house if we had one at the time,” she said.
“Doctors and the administrators were different forty years ago.”
“Where did the humanity go?”
“Forty years ago, there wasn’t any money in hospital administration. But businessmen got involved and realized there was a lot of money to be made in healthcare. Money attracts scum.”
“There’s nothing you can do to help Dr. Kline?”
“They tried to kick me off staff four times. I don’t want to give them a chance at a fifth time.”
“No more attacking windmills?”
“No.”
***
Lucas went to the office of Dr. Fowler.
Her gray hair was cropped androgynously short. Her eyes were a steely pale blue, almost gray as well.
“Yes?”
“Dr. Fowler, I need to talk to you about Dr. Kline.”
“She is a disruptive physician.”
“She’s a patient advocate.”
“The advocate finally made a mistake: she gave hydroxychloroquine to a woman with Covid. She’s finished. I will see that she is removed from the staff and report her to the governor who will take her license.”
Lucas didn’t say anything. He looked around her office. Medical textbooks encased her like a protective shell. Dr. Fowler wore a surgical mask. She was removed from patients, and he wondered why she wore a mask.
“Dr. Albright put your mask on.”
He was about to comply but said, “I want you to hear me. I will put the mask on once you understand what I’m about to say.”
“Say it then put your mask on.”
“Dr. Kline did not give that woman hydroxychloroquine, I did. Check the video from the remote viewing of her patient.”
“We didn’t record those interactions. It would be a HIPAA violation.”
Dr. Albright’s gamble worked. There would not be any hard evidence against Dr. Kline.
“I administered the drug. Dr. Kline is innocent.”
“Dr. Albright, that is nothing to joke about. You are smarter than that.”
“It’s no joke.”
“Your career would be over, you understand that?”
“Yes, but I can’t stand by and let you harm someone who’s innocent.”
“Are you sure?”
“Very sure.”
“Yes, very well then, you are finished.”
She stood. He looked down at her shoes. The soles were bright red as if she walked through pools of blood to get to her office. He’d never seen shoes like that.
Lucas met Samantha and told her what he had done.
“Dr. Albright, I can’t let you do that.”
“I’m old. You have forty more years to practice. You’re a good, kind doctor. Every life you save, every patient you heal will be a tribute to me long after I’m gone.”
Dr. Kline hugged Dr. Albright.
Lucas went home. His career was over. He thought he would practice “till death us do part.” He was stunned.
As if a switch was flipped, he noticed he couldn’t smell. He took some mints from his pocket: nothing, no taste. He felt febrile.
When he got home his wife was waiting for him.
“Stay there, darling. I’ve got COVID. I can’t smell or taste.”
“I’ve the same symptoms,” she said. “We’ll ride the COVID storm out together.”
“I will remain at your side. I can’t go back to the hospital.”
She got a puzzled look on her face.
“Because you have COVID?”
“No, that’s not it.”
He told her about his meeting with Dr. Fowler. He didn’t know how she would take it. Like the sudden loss of smell and taste and COVID, their lives had changed.
“Glorious, hoo-rah,” she said. “You have finally slain a windmill. It’s what you always wanted to do. Your life’s work is complete.”
Her reaction made him relieved and very happy.
“I couldn’t have done it without you Sancho.”
“When we recover, we’ll look for the Kirtland’s Warbler.”
Lucas thought of the patients dying alone, being viewed remotely on video, no family. He took his wife’s hand.
“And we may sight an osprey.”
“No owls.”
“We won’t see or hear them.”
“We’ll sing, whistle, and dance past them.”
“And rise from the ashes.”
“Together?”
“As one.”
Dr. Olaf Kroneman graduated from the Michigan State University College of Human Medicine with an M.D. He interned at the Mayo Clinic in Rochester, Minnesota, then attended the University of Virginia to complete a residency in internal medicine. Upon completion of his residency, he participated in a fellowship in nephrology at Massachusetts General Hospital and Harvard Medical School. He entered private practice in 1983. His interaction with patients and other healthcare professionals prompted him to write. Inspired as well as horrified by the things he witnessed, his writing is influenced by actual situations but is fictionalized to protect people’s identities.
His work has appeared or is forthcoming in Broad River Review, Cobalt Review, Dime Show Review, Diverse Voices Quarterly, Forge, Hawaii Pacific Review, inscape, The Healing Muse, The Helix, The Hitchlit Review, Left Curve, Louisiana Literature, Medical Literary Messenger, moonShine Review, Oracle Fine Arts Review, Perceptions Magazine, Quiddity International Literary Journal, paperplates, Penmen Review, riverSedge, and Gemini Magazine. His story “Fight Night” won the Winning Writers Sports Fiction and Essay Contest, and “The Recidivist” won the Writer’s Digest short story contest. His essay “Detroit Golden Gloves” was selected as Editor’s Choice by inscape, honoring the top nonfiction piece of the issue in which it was printed. In 2010, he was nominated for a Pushcart Prize for my story “A Battlefield Decision.”