GRACE AND GRAVITY

by Molly McGinnis

the sudden smell of burnt hair, and when I rolled onto my stomach, my roommate, Megan, crouched by the coffee table, holding a brownie in one hand and a cigarette in the other and whispering, “Shit.”

It was October of 2014. I lived with five other college sophomores in an apartment near campus and all but one of us—my best friend, Rhys—were sprawled around the futon with mugs of tea or vodka and bags of tortilla chips. I had an ethics paper due the next morning, so I got up and returned to the two lists I had been making at the kitchen table: first, my potential topics, which included, simply, “Ebola” and “feminist authors,” and second, the thoughts distracting me from writing the paper. These were more detailed: that nothing felt real, that time was moving too quickly, that I was hurtling toward death, and, much worse, so was everyone I loved.

My goal was to start the essay at nine. It was 8:45 now. I wrote “Ebola” at the top of the Word document and then scrolled through the latest news: unrest in Ferguson, where Michael Brown had been shot and killed that summer. A clergyman had been arrested at the latest protest. In Dallas, Texas, a patient had just been diagnosed with Ebola. I paused here, alarmed, when Rhys walked through the door. 

Around this time, everyone had been pulled into the orbit of Rhys. She would deny this, which is part of what made her compelling—strangers would stop her on the Metro, or delivering takeout, or at the free embassy events we’d sneak into now and then. She moved through the city in a full-body halo of liveliness and curiosity, so when she showed up in the yellow light of the doorway, her face the shade of the Halloween cobwebs on the closet beside her, it was clear that something was wrong. 

“Great day trip,” she said. “I’m just kind of dizzy.” She would tell me more in a moment when she’d washed her hands. One could never be too careful.

Rhys had spent the summer in Tajikistan, studying Persian and developing a mysterious illness, which she’d treated with packets of hydration powder lifted from the American embassy and large glasses of vodka offered by her host family. She was better now, but still sick and gaunt: when I’d flown back into DC in August, I’d walked right past her at the baggage claim. 

After five minutes, I went looking for her. She was in the first bathroom, crouched on the rug by the sink under a jungle of styling products and black cords. I joined her. She opened her eyes and gave me a thumbs up.

“What happened?” I asked. 

“Bus ride,” she said. “I just need some water.” I brought her a glass, which she sipped before throwing up. The cost of an ambulance ride to the hospital was too much, so we decided an Uber would be fine—she would stay silent, and I would say we were clerks on our way to a nightshift. At this point, I couldn’t tell if she was hearing what I said, but she agreed, and I pulled her to her feet. We grabbed an empty paint bucket from the closet and staggered into the hall. 

When I’d moved into the building that fall, Rhys had commented on the unusually long, wide hallways, and the comment came back to me now. The tangerine walls, the purple carpeting. Wide hallways meant one thing, she said. This was once an asylum or a hospital. It had to be haunted.

We made it about halfway down the long, bright hallway when she collapsed to the floor, vomiting dark blood into the white bucket. Her eyes sank back, like someone had dusted a finger in ash and drawn loose circles around them. I gave up and called 911. 

I reported what I knew to the dispatcher and mentioned her trip, her illness over several months, the blood. The dispatcher said she would send someone, and having no reason to doubt this, I hung up. Digital numbers blinked and resegmented on my screen. For once, time had slowed. As I waited, I noted this, how close to the moment I felt.

When twenty minutes passed and the elevator doors didn’t open, I called the dispatcher again and asked if the ambulance was close. I told her Rhys was breathing, but I couldn’t tell if she was awake. The dispatcher hesitated. Finally, she said that yes, the ambulance was close. Or it had been. It had arrived and then driven away.

“They didn’t have the right protective gear,” she said. I explained that Rhys had been to Tajikistan, not West Africa. 

No, the dispatcher said, her symptoms were consistent with Ebola. Not understanding anything about supply chains, I asked if the EMTs could get protective equipment from the Department of Homeland Security, whose long complex and parking lot sat right behind our residence. I thought of the bright beams of the cars that came and went all night. Someone was always there. 

“No,” she said. “I’m sorry, ma’am. Anyway, they said they turned around.” Stunned, I hung up. As I did, the elevator doors at the end of the hall opened in an accordion of white light and a young man in a magenta toga stepped out, laughing. When he saw us in the middle of the hall, he stopped, then slowly approached.

“Are you guys okay?” he asked, pointing at Rhys, who was slipping in and out of consciousness. “Can I help lift her up?”

“No,” I said. “Don’t come any closer.” He hesitated, then took a step back. “I think you should go inside your apartment and close the door,” I said. “And tell people not to come outside.”

Hot pink fabric fluttered off his shoulder as he jogged down the hall. A door I couldn’t see opened and closed, and then we were alone. 

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In March of 2020, seven years and several months after that night in college, I am sitting at the desk in my bedroom, sending messages to friends at local DC hospitals. I have just started volunteering with a group of Georgetown medical students who are collecting and distributing donations of personal protective equipment (PPE). We have received panicked messages from mentors and colleagues who are treating patients with the SARS-CoV-2 virus and who cannot access PPE.

I try the hospitals’ official supply chains first, and some accept our donations. When official sources don’t respond, I turn to friends and old classmates and ask if they have what they need. They never do. Our group is called Med Supply Drive; early in the morning and late at night, I write scripts for volunteers to call shuttered tanning salons and labs, asking for donations of gloves, gowns, and N95s. Mysterious offers appear: a man in Maryland leaves a stack of unused hazmat suits in a box on his driveway. One supply request from an ER doctor appears with a heartfelt thank you note and a question: “If we do not protect our protectors, who will take care of us?”

During the day, I work remotely as an ethics research coordinator at a professional medical society. I coordinate Zoom meetings, draft literature reviews, and write outlines for occasional ethics vignettes. One of our major projects, even prior to the pandemic, focused on the crisis of burnout and clinician suicide in the United States. Now it has pivoted to focus on the trauma and chronic stress that healthcare workers are experiencing. One of our volunteers, a clinical health psychologist and ethicist, sends a list of resources and symptoms to watch out for.

As I read through them, I notice that they mirror much of what I experienced in college. The derealization, or feeling that objects were not real, the nightmares, the time distortions, the overwhelming fear that the people you love are going to die. They are common posttraumatic symptoms and can follow prolonged exposures to stress as well as acute traumatic events. They might appear as part of a disorder or not—one can experience these things without meeting the diagnostic criteria for PTSD.

I dig up the journal I kept when I was nineteen, looking for clues and suggestions. I knew from the start that it was panic, not altruism, that inspired my Med Supply Drive work: panic that my mentors would get sick, and almost worse, that they knew this and were helpless. I look for a list of the breathing exercises I used to do, planning to send it to a doctor friend who has emailed me describing the failed protocols at her hospital and her racing heart and her fear of losing her patients. I try to respond to the messages I am receiving from friends working in clinics and emergency rooms and find that all I can offer is encouragement and PPE, though never enough of either. In a month, I run out of sympathy cards.

+

After the toga boy left, I watched the elevator to keep people out of the halls while I called Justin. He was four years older, a professional, someone we thought of as a friend but also as a “real” adult. He had informed opinions about local restaurants and collected tiny bottles of liquor that he never drank. He was the first person we called in an emergency. He would know what to do.

I quickly explained what had happened, and he asked me to wait. I tried to keep an eye on both Rhys, who was still breathing, and the elevator doors, which were still closed. I willed them to open and willed Rhys to breathe.

+

Ethics vignette 1: Two nineteen-year-old women, M. and R., are alone in the hallway of a densely populated apartment building in a major metropolitan area in October of 2014. M. has dialed 911 and reported R.’s symptoms: vomiting blood, unresponsiveness, loss of consciousness. An ambulance arrives, then drives away. R., now informally identified by paramedics as a potential Ebola patient, is left with her exposed roommate in the middle of a hallway in Washington, DC. 

Ethics vignette 2: Two paramedics are called to the scene of a potential Ebola case without adequate PPE and without adequate information. They know that patients in Washington, DC, are not always immediately truthful about the countries they’ve visited. They also know that they cannot afford to miss work due to illness. They do not want to get family members sick. And perhaps they also consider that they cannot afford to risk the subpar treatment that Black patients, like themselves, including those who are healthcare workers, already receive in America. 

Analysis: Both vignettes illustrate a principle in medical ethics called the duty to care. The first vignette shows the moral duty of clinicians to care for their patients, and a case in which this duty was not upheld. The second vignette shows a second type of duty to care—the reciprocal duties of governments and institutions to protect their frontline workers. 

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I am working on a mask distribution project at my desk late one night when I turn off the latest press conference and turn on Sylvan Esso’s “Coffee” to hum along to as I draft emails to volunteers. I remember the mercurial lyrics I loved in college, about closeness without physical proximity, comfort without touch. This song is lighter, though maybe less honest, than the song I’ve seen circulating #MedTwitter—”The Only Thing,” by Sufjan Stevens, with its anticipatory grief.

It’s been four months, and I feel more worn out than I’ve ever been. I start losing notebooks and earrings and pens in the apartment I rarely leave. One morning, out of the corner of my eye, a drop of water darts down a bar of soap in the shower and I jump. I ask Joya Ahmad, our national logistics director and a marathon runner, how she stays so energetic and organized. She is always several steps ahead of the rest of us, always ready to help.

She tells me what she does during a marathon: “There comes a point when you get really tired. Your body wants to stop. So, I close my eyes, tell myself I’ve just woken up, just had a ton of sleep and water, and that I’ll make it one more minute.” The minutes add up. And then you find yourself at the end. It sounds so simple. It sounds impossible.

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Ethics vignette 3: R. is treated for dehydration at the hospital. She does not have Ebola. Still, the ward clerk, upon R.’s arrival on the gurney, stands up and shouts, “Okay y’all, we’ve got a ‘Bola coming in!” 

M. writes her first ethics paper in an isolated section of the waiting room. Several months from now, R. will recover fully from the mystery parasite. A year and a half later, the campus psychologist will tell M. that she has been a useful case study. He will explain that for some people, posttraumatic symptoms do fade with time, as hers appear to have.

Time slows to its regular, promised pace. The derealization might return for a few minutes every couple of years, though M. is not sure what provokes it—sometimes standing at a bus stop under a black sky and orange leaves, returning from a day of data entry and ethics vignettes, the edges of the branches might seem off and M. will wonder why they look so strange; or at a party, staring into a bowl of cherry punch, she will marvel at the solidity of the bowl, the table beneath it. She will tell R., over coffee, that admiration seems to be the best way out. Appreciation for an effect which, when stripped of fear, is simply an ability to see the world, however briefly, with heightened amazement.

To some extent, M. might continue to find an odd sense of calm in the middle of a crisis, which she remembers as she walks to the side door of a hospital to drop off a delivery of PPE. It is unclear whether this sense of calm comes from the disaster environment itself or from her ability to act, however slightly, on a sense of duty.

Analysis: Is a person who remains drawn to high-risk situations still experiencing posttraumatic symptoms? Or are they trying to prevent them from occurring in others? Maybe there is no distinction. Maybe it doesn’t matter.

A better question might be: should another pandemic approach, are we prepared to assume responsibility and reciprocate the duty to care for our healthcare workers? 

+

At the hospital, Rhys was given fluids and released a few hours later. She never did receive a bill for the ambulance. Megan, weed brownie still in hand, arrived in a rideshare and paced outside the emergency room entrance. I finished my ethics paper in the company of night clerks and security guards. I tossed out the Ebola topic and chose feminist literature instead.

Now, though, in the hallway, the EMTs were chatty and apologetic, and since I’d already been exposed to Rhys, they had me ride with them to the hospital. They offered explanations as they rolled the gurney down the orange halls. 

“We weren’t sure when you said Tajikistan,” one said. “Was that West Africa?” 

“You know how it is around here, too,” said the other, meaning Northwest DC. “Sometimes we get someone who says they were in Nebraska and then as soon as the ambulance doors close and the family’s out of sight, it’s like, actually, I was in Nicaragua.” I could barely see Rhys under the glare of the fluorescent panels. I climbed up beside her.

The first EMT glanced at me sideways as she checked Rhys’s vitals. 

“It’s scary right now. We’ve never seen something like this,” she said. “And you know, I’m a grandmother, too.” She wore pale silver eyeliner that glittered under the harsh bulbs. It looked like something someone from the future might wear, someone who had outsmarted the rhythms and despairs of ordinary time. I felt then that I did know, and that we had both been put in a terrible position.

“I like your eyeliner,” I said, because I was only nineteen, and because I did. 

“Thank you,” she said. And then she smiled, just slightly, and lifted the IV bag toward the light.

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Molly McGinnis studied literature at American University. Her work has appeared in Guernica, CQ Researcher, CommonLit, The Sierra Nevada Review, The Journal of Clinical Oncology: Oncology Practice, and elsewhere. She is currently a graduate student in the Department of Epidemiology at George Washington University.