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From the Editor

Courage and Fortitude in the Time of COVID-19

Last month, on March 8, I went to visit my 94-year-old Mother. She is an extreme statistical outlier because she requires no medications, lives alone in her own home, and drives round trip to Houston once a week (180 miles). That weekend, we celebrated my birthday and I checked the supplies that we had been stockpiling in her garage for a month. By Feb. 1, enough information was coming out of China to know that the virus originating in Wuhan was the perfect storm.

I began ensuring that Mom had enough food, coffee, Darjeeling tea, opera CDs, history books and needlepoint thread to last for at least 3 months. When I left her house on March 9, I told her I was her last visitor for a very long time.

Mom was philosophical about her quarantine. I left her sitting beside the fire, reading a history book. The uncanny thing about Mother and history books is that at any moment she might look up and say matter-of-factly, “You know, that Nikolai Bulganin was a scary man—his blue eyes could look right through you.” I once stumbled on candid pictures of Bulganin and Khrushchev, which she had snapped at an embassy party in Moscow and then tucked casually in an album of family photos.

It’s hard to ruffle a woman who tightened her belt on hunger during the Great Depression, lost childhood friends at Pearl Harbor, endured WWII rationing, saw McArthur during the European Occupation, spent the Korean War in Japan, looked infamous Soviet dictators in the eye, and was harassed on the streets of Moscow by the KGB. Compared to those things, staying comfortably at home with the power grid intact and an unlimited supply of food was not particularly upsetting.

Most of us are having a harder time of it. Currently you may be busy trying not to lop any young branches off your family tree. However, even when sheltering at home, I am busier than I have ever been. Like me, you are probably launching telemedicine services and scrambling to find ways to meet complex medical needs when every thread of infrastructure is frayed or broken. You are worried about your family, your patients, your institution, and perhaps your job. Some of you are on the front lines of this battle, caring for critically ill patients, living under quarantine away from your family and taking your temperature every day.

A dear friend who is an intensivist spent the weekend besieged with unstable ventilator-dependent cases. She rallied the frightened and weary ICU staff by reminding them, “This is what we signed up for, because we wanted to make a difference and to save lives. We were created for this moment in time.”

Throughout history there have been many pandemics, but none in an era of such technological sophistication as ours. The speed with which innovation is occurring is indeed breathtaking. Burdensome federal regulations, some of which we had lobbied against for years, are being cut or suspended at a rate that is astounding. The rate at which information is being analyzed and disseminated is mind-blowing. We are testing the boundaries of remote operations of every kind, and when this is over, we will not go back to business as usual. We will have different expectations of government, industry, technology and ourselves.

COVID-19 may be the crisis of our lifetime. The economic consequences will be just as challenging and much longer lasting. None of us will be unaffected and we will not be the same people when it is over. In 1940, when the outlook for Britain was grim, Winston Churchill told his fellow countrymen, “This is our finest hour.” I thought I understood what he meant but I didn’t. He meant that you do not know what courage you are capable of until you must overcome your greatest fears. You do not know what strength you have until your strength is tested to its limit. You do not know how innovative you are, until your creativity is the only resource you have left.

Compared to my Mother’s generation, we have had it pretty easy up to now. Although they deserve being called “the Greatest Generation,” the courage and leadership that I have witnessed, particularly among healthcare providers, is of the same caliber. I hope that in my 10th decade of life, when my grandchildren face their challenge of their generation, I can look up from my book and say, “Let me tell you about 2020, and about courage and fortitude in the time of COVID-19.”

Caroline E. Fife is Chief Medical Officer at Intellicure Inc., The Woodlands, TX; executive director of the U.S. Wound Registry; medical director of St. Luke’s Wound Clinic, The Woodlands; and co-chair of the Alliance of Wound Care Stakeholders.

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Caroline E. Fife, MD, FAAFP, CWS, FUHM
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