I had been looking forward to a little respite over the Memorial Day weekend from the daily COVID news. Are you tired of reading about COVID-19? I am weary of writing about it, but it is like a bad dream from which I can not awaken. I am obsessed with the subject and its various subtitles. Now as we have experienced the traditional beginning of summer, I feel unsettled and unable to anticipate what will happen, especially after seeing so many reports from around the country of people totally disregarding the game plan for a safe resumption of some business and limited social contact. 

 

Even more distressing than seeing the packed beaches, bars, and boardwalks, is to realize that over twenty states are reopening before reaching the milestones that have been recommended for a presumptively safe reopening. It was reported in the past few days that the virus may be spreading in as many as 24 states as we entered the Memorial Day weekend. Those reports suggest that as we enter summer, we are heading into a period of great uncertainty. I am left with the feeling that for many people frustration and weariness have replaced the little bit of concern and caution that they were forced to have. Most distressing is the lack of coordination of purpose and the message coming from the country’s leadership as the president’s behavior makes the act of wearing, or not wearing, a mask the equivalent of a political or cultural statement.

 

The cheerleader and deceiver in chief for irrational and self serving behavior is our unstable president who is a one man public health hazard. I have given up trying to keep a list of the daily absurdities coming from him. I am tired of hearing about his continuing attempts to reopen the economy that disregard the advice of knowledgeable scientists. I think a lot about what will come of the ongoing revelations by the pandemic of the healthcare and economic inequities in our society, and I am sure that as long as he is in office the injustices will only increase. There is evidence that even during the pandemic he is still determined to systematically undermine our tattered social safety net. His administration is still seeking to get the Supreme Court to rule that the ACA is unconstitutional. Republicans in the Senate are resistant to passing a third bill to support those who have lost jobs, small businesses, and state and local governments. In healthcare we see that most of the financial support has gone to the wealthiest organizations.  Even without his help, the staggering unemployment numbers mean that many many Americans have lost their employer based health insurance. I wonder whether we will have the energy to try to repair what has become even more obviously wrong in our society once the pandemic is eventually over, even if we do succeed in voting him out of office. The stain he will leave will take a long time to remove. 

 

At a personal level I have great empathy for all who are frustrated by the sacrifices and inconveniences that we have experienced from the pandemic. I am increasingly aware of my distance from family and friends, and the loss of the ease of gathering with them that we always took for granted.  I am concerned about the effects that the virus will have on the education and activities of my three grandchildren. I wonder when I will see family members who live far away. I am concerned about the impact of the pandemic on my old patients and former colleagues at Atrius Health. I am amazed by the resilience demonstrated by the Guthrie Clinic and the staff of the Boston University Medical Group where I have ongoing fiduciary responsibilities as a board member, but I wonder about the impact on the missions of those organizations if we were to be confronted by a second wave.  I wonder what the ultimate impact on my community will be if our impatience and imprudence leads to more losses. I am concerned about the ongoing challenges to my church. I have many more questions and concerns than answers. What will happen this summer? There are no certainties beyond the fact that the pandemic will eventually end, but who knows when or how?

 

The Memorial Day weekend should have been a small reprieve from the ongoing COVID concerns, but it was also a reminder that we are in a new era in which we are given directives that our president ignores. But, there were some very positive thought provoking moments. I was surprised to find myself inspired by watching and listening to Norah O’Donnell of CBS News talk with 5 Star General Mark Milley, a former commander of Green Berets, and the current Chairman of the Joint Chiefs of Staff. He is our highest ranking military officer. For most of the two minute video they wore masks as they walked through Arlington National Cemetery while making sure to maintain social distancing. 

 

There were other examples of responsible behavior coming from politicians. Joe Biden and his wife showed up at a memorial to fallen soldiers in Delaware wearing masks. My favorite clip of the day was Andrew Cuomo’s inclusion of healthcare workers and essential public employees who had given their lives in the line of duty fighting the pandemic in his Memorial Day comments. He says that their families will not be forgotten, and that they will receive benefits as a small gesture of appreciation for their sacrifice.

 

Those good feelings were undermined by the videos that news programs broadcasted of crowded beaches and boardwalks where ordinary citizens followed the president’s example of irrational behavior. Through the day, the president demonstrated his lack of appreciation for the personal responsibility that comes along with the freedom that other men and women died to obtain and preserve by making a defiant appearance sans mask at the tomb of the Unknown Soldier, and then later in the day at Fort McHenry in Baltimore, a city that he apparently does not like.  He is a totally predictable showman and not a leader, so given the extra attention that the day focused on him, he took advantage of another day of flaunting his ignorance and lack of respect for his office as a way to demonstrate his leadership to that controlling minority of those who share his disdain for rational behavior that recognizes everyone’s responsibility to be a good neighbor. 

 

It was not an easy weekend to observe if you are worried about a “second wave of infection.”  As an honor to those who have died, and as a warning to those who discount all that has happened, The New York Times had a remarkable front page on Sunday. Please click on the link if you did not see it. It listed the names and a brief description from published obituaries of 1000 of the nearly 100,000 who have been killed by the virus. An interesting benefit of scrolling down from the top of the article is that it gives associated milestones and the number of deaths for each day. We can see that on April 25 we had lost 53,210 Americans. As of yesterday, according to the Kaiser Foundation scorecard there were 98,078 deaths with 498 new losses as of May 25. If that rate continues we will pass 100,000 during this week. It is impossible not to ask how many of those lives could have been saved if we had a responsible leader who was concerned about a larger agenda than himself.

 

I spent a quiet Memorial Day by the lake. The flag you see in today’s header flies from the end of my dock from mid May when the dock goes in the water as the weather warms up, and it stays there until mid or late October when it comes out in anticipation of another winter. Note that I have attempted to fly the flag at half mast in honor of those recently lost to the coronavirus. Nancy Pelosi and Chuck Schumer got our reluctant president to order flags to be flown at half mast over the weekend in respect for those who have died from the virus. As I get older, the flag means more to me, but not because I ever gave anything to it other than my allegiance, but I hold in highest esteem all those who did defend it, and those who have given and continue to give service to others in our country. Governor Cuomo is right. There are many who have “shown up for service” over the last few months. I am impressed that there are probably millions and millions who have in some small way been willing to extend themselves for neighbors and strangers.

 

I am angered when I see people ignoring the precautions that could prevent the need for future sacrifices. In my opinion the president’s current antics are much more egregious than his pre COVID behavior because what he is doing now is a demonstration of either his disrespect for science and prudent behavior, or his self serving and pathetic attempts to desperately find a way to get reelected even if what he does causes the death of others. Maybe his lies and extortion in the Ukraine affair did not disqualify him for office, but his bizarre antics over the last three months make me think that it is time for someone to evoke the 25th amendment. With over 100 mindless tweets over the weekend, what else would he need to do to demonstrate beyond doubt that he has lost his mind?

 

The coronavirus has presented us with many contradictory images. It is hard to see pictures of healthcare workers in PPE replaced by videos of people on crowded beaches and boardwalks. The Washington Post published an excellent description of the mixed messages coming from leaders, and the episodic return to pre-COVID holiday behaviors at recreational spots across the country. It is very disturbing for me to see that many people apparently disregard the fact that the death toll will probably pass 100,000 by midweek, and that case rates and deaths are still climbing in more than twenty states. Their actions seem to say, “I have had enough. Good luck to you. I am going to satisfy myself.” 

 

As I began to write at the end of Memorial Day, I saw a piece about “Decoration Day,” the forerunner” of Memorial Day in the daily email that I get from the Atlantic. The note was from Annika Neklason, an associate editor. In the note she offers a poem by Longfellow, “Decoration Day,” that the Atlantic had published in 1882. Along with the poem came the following explanation:

 

About this poem 

 

“Decoration Day,” a remembrance honoring the Civil War dead, was first published in our June 1882 issue. As our poetry editor David Barber explains, the piece predates the Memorial Day holiday as we know it:

The poem pays tribute to what was then a new form of civic observance: a day set aside to commemorate those who had perished in the Civil War, by placing flags and flowers on soldiers’ graves, a custom that gradually gave rise to our modern Memorial Day honoring all who give their lives in military service. Its first readers likely felt an elegiac pang all the more acutely: By the time the poem circulated in the June 1882 Atlantic, it would have been national news that Longfellow had died just a few weeks earlier at his home in Cambridge, at the age of 75.

 

Decoration Day

By Henry Wadsworth Longfellow

 

Sleep, comrades, sleep and rest
On this Field of Grounded Arms,
Where foes no more molest,
Nor sentry’s shot alarms!

Ye have slept on the ground before,
And started to your feet
At the cannon’s sudden roar,
Or the drum’s redoubling beat.

But in this camp of Death
No sound your slumber breaks;
Here is no fevered breath,
No wound that bleeds and aches.

All is repose and peace,
Untrampled lies the sod;
The shouts of battle cease,
It is the Truce of God!

Rest, comrades, rest and sleep!
The thoughts of men shall be
As sentinels to keep
Your rest from danger free.

Your silent tents of green
We deck with fragrant flowers
Yours has the suffering been,
The memory shall be ours.

 

In my local newspaper today I find an article from the LA Times by Noah Bierman and Eli Stokols entitled “Grief over virus deaths divides US: Unlike wars and terrorist attacks, numbers hard to comprehend.” There was a quote in the articles from David Kessler that reminded me of a point that has been made about deaths from medical errors. Don Berwick has said that if a 747 crashed everyday there would be public outrage, but since the hundreds of deaths from medical errors every day were spread out across more than 5000 hospitals across the country, it was easy for people not to notice or be concerned. Kessler points out that it is hard for many to be concerned when the equivalent of 12 planes go down in one day as they did recently. They write:

 

Critics say President Trump, loath to dwell on those dismal figures, is both stoking the polarized response and counting on a fragmented experience to distract the nation from the almost incomprehensible death toll — nearly triple that of any other country — which could tar his presidency and jeopardize his chance for reelection in November.

“I don’t think we’re taking this in,” said David Kessler, an author of six books on grief.

“It’s easy to digest a statistic. It is not easy to digest 12 plane crashes a day,” Kessler said. “Especially when there are no visuals. We aren’t seeing 90,000 caskets. That kind of stuff would shock us. Maybe this is too big for us to comprehend.”

 

The authors suggest that the president’s words and actions, motivated by his desire to be reelected have contributed to the divide of concern within the nation along political lines. They quote Julian Zelizer a Princeton Presidential historian:

 

“It’s almost irrelevant that the numbers are people. He switches them, mocks them — he does everything with these numbers to avoid the fact that these are people,” said Julian Zelizer, a presidential historian at Princeton University.

Zelizer argues that Trump’s version affects how the rest of the country experiences the pandemic, reducing deaths to a number on a television screen and diminishing the “human introspection in terms of what the death toll is compared to wars.”

 

It is likely that the one thing that will not be uncertain as the summer rolls on is that the fear of a second wave will continue among some of us while others will continue to disregard the risks. That tension will enhance the uncertainty that the epidemiologists will try to help us manage. The president will continue to argue that his management has been “perfect.” He incapable of ever admitting error or expressing empathy or remorse.

 

Since Memorial Day was always meant to be a day when we honor the memory of those who lost their lives in our nation’s struggles, I do not think it is inappropriate to extend a moment of honor to those who have lost their lives to this new enemy that is spreading around the world. The president likes to refer to the virus as an enemy, he did so yesterday at Fort McHenry. In his own way, perhaps he was trying to express concern and encourage us to be strong. The words look good on the page but are less than convincing when heard.

 

“In recent months our nation and the world have been engaged in a new form of battle against an invisible enemy,..”Once more the men and women of the United States military have answered the call to duty and raced into danger. Tens of thousands of service members and National Guardsmen are on the front lines of our war against this terrible virus, caring for patients, delivering critical supplies, and working night and day to safeguard our citizens.

“As one nation, we mourn alongside every single family that has lost loved ones, including the families of our great veterans. Together we will vanquish the virus and America will rise from this crisis to new and even greater heights.”

 

Words are easy. Actions take focus and effort. None of us knows what the summer will bring, but each of us will be a small part of the collective outcome. It is my prayer that an effective majority of our neighbors will have the wisdom to try to move forward by plans built on data, and modified by data, as data seems to suggest is appropriate. I wish that I could say that I have confidence in our national leadership, but I don’t. I do have confidence in the good will and good intentions of most Americans. Your task and mine for this summer will be to demonstrate the personal will and good judgement that will diminish our losses and honor those sacrifices that have already been made.