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Vol. 42 No. 11 · 4 June 2020
Diary

In the Isolation Room

Nicholas Spice

2849 words

‘It’ll  have me in its sights,’ I liked to say, as if by naming the worst I could ward it off. Sure, as a 67-year-old man with a chronic respiratory allergy I was cleanly in the demographic dark zone; but I was fit; I biked to work, so could avoid public transport; and, in any case, I had ‘no intention’ of getting the virus.

26 February. The presence in London of Covid-19 has entered our peripheral vision at the offices of the LRB and I write to my colleagues to suggest we review our preparedness for remote working, since ‘in the coming months’ someone could contract the virus, which would mean we’d all have to go home for a fortnight.

29 February. I go down to Dorset to conduct a community choir in a concert at the Methodist Church in Gillingham – a convivial gathering of around a hundred people, most of them over sixty and not a few considerably older.

2 March. A member of staff calls in sick with a cough and a temperature. By the end of the week, she has recovered, but we ask her to self-isolate for 14 days.

5 March. The UK records its first death from Covid-19. In London, there have been four confirmed cases.

7 March. I spend five hours in the middle of the day with the choir I run in Highbury in north London, rehearsing for a concert at the end of the month. There are twenty of us, and we sing in a cosily compact semi-circle. At 2 p.m. we take an hour for lunch together. The programme, appropriate for a concert in Lent, includes motets by Schein (‘Lehre uns bedenken’, or ‘Teach us to understand that we must die’) and Schütz (‘Selig sind die Toten’ – ‘Blessed are the dead’), and the intensely plangent five-part Lamentations of Robert White, who died of plague in 1574, at the age of 36, along with his entire family.

9 March. Europe is closing down. Flights are being cancelled. Two LRB editors have plans to go to New York, where the situation is just beginning to kick off. Sam decides to cancel. Alice says she’ll risk it.

12 March. At 9 a.m., just as I am about to set off for work, someone from the choir phones to say she thinks she has Covid-19: I decide to self-isolate. First, I call my wife, L., and then the office, and then Alice to tell her not to fly, but she’s about to board and we agree instead that once there she should take the first available flight back to London. I email the choir and everyone I’ve been in contact with since the rehearsal on Saturday. Then I write to the parish priest. The church hall where we rehearse would have been busy with churchgoers on Sunday. During the week it is used by a local playgroup. I notice that I have a headache, which is unusual for me, but I put it down to the pressure of the situation. Later in the day, the government announces the decision to stop testing members of the public.

13 March. The government seems to favour letting the virus take its course (‘Be prepared to lose loved ones’), a sauve qui peut policy which tacitly cuts loose the over-sixties, most of whom vote Tory. Like many businesses, we give up waiting for official directives and decide to move the magazine staff as quickly as possible to remote working. The outlook for the bookshop and cake shop is bleak.

14 March. I’m feeling distinctly under the weather. I have a raised temperature and an intermittent cough, but the notion that I have Covid-19 seems implausible.

16 March. At a meeting in the morning, we decide to close the offices of the magazine the following day. It seems certain that we’ll also have to close the bookshop and café, and, with the government’s announcement that all shops must close forthwith, the decision is made. By lunchtime, I am feeling seriously poorly, and, in the afternoon, I call NHS 111, and to my surprise get through quite quickly. I explain that I have a slight temperature, a headache, a cough and a fluey feeling and I am told that I almost certainly do not have Covid-19, that a test isn’t on the cards, but that someone more qualified will call me back, which they do within the hour. This time, the woman I talk to takes the view that I might well have Covid-19. I phone the office and tell them I’m too ill to work and take to my bed.

18 March. I wake with a temperature of 38°C, but during the day it drops to normal, before rising again in the evening. I have lost my appetite but gained a curious taste (or is it a smell – a kind of olfactory hallucination). I feel too ill to read or listen to music or watch TV, but I cannot sleep, partly because I have to sit up so as not to cough too much, and partly out of a queasy wakefulness in which half-formed thoughts circle endlessly. L. and I decide to segregate our domains: I will confine myself to the little upstairs room overlooking the garden, and the bathroom in the attic; she will use the rest of the house.

20 March. For the first time in days, I feel like doing something, so I get up and answer emails for a couple of hours. It seems I might be getting better: my temperature is normal and stays normal until 3 p.m. At 4 p.m. it has gone up again and by 9 p.m. it’s nudging 39°C. My breath is getting short. When I go up to the attic bathroom, I have to stop on each stair for a few seconds.

21 March. I get up for a pee at 8 a.m. and find I am seriously short of breath. I stagger down the landing and collapse. L. calls 999 but is cut off before she can say much. Sitting on the stairs, with my head against the wall, I recover my breath and my balance and tell her there’s no need to call for an ambulance. I go back to bed. The improvement of the previous day has faded away. By the evening, my temperature is back above 38°C. L. urges me to call NHS 111 again. As before, I get through quickly and am told that a clinician will call me back. At around 11 p.m. she calls, a woman with a European accent I cannot place. She is attentive and judicious and her first advice is that I should try to avoid hospital (‘It’ll be a nightmare for you’) and I am all too ready to agree. And then, almost as an afterthought, she tells me to walk up and down while speaking to her. Her change of tone is startling. She says she’ll call an ambulance straight away. I do not think to argue. L. fetches a small suitcase and collects the things I will need: socks, underwear, pyjamas, washbag, phone and charger. She throws in some muesli bars and a bottle of water. I contribute the last three LRBs and, for some reason, Bleak House, which I last read 45 years ago. I get dressed, but the clothes stick to me and, despite the imminent arrival of the ambulance, I am seized by the thought that I should shower, since it may be a while before I get to wash again. Afterwards, I sit in a chair and wait.

Around midnight, L. opens the door to two tall young paramedics, dressed in green and with face masks and goggles. They surge up the stairs into the little back room, seeming to fill it completely. One of them is carrying a mobile monitoring station, like a very large old-fashioned ghetto-blaster or a battlefield radio. He manhandles it with assurance and within a few minutes has taken my blood pressure and my temperature and fixed an oximeter to my finger and a dozen ECG tabs to my chest and back. Like an old telex machine, the monitor disgorges a printout, which the young man glances at, muttering something to his colleague. They have Australian or possibly New Zealand accents and they talk to each other in a speedy technical patois. They tell me to collect my things and come down to the ambulance. I put on my scarf and jacket, check that I have money, pick up the suitcase, and follow them downstairs. At the open door, L. and I embrace hurriedly and with a certain agitation. On the pavement, I look back at her, standing in the doorway, half silhouetted against the hall light. As I wave goodbye, it occurs to me that this is the moment when I am to have the thought ‘This may be the last time that I see her’; so, I have that thought, and then, like a shadow, it crosses my mind that, if I do die, the sharpest poignancy of this moment will be lost on me. I walk to the ambulance and get in.

The ambulance was bright, welcoming, cosy even. While they waited for the go-ahead from the hospital and filled out their reports, the two paramedics chatted quietly, and, for a moment, I was back on a family caravan holiday, when I was five, snuggling up in my bunk bed listening to my parents’ murmured voices on the other side of the curtained divide. And again – when the signal came for us to set off and one of the paramedics said that since my oxygen levels were so low, they could ‘blue light it’ – I felt like a small boy given a ride in an ambulance as a treat, thrilled by the wail of the siren and the power of the vehicle as it sped up the Holloway Road.

I was in the Whittington Hospital for just over a week: a night in A&E, sitting on a trolley waiting for a bed; two days in an isolation room on one ward; six days in an isolation room on another. The illness climbed quickly to its apex and then subsided in a straight line towards recovery, although two months after symptoms first appeared, I am still not quite myself. I guess I should say that the experience was traumatic, but it was more Traum than trauma. Events took on a certain gratifying theatricality, rather as they do in dreams. I watched myself as the protagonist of an enthralling drama, even as I experienced it as acutely uncomfortable, lonely and, at times, frightening. To be a patient is to be a solipsist: for a while, the world revolves around you. This is why being ill as a child was so special – I had my mother to myself. And it was to childhood that I reverted throughout my time with Covid. For the nurses, most of them in their twenties and thirties, I was an oldish man, perhaps nearer in age to their grandfathers than their fathers, but, as I sat cross-legged on my bed in my hospital gown, I reinhabited myself as a seven-year-old boy, in hospital for the first time with my wrist in plaster after I had put it through a window. Now, like a child, I quickly established my little routines. Being very weak, the big adventures of the day were the carefully planned sorties from my bed, briefly unhooked from the oxygen mask: shaving in the morning and washing in the evening, making it to the loo and back, getting as far as the socket on the other side of the room to charge my phone. By the end of the week, I was beginning to get mildly institutionalised, so that when a young doctor turned up by surprise on the Sunday afternoon and told me I was being discharged, I felt vulnerable and exposed and half wanted him to let me stay longer. This perhaps has an analogy in the psychology of lockdown – the speed at which we adapted to such an exceptionally restricted state; our apparent reluctance to come out of it.

As for the NHS, in the things that really mattered, it was hard to fault. The 111 helpline was responsive, and the unknown clinician who insisted I go to hospital saved me from something much worse. The ambulance came quickly and the paramedics behaved with the reticent chivalry of medieval knights. Despite the carousel of doctors and nurses, the medical direction was attentive and joined-up. The vertical integration of data was impressive: the hospital doctors had instant access to my notes, and, when I consulted her after I got home, my GP could see everything that had been done in hospital. My discharge papers were a model of accurate and complete medical accounting.

It was at the edges of the main action, in the mise en scène, that one could see a system under strain: the dilapidation of the fabric, old paint, chips out of the corners of walls; the lack of a bed in A&E; the scarcity of pillows; the abysmal food. The nurses were unfailingly kind and patient, their demeanour impeccably professional, but when I pointed out that there was no towel or that the heating didn’t work and that when the wind was in the north, a stiff breeze blew into the room through a gap in the window, they took a half-distracted interest, as if they simply didn’t have time to attend to such things – which was undoubtedly true – or had long ago understood that it was fruitless to point them out.

Only once was I truly afraid. It was the Sunday morning after I was admitted, when I had been translated from the shabby and harassed underworld of A&E to the Elysium of a calm, sunlit, airy, largely empty ward, and the consultant came to speak to me about what to expect. She was direct, brisk even (‘Please turn your head away when you cough’), as she outlined the options: my oxygen levels were still too low; they’d try a CPAP machine (‘We have learned that from the Italians’) though it wouldn’t be pleasant (‘A bit like sticking your head out of a car window at speed’); if that didn’t work, and with my permission, she’d have to intubate me. I said ‘Of course!’, but in that moment I felt a cold, analytic fear that I have never felt before, and I saw myself travelling along a high mountain road, hugging the rockface, and ahead there was a fork and, on the right, the road swerved sharply down towards darkness.

I avoided the ICU and the ventilator. Six hours on the CPAP machine and my oxygen levels began to recover. Five days later, I was off oxygen altogether. To quote the infamous Jair Bolsonaro: ‘So what?’ Why am I writing this piece about my illness which, in the scheme of things, was not so very bad? There are far worse hospital stories than this. And yet, everyone who wrote to me while I was in hospital and afterwards said: ‘How frightening, how terrible!’ And, in a sense, it was frightening and terrible, but as much because of the wider context as the particular fact of my case. The feeling of being unsafe is more acute in a world where everyone is beginning to feel unsafe. To be seriously ill in ordinary circumstances is to measure one’s distance from health. To be seriously ill with Covid-19 is to measure one’s distance to death.

There are ways in which my Covid story seems like a synecdoche for the pandemic as a whole, perhaps especially in this experience of a psychic surplus. As events have unfolded, it has become clear that the virus is far from impartial in its attentions. Nevertheless, its effects have been widely enough distributed to create a ‘species event’: a temporary mass awakening to the commonest fact of life, mortality. The likes of Bolsonaro and Trump cannot credit this. Why suddenly care about people dying? Don’t we ignore the deaths of others every day? What these men don’t see – and this is a true measure of their derangement – is that Covid-19 has broken out of the ghetto, that place where other people die, and has spread to every street in the city. If the capitalist system is to survive, we shall need to go back to our dream of safety, and fast.

In Britain, it is now a commonplace that the government was caught napping by Covid-19. And yes, the people ruling us have been inept, pig-headed, furtive and dishonest, but what else did we expect? Is the energy we put into cursing them for their unpreparedness perhaps in part a sign of our anger at our own unpreparedness? And isn’t unpreparedness of the essence when it comes to death? ‘Oh Death,’ Everyman says, ‘Thou comest when I had thee least in mind.’ Playing catch-up is death’s favourite game.

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