The Elderly and Covid-19: On the Frontlines of a Pandemic

Part Three of EMT Maya Alexandri's Coronavirus Diary

Nineteen years ago, about six months apart, my grandparents died. They had been my source of unconditional love. My “small person” memories are all about them. My grandfather (who was a small person himself), big and protective, walked me to my first grade class each morning. My grandmother, making corn fritters with me, taught me to whip the egg white meringues for the fritters with a hand-held eggbeater. My grandfather read the stock listings in The Wall Street Journal with a magnifying glass, while telling me about the importance of financial independence. My grandmother asked me, apropos of nothing I could see, if I believed in a personal god.

Possibly because I loved my grandparents so much and never wanted their physical presence absent from my life, and maybe also because so many older people I meet are so cool—and underappreciated for that quality—I have cultivated strong relationships with people who, age-wise, could be my grandparents. Like the little match girl lighting match after match to keep vibrant the vision of her grandmother, I kindle the spark with every older person I meet, the warmth of our rapport bearing my question in its subtext: will you be my grandparent? (I still think of these older people as being my grandparents’ age, even as I’ve aged to the point where these folks are more in my parents’ age-range.)

My best friend, for example, is a 93-year-old gay widower named Izzy, who is a retired international literary rights manager, opera buff, and bon vivant. Hailing from the epicenter of the Covid-19 pandemic, Izzy evacuated the Covid-19 crucible in March and has been staying-at-home with his 70 year-old niece, who lives—coincidentally—just a few miles from my volunteer fire station. We talk every day, and Izzy is avidly interested in my work as an EMT. “So, baby doll, what interesting cases did you have today?”

Too often, I have to tell him that I responded to a 911 call for patient whose age range is akin to his. Just articulating the suffering of senior citizens makes me fear for him. I reassure myself that Izzy is safe. He and his niece are very responsible. They are observing quarantine and social distancing guidelines. I know they have masks because I brought them some.

But the penchant of the Covid-19 virus for our older loved ones is devastating and among the saddest consequences of our inattention to the virus’ initial invasion. I recalled reports in January and February, warning that people at risk had traveled internationally or had contacts with those who had. Instead, one of the earliest reported clusters of cases discovered in Washington state was in a nursing home. None of the residents had been traveling. The clear implication of their collective illness was that the virus was already well-established and spreading in the community, whose members had unwittingly infected their patients or loved ones in nursing homes. We were already far too late. This profoundly well-adapted virus already had the strategic upper hand.

“He’s lying on the bed now, but he can’t get up. And he looks so pale and weak. We said he has to go to the hospital, but he’s so stubborn.”

And the cost—the premature deaths of so many thousands in our older generation—was being paid by physiologically vulnerable people who already found themselves in a liminal social space. People in nursing homes are not able to live independently and lack the familial and social supports to live in a non-institutional, communal environment. Even older people who are able to live independently are often in a kind of social purgatory. Their friends and family may have died. They may lack a social scene. The online world may be too baffling for them to manage. Our older neighbors and relatives are among those who may not be able to access resources of information, food, and finances during the pandemic. That they may be physically least able to withstand the biological ravages wrought by the virus is the unkindness of evolutionary pressures.

It is also a cruel deprivation to everyone who remains behind. Older people are no less valuable for being underappreciated. Their experiences, knowledge, and attachments are lost and disconnected when they die, regardless of whether we take notice. Their awareness that their perseverance has earned them the right to be (take your pick) idiosyncratic, prickly, politically incorrect, unfashionable, or liberated—however they understand liberation—is an instruction for everyone. And the process of aging, through its erosions and accretions, so often allows older people to gain what so many of us, not quite geriatric, struggle to achieve: a continuous flow of unconditional love.

Older people dying meant, to me, less unconditional love for everyone else. Whenever an older person died of Covid-19, others who had blossomed, nurtured by that person’s love, were suffering the way I’d suffered the loss of my grandparents.

*

My shift one night was almost over when the fire station exploded with clanging, buzzing, and other sonic reverberations designed to wake even the most sleep-deprived firefighter: our alarm system alerted three of our four trucks for a call—my beloved ambulance was the odd truck out. I walked onto to the red floor, where the ambulance, engine, aerial tower, and squad trucks are parked.

My partner for the night, Shosh, was already there. A bright college student on her way to medical school, Shosh was both an EMT and a firefighter. And she was standing by the engine, waiting for the vehicle’s driver. (In volunteer fire stations, people who live nearby may go home, monitor dispatch on the radio, and race back to the station when a call comes; in this case, everyone was hoping that the engine’s driver was en route to the station.) As the engine crew stood by in anticipation, yet more noise erupted: an ambulance call!

A note about the sonic effects of a fire station: they are loud. We hear dispatch on continual play, everywhere in the fire station—weight room, bathroom, laundry, kitchen, lounge, lecture hall. If you are on a shift, and you are—for some bizarre reason—going somewhere where you can’t hear dispatch, you take a radio with you, so you can listen to dispatch. Most of the time, dispatch is sending trucks in other stations on calls, and you learn to pay attention so you can anticipate when dispatch might be about to send out your vehicle.

When our station gets a call, our alarm system activates, and tones ring out. At our station, the tones for every truck are different. The ambulance tone sounds like an extremely loud, emphatic doorbell that rings three times. The engine tone is a no-nonsense pre-recorded female voice that says, “Fire response,” followed by two clangs of a gong. The tone for the squad is the alert tone that was used in the televisions series, Emergency! (That show had a “Squad 51” in it.) And the aerial tower truck is alerted with the tone from Ladder 49, which sounds to me like an anxiety-ridden cuckoo clock paired with a stuttering gong. When dispatch assigns more than one of our trucks to a call, their separate tones all ring, which can make for a deafening noise salad—to the uninitiated, it can be confusing.

We also have red and blue alarm lights installed in the ceilings of rooms in the station. Along with the tone, the blue alarm light will flash for an ambulance call; red for a fire call.

Calls also trigger the overhead lights to illuminate on the red floor, and they cut the natural gas supply to the oven and the burners on the stove—the assumption is that whoever is cooking is about to run out on the call, so best to have the flame snuff itself, rather than to have the next call at our own fire station. After each call, we have to restart the natural gas supply with the push of a button on the kitchen wall.

That’s a sore throat that just started developing, I thought, reacting to the suggestion of dryness in my throat. I wonder when I’m going to feel like I can’t breathe. This coronavirus is so good at what it does.

Once the tones ring, and the lights flash, and the kitchen flames die, dispatch announces the details of the call overhead, and those same details print out on a run sheet in the watch room—an enclosed area on the red floor where, historically, firefighters had to “watch” the ticker tape arriving with notification of fires, and then more recently, where firefighters had to monitor the radio for fire alarms, before we had our modern alerting system; and where now we have a bank of computers on which we submit our online forms that the county requires.

Multiple calls simultaneously make for the blizzard of noise, light, and dispatch instructions that I was experiencing that night, when the fire call tones had just rung out a “triple pull” (the engine, aerial tower, and squad trucks were all assigned to the call), and then the ambulance tone reverberated, too.

Shosh bailed on the engine crew (I don’t know if they ultimately got the truck on the road for that call) and ran to the cab of the ambulance. I grabbed the run sheet out of the watch room and met her in the passenger seat. Shosh switched on the ambulance’s ignition, the garage doors flew up, and I radioed dispatch, “Ambo”—I gave our call sign—“en route.” Shosh turned on the lights and sirens, and we were rolling.

*

The ambulance call was for an 86-year-old man who had fallen out of bed. Dispatch’s notes warned that the patient had a fever.

When we arrived at the apartment complex, we found that the family member who had come downstairs to let us into the building had locked herself out. In lieu of a face mask, she had a colorful scarf wrapped around her nose and mouth. She hurried past me, mumbling, as I headed to the building’s entrance.

Because the call was for a patient with a fever, I was going in alone to assess whether the patient was likely to have Covid-19, and Shosh was remaining uncontaminated with the ambulance. If I needed anything, I would radio to her. I was wearing my Smurf suit and carrying my radio and diagnostic bag—the two-gallon plastic bag containing a stethoscope and blood pressure cuff, pulse oximeter, thermometer, glucometer, and a surgical mask for the patient.

As the family member blew past, whatever words she was trying to communicate were lost to me. Because she tore off in the direction of the parking lot, I guessed that she was going to her car.

The lobby to the apartment building was fronted with broad, double glass doors, which were locked. My gaze turned to the keypad beside the entryway. I knew the apartment number to which I was going. Before I could scroll through the directory, however, a superintendent-type person strolled up and asked, “Did you call to get into the building?”

“I’d appreciate if you’d let me in,” I smiled.

He opened the doors. I strode into the building and over to the elevators at the side of the lobby. I pressed the “up” button. While I waited for the elevator, I saw—through the lobby’s closed glass doors—the family member emerge from the darkness and scurry up to the entrance.

The doors were still locked for her. Whatever the reason she’d rushed past me, it had not been to retrieve the key.

She made an anxious motion, and I returned to the entrance doors and opened them. “Can I come with you when you go upstairs?” she asked.

Her question, or maybe it was the tone with which she asked it—as if she was apologizing for intruding—made me second-guess my understanding of the situation: was she just a neighbor? “Would you kindly tell me the apartment number that I’m going to?”

She did.

“Of course, come along.”

The family member was one of the patient’s four daughters. Her name was Bunny. She recounted the saga of her father’s illness: it had started weeks ago. He’d talked to his doctor, who had put him on antibiotics, but he hadn’t gotten better. He’d had a fever that had been coming and going, along with shortness of breath.

“Why did you call 911 tonight?” I inquired. We exited the elevator and walked to the patient’s apartment.

“He fell out of bed and couldn’t get up, so his girlfriend called us.”

“Who is ‘us’?”

“Me and my husband, and my sister and her husband. My father’s girlfriend is at the apartment, too,” Bunny explained.

“Were you able to get him off the floor?” I asked.

“He’s lying on the bed now, but he can’t get up. And he looks so pale and weak. We said he has to go to the hospital, but he’s so stubborn.”

Bunny’s sister, Kitty, was waiting at the doorway of the apartment. She wore a tie-dyed fabric face mask. “Can you take him to—” and she named the hospital of her choice. “His doctor is there,” Kitty said.

“Possibly we can go there.” Typically, we take patients to the nearest hospital, and this hospital was far away. We also have protocols that can determine the choice of destination. If, for example, my assessment raised concern that the patient’s fall had been caused by a stroke, I would have to take the patient to a different hospital than Kitty had requested.

“We’re a team, sir. You and I are going to the hospital together, and we’re working together to keep you healthy during the ride.”

And, of course, if it appeared that this patient might have Covid-19, I wanted to take him to a hospital with procedures in place for ensuring the safety of the patients and the staff. I had recently transported patients to the hospital Kitty was requesting, and the emergency department there was not among the best prepared of the emergency departments in which I’d been. If he did not have Covid-19, he risked contracting it in that emergency department; and if he had it, he risked infecting others.

“Should I call Hatzalah?” she asked.

Hatzalah is an ambulance service staffed by observant Jews. Some of the male members of our fire company also volunteer with Hatzalah. I did not know anything about the transport guidelines under which Hatzalah operated, but I doubted that the Hatzalah ambulances functioned like taxis.

“I cannot advise you about that,” I said.

“Maybe she should have a look at dad,” Bunny suggested.

“That’s a good idea,” Kitty agreed.

I entered the apartment and encountered two stiff-looking husbands, both wearing fabric face masks, trying to step out of my way. It wasn’t easy: the apartment was crammed with tchotchkes.

The patient’s bedroom was at the end of a narrow hall that extended at a 90-degree angle from the living room. His girlfriend, Cookie, was standing by the bed, clutching her cell phone, and muttering that she couldn’t think.

She wore a surgical mask that she’d pulled down to her chin.

I introduced myself and asked her to wear the mask over her nose and mouth, for her protection, as well as for mine. She appeared not to understand what I was saying.

Bunny, Kitty, and their husbands (who I learned were named Erwin and Harry), had followed me into the bedroom. Bunny and Kitty now surged around Cookie and helped her adjust her face mask. I stepped around them to examine the patient.

His name was Ollie. He lay across the bed, pantsless. He had soiled himself.

“Hello there, sir, how are you doing?” I asked, as I slipped the pulse oximeter on his finger.

“Oh fine,” he joked. Although the effort he was making not to appear sick was obvious, the twinkle in his eye was genuine.

I placed a surgical mask on his face and glanced at the screen on the pulse oximeter. His blood oxygen saturation was 90 per cent. His heart rate was below 60, which is slow. I wanted to take him to the hospital.

While I took his temperature, I asked, “Any fever, shortness of breath, cough? Sore throat, diarrhea?”

“He has diarrhea,” Bunny answered.

“So sue me,” Ollie suggested with bemusement.

“When did it start?” I asked.

“Today,” Kitty answered.

“Of course I have the runs when I can’t run,” Ollie quipped.

“Your daughter told me you can’t walk, sir. Is that normal for you?” I inquired.

“I’m not much of a walker,” Ollie shrugged.

In this manner, I gleaned that Ollie had had intermittent fever for three weeks. He had a history of chronic obstructive pulmonary disease, but he did not need oxygen and normally experienced no shortness of breath or cough. However, he’d had trouble breathing recently and had developed diarrhea today. Earlier this evening, he’d been trying to get up to use the bathroom, when he found that he couldn’t walk. Notwithstanding being “not much of a walker,” he usually could get up to use the toilet. Tonight, however, he had collapsed by the bed.

He didn’t have a fever now.

Older patients can sometimes be sick without having the fever that a younger patient might suffer. The body’s ability to mount a fever as a defense mechanism against infection depends on the robustness of the immune system, and older patients can experience diminished immune function.

I had also seen older patients with Covid-19 who presented with diarrhea and acute onset of inability to walk, like Ollie. Without knowing what his oxygen saturation was normally, I did not know how to interpret the 90 per cent figure because a lower blood oxygen saturation can be a sign of chronic obstructive pulmonary disease. Ninety per cent blood oxygen saturation could be normal for Ollie.

I placed a surgical mask on his face and glanced at the screen on the pulse oximeter. His blood oxygen saturation was 90 per cent. His heart rate was below 60, which is slow.

But his slow heart rate was not normal for anyone. Patients with Covid-19 could present with cardiac abnormalities. Ollie’s overall picture made me suspect that he had Covid-19. I’d had the instinct to take him to the hospital almost as soon as I’d seen him, and that sense was only increasing in urgency.

Mindful that Bunny had described Ollie as being stubborn about not going to the hospital, I sidled into the recommendation. “You seem to have a good sense of humor, sir.”

“That’s true,” Ollie affirmed. “If I tried to jump out a window to kill myself, I’d land on a sponge.”

“I want to take you to the hospital.”

“Alright,” he agreed amiably. “It’s a date.” But then his face clouded. He looked like he wanted to say more, but he restrained himself.

“Is it difficult for you to breathe with that surgical mask on?” I intuited.

He nodded.

I radioed to Shosh to bring the portable oxygen tank and the stretcher to the door of the apartment. To reduce the potential for exposure, Shosh would remain in the hallway.

Kitty met Shosh at the apartment doorway and extracted an agreement from her that Ollie would be transported to the hospital Kitty had named, where Ollie’s doctor was. At Ollie’s side, I could barely hear Kitty talking to Shosh because Bunny rushed into the bedroom, shouting, “She didn’t bring the stretcher! She brought the bed!”

I didn’t know what to make of this statement. We don’t have beds on the ambulance.

In fact, Shosh had brought the stretcher. It’s padded and can be adjusted to support seated and supine positions. It’s also on wheels, with adjustable struts, so it can be raised or lowered to various heights. It might be thought of as a deluxe stretcher. I guess what Bunny had been thinking of, when I said, “stretcher,” was something like the field stretchers used in, “M*A*S*H.”

Indeed, something similar turned out to be needed. The deluxe stretcher could not make that 90-degree angle into the hallway, so we were going to have to transfer Ollie from the bedroom to the living room, where the stretcher was parked.

For that, I radioed Shosh to bring a Reeves sleeve. The Reeves is a flexible stretcher, like a plastic tarp reinforced with wooden slats, and with handles. The sleeve stretcher wraps around patients and enables us to carry them up-and-down stairs and through narrow areas.

A Reeves sleeve requires two people—and usually more (Ollie weighed at least 200 pounds)—to carry it, and I did not want to bring Shosh into the apartment and risk exposing her. I also could have called an engine and had the firefighters assist with moving Ollie, but—for the same reason—I dismissed that option. I decided to train Erwin and Harry to help me.

I explained how we were going to logroll Ollie onto his left side and place the Reeves sleeve on the bed where his right side had been. Then we were going to lay Ollie onto the Reeves sleeve and logroll him onto his right side, so we could pull half the Reeves sleeve under where his left side had been. Finally, we would lay him flat, now on the Reeves sleeve, center him, wrap him in the Reeves, and carry him via the handles on the stretcher.

I sympathized with his plight. He was no longer able to lift himself up or walk. He was struggling to breathe.

But first, I had Bunny bring me the portable oxygen tank from the deluxe stretcher in the living room, and I placed Ollie on oxygen. Although Ollie had done little but crack jokes while I’d been at his side, now that he was on oxygen, he nodded his appreciation: he felt better.

I was glad because I had an inkling that moving Ollie in the Reeves sleeve might be stressful for him. I tasked Bunny with carrying the oxygen tank behind us. Kitty jumped on the bed to help logroll and carry her father, along with Erwin, Harry, and me.

Ollie did his best to maintain his sporting sense of humor, but from what I could see of his facial expression, I discerned that he didn’t think the logroll was funny.

I sympathized with his plight. He was no longer able to lift himself up or walk. He was struggling to breathe. He’d lost control of his bowels. He might be suffering an infection with a potentially deadly virus. And now he was being manhandled, bumped, and jostled by people with the very best intentions, but three-quarters of them had no prior experience.

Once Ollie was burritoed in the Reeves sleeve, we carried him off the bed, out of his bedroom, and into the hallway. By this point, his facial expression was one of terror. I tried to comfort him, while also giving direction to Harry, who was holding the handles at Ollie’s feet and leading the way. Erwin had a grip on the handles at Ollie’s head, and I was holding up Ollie’s right side.

The hallway was so narrow that it could only admit us single file. I had to drop the handles I was holding, which necessitated placing Ollie on the floor and dragging the Reeves sleeve. Ollie’s face was frozen in a grimace.

I asked Ollie if he was in pain, and he said, “No.” He was just frightened, poor guy.

“We’ll have you in the stretcher soon,” I promised him.

Bunny then cut in front of Erwin in the single file line. I called a halt. Harry was not paying attention and continued to drag Ollie down the hall.

“Harry, stop,” I called. “Bunny, you can’t be in front of Erwin. He has to carry the stretcher at Ollie’s head.”

Bunny and Erwin reordered themselves, and we proceeded. At the end of the hall, we were able to lift Ollie off the floor and carry him into the living room, where Cookie was waiting, clutching her cell phone, her face mask pulled under her chin. We passed Cookie and placed Ollie on the deluxe stretcher.

We removed the Reeves sleeve from under him with another logroll. Ollie’s face during this second go-round matched whatever inner scream he was emitting. When it was over, his eyes and brow relaxed into what I gathered was their customary expression of bemusement.

I’ve seen patients’ blood oxygen saturations drop during these sorts of transfers out of their homes—the situation is very stressful.

I checked Ollie’s blood oxygen saturation. It was now within normal range. I was glad that I’d put him on oxygen while we moved him: I’ve seen patients’ blood oxygen saturations drop during these sorts of transfers out of their homes—the situation is very stressful. I took the oxygen tank from Bunny and placed it on the back of the stretcher. I also confirmed Ollie’s heart rate: it had increased and was now in normal range. I experienced a modicum of relief.

Then I secured Ollie into the deluxe stretcher, which has three seatbelts across the legs, and two shoulder straps that criss-cross the chest. As I buckled the lap restraints, I said, “We’re a team, sir. You and I are going to the hospital together, and we’re working together to keep you healthy during the ride.”

“There’s no ‘I’ in ‘team,’ Dad,” Kitty said. “Behave yourself.”

“I’ll be in the back of the ambulance with you, and Shosh is going to drive,” I said, gesturing to where Shosh was visible through the open front door, in the hallway outside the apartment. “She’s an excellent driver. She only flips the ambulance when she absolutely has to.”

Ollie smiled in appreciation of my joke.

To keep Shosh away from Ollie, I asked Harry to help me with the stretcher as we took Ollie to the ambulance. Shosh took this as her cue to head down to ready the ambulance for transport.

This time, I led the way, but Harry didn’t pay any more attention following than he had leading. Trying to angle the stretcher into the elevator, I found myself pinned against the wall, with Harry repeatedly jamming the stretcher into my abdomen and saying, “It doesn’t fit.”

“Harry, stop,” I said, for the second time, but calmly. I could see that Harry was trying his hardest, and his willingness to help was sparing Shosh a possible exposure. I slipped out from between the stretcher and the elevator wall and adjusted the stretcher’s length to allow the whole apparatus into the elevator.

Harry then stepped inside, and I hit the button for the first floor. From the lobby to the ambulance was a relatively straight shot. Nonetheless, Harry angled the stretcher perpendicular to the vector I’d established on the downhill segment from the curb to the ambulance, and I had to redirect him. But at least he didn’t clobber me with the stretcher again.

Throughout this transit, I engaged Ollie in conversation, and I was gratified that he seemed restored to his jovial mood. He told me about his recent birthday party; answered all my questions that establish his orientation to person, place, time, and situation; and authoritatively recited all the identifying information I needed to document the ambulance call (his telephone number, social security number, and birthday among them).

When I opened the back doors of the ambulance, his jovial mood vanished. Suddenly frightened, he asked, “You’re coming with me, right?”

“Of course, sir. We’re a team.”

*

I was in the weight room, exercising, when I got the text from the captain of my fire company to contact the EMS supervisors in “the Crystal Palace,” our nickname for the county’s EMS headquarters. I called the number in Cap’s text.

The EMS lieutenant who answered told me that Ollie had tested positive for Covid-19. I’d heard that the county had started this notification process. This was the first such call I’d received.

“I’m not surprised,” I said. My voice was lighter than I felt.

The EMS lieutenant—apparently reading from the electronic report I’d filed following the call—confirmed that I’d worn an N95 mask, eye goggles, face shield, gloves, my Smurf suit, and my anesthesiologist’s-style cap to cover my hair.

I affirmed that my report was accurate.

Had I disposed of the N95 mask?

Yes, I had—indeed, I’d gone through the decontamination procedures at my fire station after that call.

How was I feeling? Any symptoms of Covid-19?

I felt fine. No symptoms.

The EMS lieutenant was friendly, and I felt that her concern was sincere. I asked her please to make sure that Ollie’s family knew that he’d tested positive. Kitty, Bunny, Erwin, and Harry had all been wearing fabric face coverings, and Cookie had not worn her mask properly—they’d all been exposed.

I have lived a good life. I have been loved unconditionally. I have done my best to love unconditionally, as I have been loved. If it’s my time to die, it’s my time to die.

When our conversation ended, relief flooded me. Thank goodness I’d kept Shosh out of the apartment and away from Ollie! Thank goodness I had not called for an engine to move Ollie and exposed an entire crew of firefighters to Covid-19.

I returned to the rig in the weight room. I felt unbridled love for my fire station’s little rig. Every gym in the area was closed, and without this rig, my muscles would be atrophying, and I would be deprived of a favorite source of endorphins. Throwing weights around is, in my experience, an unparalleled method of stress alleviation.

I resumed my work out. I was alternating sets of back squats and clean and push jerks. The barbell was positioned on the ground for the clean and push jerk. I gripped the bar and exhaled. I inhaled, lifted my hips and shoulders, straightened my knees, pushed my hips forward, shrugged my shoulders to toss my arms (holding the barbell) upward, and bent my knees again to a full squat, receiving the barbell at shoulder level.

Now I’m going to get Covid-19, I thought. Poor Ollie. An 86-year-old man with COPD was not in an ideal position to weather the viral attack. He might be intubated right now in an ICU. He might be dead.

His daughters might be suffering like I’d suffered the loss of my grandparents.

I exhaled and straightened to a standing position. I inhaled, bent my knees to a quarter squat, and exhaled, straightening my legs, squeezing my gluteus muscles, and extending my arms (holding the barbell) overhead.

That’s a sore throat that just started developing, I thought, reacting to the suggestion of dryness in my throat. I wonder when I’m going to feel like I can’t breathe. This coronavirus is so good at what it does. We organize ourselves, socially, to obscure the reality that we’re subject to evolutionary pressures. We’re not exempt. Throughout history, human populations have been culled by microorganisms. I respect this coronavirus: it is very good at it what it does.

I inhaled to lower the barbell to my shoulders, then I dropped it to my hips, and bent my knees to lower it to the ground.

I don’t want to be intubated, I thought. I know feeling like I can’t breathe is terrifying, but I’m not scared of dying. I’m not going to cling to my expectations for my life. Reality is not a great respecter of human plans; I’m not the first human to have to adjust. I’m not going to lead with my ego; let my humility be my guide.

I repeated the clean and push jerk: inhaling, lifting my hips and shoulders, straightening my knees, pushing my hips forward, shrugging my shoulders, and bending to a full squat, with the barbell resting at shoulder level.

I have lived a good life. I have been loved unconditionally. I have done my best to love unconditionally, as I have been loved. If it’s my time to die, it’s my time to die, I thought. I accept that.

Again: exhaling, straightening to standing, inhaling, quarter squat, exhaling, straightening up, squeezing my glutes, arms triumphant overhead.

It’s ok for me to die now.

____________________________________

Read parts one and two of Maya Alexandri’s coronavirus diaries here and here. Out of consideration for the privacy of the patients, and the company’s members, all efforts have been made to preserve the anonymity of the company. If you want to contribute financially to support Alexandri’s volunteer fire company’s operations during the Covid-19 pandemic, you may do so at this GoFundMe site. We appreciate that financial contribution is not within everyone’s means in this trying time, and we are grateful for any expressions of generosity, be they words of encouragement, good intentions, or your prayers.

Maya Alexandri
Maya Alexandri
Maya Alexandri is the author of The Plague Cycle (Spuyten Duyvil 2018), a short story collection, and The Celebration Husband (TSL Publications 2015), a novel. Her short stories have been published in The Forge, The Magnolia Review, Coe Review, The Stockholm Review of Books, and many others. Maya has lived in China, India, and Kenya, and she has worked as an actor, lawyer, UN consultant, and blues-rock singer, among other trades. She is currently a third-year medical student and a 2nd Lieutenant in the U.S. Army. For more information, see www.mayaalexandri.com.





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