Dr. Lydia Kang, an Omaha doctor and author, was co-writing a history of pandemics, “Patient Zero: A Curious History of the World’s Worst Diseases,” when COVID-19 emerged and circled the globe. Kang’s book, “The November Girl” won a 2018 Nebraska Book Award.

“Mom’s home! Look away, look away!” 

This was how I greeted my kids during the first half of the COVID-19 pandemic after an internal medicine clinic shift at Nebraska Medicine. I’d shed my doctor scrubs in the laundry room, start the washer, and dash upstairs in my underwear while my kids shielded their eyes for modesty’s sake. After a shower and in clean clothes — after I had banished every possible viral particle off my body — I finally asked how their day went. If they were okay. If Zooming for school, day in and day out, was numbing their brains or making them depressed.

This was one slice of my pandemic normal. It started much differently. 

In late 2019, well before the pandemic became a daily thought in our minds, I had been chatting  with my editor and co-author about writing a new book to follow “Quackery: A Brief History of the Worst Ways to Cure Everything” in 2017. Nate Pedersen and I felt ready to write a new book, and together with our editor, we set our eyes on the subject of pandemics. We could call it “Patient Zero: A Curious History of the World’s Worst Diseases.”

In one of our email chains in early January 2020, I mentioned that I’d seen some articles about a small outbreak of a SARS-like virus in Wuhan, China. 

“Maybe this will make it into the book!” I wrote at the time. I was doubtful. It felt like one of a thousand news headlines that faded into obscurity once the hype or real danger passed. 

In early February, we finished the book proposal. We were ready to start writing about zoonoses — those are infections that leap from animals to humans — mad cow disease, the evolution of germ theory and much more. But by the end of the month, the US had its first case. The Chinese government shut down all travel to and from Wuhan.

I started obsessively tracking the daily cases. The Biocontainment Unit at Nebraska Medicine leapt into the national news, busy trying to prevent COVID-19 from exploding. Unable to find masks online, I spent weeks stitching together cloth masks for my family here and afar. I couldn’t find elastic for masks. When I drove to Omaha fabric stores, I found lines that stretched into the parking lots. 

Kang at Nebraska Medicine, where she works as a primary care internal medicine doctor. Many of Kang’s patients have contracted COVID-19, and several have died.

We didn’t yet know that the Biocontainment Unit was caring for a splash in the midst of a tsunami that had already slammed into our shores. By March, my kids’ school went to online learning. My son’s senior year of high school fizzled. I took guilty pleasure as everything shut down. I’m an introvert at heart. I crossed off events on my schedule with glee, started Zooming with friends and patients, enjoyed wearing scrubs or yoga pants all the time. I started to believe the elastic waistband to be the best invention in human history — aside from antibiotics and vaccines. Since I’m in primary care internal medicine, I didn’t stand on the front lines. That made the guilt worse, as people cheered me on as I showed up for work. 

In my slob-wear, I didn’t feel like a hero. I began to resent the moniker when I saw others refusing to use masks or pay attention to physical distancing.

Meanwhile in New York, where we’d lived for 16 years, my doctor friends fell into a nightmare COVID-19 surge. One of my former colleagues landed in the hospital; non-ICU physicians had to begin working in the ICU. When my patients doubted the severity of the crisis, I’d relay the horror. I hated to scare my patients, but they needed to see what Nebraska could become if we weren’t careful.

I missed my extended family on the East Coast. I worried about my elderly parents in Maryland. I fretted over my fragile elderly patients, now physically and socially isolated in a way that risked their cognitive health. Some of them died because it was their time. Some died due to COVID-19, and some succumbed to the consequences of their necessary isolation. I miss chatting in Spanish with Ms. L. I miss seeing Mr. F and his worn cowboy boots at every visit. I have zero doubt that COVID-19 played a role in their deaths.

Procuring the COVID-19 vaccine for my elderly parents from afar was a logistical mess. I’d stay up until midnight when new slots opened up at the Maryland mass vaccination centers, quickly filling out the online form, refreshing my screen, refilling the form, and repeating the entire process again and again, only to find that all the slots were filled faster than I could keep up. It seemed like a bizarre video game with nightmarish consequences for losing. I finally exhaled when they received their vaccines in April 2021.

All the while, I kept writing this book on pandemics. Did you know that Mary Mallon, aka “Typhoid Mary,” was famous for a dish called “peaches on ice” that probably gave her employers deadly Salmonella typhi? Or that HIV likely first infected humans, not in the 1980s, but in 1908? It was all eye-opening and fascinating. And chilling. 

Writing about the xenophobia that surrounded the plague outbreak in San Francisco in 1902 was particularly horrifying for me. Residents of Chinatown were called “filthy” and “bred disease” by their own mayor, James Phelan. (He would later run for Senate with the slogan “Keep California White.”) The authorities cordoned off Chinatown, but allowed white people to leave the area. Even though scientists understood that fleas spread bubonic plague, Chinese Americans were still blamed. I was revising this chapter when President Trump crossed off  “corona,” switched it out with “China” and hung a new name on the virus now sweeping the country. I felt physically ill when I saw that. I knew what was coming.

Our family is both Korean- and Taiwanese-American. A stranger once swung a fist at me on the New York subway and muttered an anti-Asian slur; I have many unseen scars from being bullied as a child in Baltimore because of my race. When I first moved to Omaha, any time I entered a store or meeting, my eyes would scan the area. Am I the only minority in the room? Are people staring at me? The answer was often yes, but over time, I stopped being so aware. Both strangers and colleagues in Omaha were pleasant and civilized towards me, and my worries dissipated. Until COVID-19. 

As anti-Asian violence escalated in the country, I was grateful to hide behind a mask. I considered wearing a baseball hat, to hide my telltale dark ponytail. I was glad that my kids had to stay at home, and terrified my parents might be shoved in a parking lot while getting groceries. I suddenly lived in fear in Nebraska. It felt horrible, because I love Nebraska. No one wants to be afraid of their hometown and its people. I was. 

Now, I had to write a whole chapter about COVID-19. I do fear the backlash I will get when the book is released in November — partly because of what I look like, partly because I chose to write about the politicalization of COVID-19. Yes, the Chinese government did some terrible things. Yes, our government could have also done better, too. 

As soon as I wrote anything, the information would change. I felt stuck. As did everyone in the country, and the world, who were learning along with experts how unprepared we were. How poorly we all do in the face of uncertainty. Facts are immutable, yet they change. That’s how science works. We gather data, which transforms existing data. We test hypotheses. But even with the solidness of science, everyone chooses to believe their own truth. It’s incredibly human, and it means people can choose to endanger themselves and others. The arguments over every aspect of this infinitesimally small virus were, are, and will continue to be ugly. 

In the past, I have kept my writing world and my doctor world separate. Keeping my two worlds tidily apart never felt more impossible than in November 2020 —the worst month of the pandemic for my family. That month, I did a lot of telehealth visits with terrified patients infected with COVID-19, peering at the tchotchkes on their shelves and comfy armchairs they sometimes slept in. I fielded desperate daily calls from other COVID-19-positive patients or those at risk. Should they get Remdesivir? Vitamin C? 

I waited on my own COVID-19 test results while I cared for my spouse — also a physician — who was sick with COVID-19. Bundled in blankets and isolated in our basement, he slept through much of his illness. Three times a day, I’d deliver meals to him while holding my breath, hoping desperately that his fever would break and his oxygen saturation wouldn’t drop. Luckily, no one else in our household contracted COVID-19. Amidst the chaos, I continued to write the chapter on the politicalization of COVID-19. 

It was surreal. But let’s be honest; the entire pandemic has been surreal. From our hasty post-work COVID-19 streaking and showers, to once wondering if touching grocery store produce would give us COVID-19, to the new verbs that have entered our lexicon: “masking,” “distancing,” “Zooming,” our world will never be the same. 

In my electronic medical record, I keep a list of the patients I’ve lost these last two years. Every time I open up the chart to answer emails and sign prescriptions, I stare at that list. It reminds me of what and who is at stake. Priceless lives. Beautiful people. 

The Delta variant is killing people. The ICU at our hospital is packed. Again. Compassion fatigue amongst healthcare workers is ascending in a terrifying way. There is only so much one can do in the face of seemingly unending chapters.

I haven’t worn scrubs in a while, since the fear of carrying COVID-19 particles on my clothes is mostly gone. But if a new variant takes over, if cases again overwhelm us (because this damn virus relentlessly changes to attack us), then I will again put on my pandemic uniform. Buy new masks. Keep writing. Show up for work, and take care of those who will let me. Because this is what we do. We keep going, despite so much to lose, and already lost. We cling to empathy and trust science, not pseudoscience, so we can save lives and not destroy each other. 

Like the virus, we adapt. Like the virus, we are in it to survive. 

Unlike the virus, we will emerge as survivors. We can tell our stories, again and again, so people can learn something for the next pandemic. 

Because I can tell you this with 100% certainty: there will be another.

Dr. Lydia Kang practices internal medicine at Nebraska Medicine and is a professor at the University of Nebraska Medical Center. She’s the co-author of a new book on pandemics, “Patient Zero: A Curious History of the World’s Worst Diseases” to be released in November.

Kang is an author of young adult novels, historical fiction and nonfiction. Her novel, “The November Girl” won a 2018 Nebraska Book Award.

The Flatwater Free Press is Nebraska’s first independent, nonprofit newsroom focused on investigations and feature stories that matter. 


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