“That uncertainty is the fabric of anxiety,” said Dougherty. “That is what anxiety is.” Dougherty is a former full-time documentary filmmaker who began to transition out of the profession after Canadian documentarian Allan King turned to her one day while they were working on a project together and told her she was in the wrong field. Her true calling, he felt, was to become a psychoanalyst. She told him she didn’t know what that was, but he persisted. Eventually, she enrolled in a master’s program in psychoanalytic studies, while continuing to work in filmmaking, both fields leading her to listen to and document people’s trauma, their triumphs, their shaky steps toward healing. After she graduated, she began psychoanalytic training and started her first practice in her Toronto apartment. That was ten years ago. Today, Dougherty makes documentaries about psychoanalysis. She has never lost her belief in the power of storytelling: how it can connect us, unburden our shame, release whatever load we’re carrying. She believes at least half the power of it is in the other side—the act of listening to someone’s life, of validating that their experiences matter through your own attuned presence.
During the early weeks of COVID-19, she knew she and her army of listeners couldn’t make their temporary patients’ anxiety vanish in a few free sessions. Her job, as she saw it, was simply to attend and, in doing so, to help them better tolerate the sense of not knowing, even if only incrementally. That is, after all, what therapists do: they allow people to feel witnessed and heard, to download their anxiety into another person who can contain and detoxify it. Dougherty also hoped that, in some way, she was giving permission for frontline workers to reach out for help, to say that they couldn’t handle everything, not always. On the other side of it, her new mental health network gave therapists—many of whom had also had their worlds upended in their own ways—the opportunity to feel like they, too, were using their skills to do something essential. They were healing in their own way. The slow build of everyone recognizing how protecting and cherishing frontline workers’ mental health keeps us all alive was worth Dougherty’s own long and sometimes stressful days. She couldn’t take away the pandemic, but she could let people know they didn’t have to endure it alone.
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It’s tempting to tell the story of women’s volunteerism and community engagement during the pandemic as repeated acts of simple selflessness. If, financially, the early days of the pandemic felt to many people like falling without a net, then emotionally, it felt like a giant, sharp-edged spoon, scooping out purpose, scraping down the sides of their lives, shaving away direction, meaning, aim, connection. The social isolation was both abrupt and jarring, cleaving time into before and after, normal and not. Some of us stayed home because our privilege afforded it. Millions of others stayed inside because they suddenly had no jobs left to go to. Across the country, we mourned. Across the country, we looked for something to do, something to ward off the sense of feebleness. We wrote hopeful messages in chalk on sidewalks and used kitchen utensils to bang pots and pans at 7 p.m., hoping the colour and the cacophony would communicate connectedness, kindness. We wanted to tell someone everything would be okay; we wanted someone to tell us everything would be okay. It is an incredible quirk of humanity that when things are at their darkest and most chaotic, what gets so many of us through is being able to reach out and help somebody else. Women helped lead so much of that, and while they gained so much, there is always, always a cost.
As the first weeks of the pandemic transformed into the first months, the calls to Dougherty and her team of therapists became less about anxiety and more about burnout. As a therapist, she tries to live by the creed that you have to take care of yourself before you take care of other people. That applies to healthcare workers and it applies to community advocates. Throughout the pandemic, and the uptick in her anxious clients, and the creating and running of an entire help network, Dougherty made sure to create blank spaces in her schedule. She took baths, walked her dog, sewed pandemic quilts, attempted naps. Still, it was easy to leave herself behind, and she recognized that telling frontline workers “take time for yourself” could feel like a ridiculous, terrible panacea. She said it anyway, insisting they figure out a way. And all around the country, her fellow community leaders tried and succeeded, tried and failed to do the same. That’s the other way to tell this story of inspiring, life-saving community outreach during the crucial months of COVID-19: that it was hard, and it took a toll. More than that, it exposed how deeply society relies on community advocates to fill gaps. Underneath all that genuine kindness is a type of survival, a sense of being forgotten by the systems that are supposed to take care of you.
Life crushes forward even during a pandemic. Mita Hans’s job as a social worker took her on twelve-hour overnight shifts to seniors’ community housing buildings. One person whom she cared for contracted the virus just as the caremongering movement catapulted toward fame. During one harrowing night, it didn’t look like her client would make it. This is bad, Hans remembers thinking, again. This is not the flu. Her client survived, but others in her care also got COVID-19. The building had temperature control, but no ventilation, no open windows, no way to leave during a shift. Hans got tested every two weeks, and kept showing up for work every evening, stress hollowing her out, wondering if that would be the night she, too, became sick. Meanwhile, Harper’s husband worked on the front line with Toronto’s marginalized communities. Harper spent her days volunteering and organizing with Caremongers-TO, looking after their son, working her job as an account manager for a third-party rare book dealer, and wondering if her husband, and everybody else, would be okay. (In fact, the day we all chatted over Zoom, she received a fist-pump-worthy call that he had tested negative.) She had to constantly remind herself that she’d been through worse. Some days it helped and some days it didn’t. “We were hurting just like everybody else,” Harper said. “We’re stressed, just like everybody else. We’re anxious, just like everybody else. And we’re trying to do this work.”
Thousands of kilometres away, LaMeia Reddick was also stressed and trying to do good work. In early March, she was in the process of trying to move out of her mother’s house, but good luck finding housing in a newly declared pandemic. She ended up spending a few weeks in a heavily discounted Airbnb in Halifax, telling herself she could use the tough time as a writer’s retreat, as a way to recharge. But when she heard there was a shortage of workers for the city’s emergency shelters, she signed up for a few overnight shifts as a support worker. As she tried to navigate CERB and reimagine BLxCKHOUSE—obviously, she wouldn’t be hosting crowds of people in her mother’s house anytime soon—she also tried to figure out the balance between the community’s needs and her own. She was still trying to figure it out when a Minneapolis police officer held his knee on George Floyd’s neck on May 25, pressing it down and down, even as Floyd said he couldn’t breathe, even as it killed him. All the thick, complicated grief she was holding in spilled over, heavy and too much and inescapable. Reddick, characteristically, responded to that dark, tragic moment with community aid, raising twelve thousand dollars to create a fresh, needed pop-up space for BLxCKHOUSE on her mother’s driveway and a homework café in the backyard.
There is a word often used to describe people like Reddick: resilient. She herself has used the word to describe the community of North Preston. It’s in the way the community can lift itself up, can continue to find joy and to love each other and achieve excellence, even through a pandemic, even through endemic racism, even as governments forget and punish and kill them. It’s in the way people like Hans, Doan, and Harper reach out to help others, even when they’re in danger, even when they want to curl up in a ball and just sleep, or try to. This idea of resilience—of making it through tough times, past obstacles, of bouncing back—is something that Reddick thinks about all the time. She wants to celebrate it, and she wants to conceive where it can take her community once the pandemic is ov
er, what new systems it can create, what hope it might cultivate. There is a lot to learn, Reddick told me, from children who grow up in devastating circumstances and still have bright smiles on their faces. But the other thing about resiliency is that it’s complex, she added. It doesn’t grow in privilege, in ease, in fairness. “The fact is, why do I have to be so resilient?” asked Reddick. “Why do we not have the basic things that a lot of other communities have?” The fact is, sometimes people have no choice but to go on.
“WE’RE TRYING TO TREAT A DISEASE THAT WE BARELY KNOW ABOUT.”
Dr. Kanna Vela, emergency room physician
Four
VIRUS ON THE FRONT LINE
Before the first patient arrived in New York or Madrid or Toronto, Janet Pilgrim believed the new coronavirus outbreak would be like the first one. When SARS hit Canada in 2003, Pilgrim was a frontline nurse at Toronto Western Hospital’s emergency department. She remembered the fear and isolation and the sense that death was riding in. At the time, she was set to get her driver’s licence in nearby Mississauga, but after learning she was a nurse in the city, her instructor refused to teach her. Friends wouldn’t let her enter their houses. Forget frontline hero; she became a pariah. It was like her breath was a loaded weapon, every exhale a grenade. Nearly everybody was afraid she would expose them to the virus and that they, in turn, would spread it to their families. She was afraid for her family, too. Her children were only two and three years old, a particularly vulnerable age for SARS. Her colleagues were getting sick. Some were dying. The so-called killer bug had largely caught the healthcare system off guard, and everyone knew it. The news channels blinked panic, people in masks on the street, comatose patients on stretchers.
In early 2020, those memories piled into pyramids and, thinking back, Pilgrim thought she had an understanding of what was coming. She also thought the hospital was well-prepared to handle it. She had now been at the hospital for three decades, and had advanced to nurse manager of general internal medicine ward 8B. Her team of sixty had successfully managed various outbreaks at the downtown hospital over those years, including H1N1 in 2009. Controlling the new virus wouldn’t be easy, but her team worked well together, was highly skilled, and had done it before—or so they thought. Along with leaders at the other hospitals within the University Health Network (UHN), the umbrella under which Toronto Western and several of the city’s other sites sit, Pilgrim began strategic planning and collaborated on emergency preparedness guidelines and protocols. As news blighted Wuhan, hospital leaders decided they needed a uniform response. This time, there would be neither pockets of failure nor pockets of excellence. Every precaution and procedure would be unveiled at the same time, on the same day, in the same way. People from across all departments of all the hospitals collaborated, planning meticulously, examining every angle, determined not to jeopardize frontline healthcare workers again. Pilgrim remembers assessing the plans and thinking, We’ve done a good job. That confidence was fleeting.
“By the time the virus truly came through the doors of Canada,” said Pilgrim, “the world was in a pandemic.” SARS had caused havoc on two continents. In contrast, the emerging coronavirus had eclipsed the globe. Oh. My. Goodness, thought Pilgrim, each syllable an anvil thudding sand. How has it already impacted so many? Almost overnight, people became consumed with counting COVID-positive cases, with counting deaths. Hospitals in Europe were running out of beds in their intensive care units (ICUs). PPE was in dangerously low supply, seemingly everywhere. A shortage of ventilators meant doctors had to decide who would live and die, their days bloated with impossible choices. Pilgrim watched the accelerated advance and realized this new virus wasn’t like SARS at all. That virus was unquestionably deadly and awful, but it was also fathomable—it happened on a scale the human brain could understand. This virus was what people called it: a wave. One so big it felt biblical, threatening to scrub the world clean. Whatever careful plans the hospitals had made, she now knew they needed to work on additional plans. Maybe they were barely prepared at all. And every second they failed to fix that could add a blunt tick to the world’s new death-watch obsession.
In response to this realization, a physician within the UHN reached out to a doctor in Spain who was tweeting about his hospital’s COVID-only units. By then, the European country had outpaced mainland China’s death toll, coming second only to Italy. Healthcare workers in Canada had no reason to believe they wouldn’t suffer the same dismal fate if they didn’t learn from the mistakes made in the rest of the world. Doctors in Madrid gladly shared the harsh lessons they’d learned, those in turn imbued with grim knowledge from Wuhan. Soon, Pilgrim and her colleagues had a new plan. They decided to reorder the hospital into taped-off, colour-coordinated risk zones, reminiscent of a basketball court. Staff drew red lines around individual patient rooms, indicating extremely high contamination danger. Nurses and doctors inside the red zone must wear PPE and must also take it off before exiting. The intermediate-risk green zone was where everyone put on their hygiene armour. The nursing station itself sat in the blue, or “super clean” zone, which nobody could enter without washing their hands. They drafted safety checklists, practised patient visits, learned how to work PPE with nursing partners, drafted post-round checklists. Over and over again, they rehearsed for disaster.
“And then reality hit,” said Pilgrim. On a Friday afternoon—because bad news is always delivered on a Friday, something Pilgrim vowed right then to change—her clinical director told her that her ward would be the designated COVID-positive unit. The words knocked around in her suddenly hollowed-out chest, again: Oh. My. Goodness. She had spent the preceding weeks psychologically preparing for the pandemic. But it’s one thing to steel yourself, and quite another to tell your team they’re going to war. Fear throttled the entire world, and at the time, Toronto Western was no different. She gathered the afternoon shift inside a room. As a nurse and a team leader, Pilgrim has had to deliver some pretty tough information. This was the hardest. She wasn’t just saying, Prepare for a rough few weeks at work. Read between the lines and the message was, Prepare for death. “Okay guys,” she told the assembled crew. “I have some news.” Pilgrim tried a positive spin: because of their stellar work on previous flu outbreaks, and their familiarity with PPE, hospital administration had designated them as the COVID ward. When she finished, the room went silent. She could see the fear etched on their faces. Tears slipped.
They were afraid for their families. What if they passed it on to their elderly parents? What if they took it home to their husband, their child? How would they keep everybody safe? The questions collapsed into each other, and Pilgrim sifted through the rubble of fear, rescuing each concern, addressing every fear. Inside, she felt their pain. On the outside, she made a mantra of reassurance: we know how to do this, we are a strong team, we can make it through together; we are nurses, we are professionals, we will offer professional care. “Let’s pause,” she said. “Let’s remember what we know.” Eventually, she felt everybody begin to breathe again. After they left, Pilgrim stayed behind and had the same wrenching conversation with her night staff. When dawn crested, she told her morning staff—a déjà vu of clawing fear, panic, resolve.
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As Pilgrim prepared her ward, about an hour’s drive away, in Hamilton, Cathy Risdon sat down to write three emails. Risdon is a vice-chair in the Department of Family Medicine at McMaster University, and the school’s director of health services. She’s been in the department itself for over twenty years, focusing on building collaboration, communication, and professionalism within the medical field. She’d need all those skills now as she tried to distill one of the most catastrophic, unprecedented crises in modern history. Even as most of us were compassionately, robotically swapping “Cheers” and “Best” for “Stay safe” and “Be well,” to Risdon the once-simple act of emailing felt loaded, impossible. What do you say when safety and
wellness are so deeply uncertain, so compromised—especially for those on the front line? Risdon’s first email to her physicians and residents was, more or less, the warm-up act. She explained the importance of handwashing and talked about the power of prudent care in protecting the community. The second email, sent about ten days later, praised their work. She told her staff they were doing a great job and commended the way they were mobilizing and looking out for each other.
But as she sat down to write her third email, the world felt like a different place. There are people in our professional circles, and in our clinics, that could die from this, she thought. The slimmest of margins, and a whole lot of luck, might be the only thing stopping Hamilton or Toronto or Vancouver from becoming New York or all of Italy. It was the lull before SARS-CoV-2 had infested Canada. People might have wanted to use the pause to grow sourdough starters, or learn a new language, but what they really should be thinking about, she became convinced, was if their wills were up to date. Risdon began to type: “Based on the experiences of other countries, we need to be prepared for the possibility that some very hard, sad things will happen to people in our work circles and our family circles.” Warning of overwhelmed hospitals and a shortage in care, she continued: “A lot may happen without our ability to prevent or control it.” The best thing her staff could do now was break the taboo on discussing death—before it was too late. “Do you have a will?” she asked her staff, encouraging them to have an honest, compassionate conversation with their loved ones. “Powers of attorney for finance and personal care? Are all your insurance policies and financial documents organized and easy to find?” If the worst happened, what kind of death did they want?
Women of the Pandemic Page 8
