My neighbor, M, just came home from the hospital this week. She is recovering after a month long illness.
M is one of the original residents of my building. She is a trim and fit woman of 70 with straight blondish gray hair and pale blue eyes. A psychologist by profession, she worked with patients during the AIDS epidemic and also with children in the Dutch school system. She has been retired for quite a few years now. In 1989, the previous building at our current location was demolished, and our modern, austere building with 7 apartment units was built in its place. M was a single parent with a young son when she moved here and has spent the past 31 years tending the community garden, calling the building management when things break, informally mediating residents’ disputes, holding important building keys, and watching the comings and goings of all the dozens of various residents over the years. If you need to know something about Dutch living, Amsterdam, or the local community, you can bet she can help. She is our building matriarch.
I’ve known M since I moved into the building two years ago. At first we only saw each other in the stairwell. She was one of the first people I told when my long-time partner and I separated, and he moved out. She offered very practical advice that day, and I’ve often thought about it and appreciated her candor. Dutch people are quite well-known for this, but I am still very touched when it happens. One thing I love about most Dutch people is their ability to hold a calm space no mater what the situation. I can express frustration, fear, or pain, and they don’t immediately go into a look on the bright side mode, or a problem-solving mode, or attempt to change the subject to something more pleasant mode. M has allowed me, many times, to sit in whatever I am feeling and be supported. She lends an air of being able to take it. When my bathroom needed to be remodeled to repair a barely functioning shower just a few weeks before the outbreak of coronavirus reached Amsterdam, she offered me a place to stay. We had many conversations over tea in her kitchen, learning even more about each other and how our lives were actually quite similar.
M first started having symptoms in mid-March, a fever of 39.5C (103F), blurred vision, digestive upset, and a severe headache. She called the huisartsenpost, which is a regional, after-hours center where several doctors work together to manage cases. She was told that if her fever was less than 40C, then she was not to worry and to remain at home. She managed to care for herself for awhile, but her condition continued to deteriorate. Her son is living in Asia, and after speaking with her one day by phone, he realized that she sounded confused and was not in any condition to be alone at home. At that point, she had been alone, caring for herself for almost 2 weeks. He called the huisarts (doctor), who came immediately, followed by an ambulance. The crew arrived wearing full protective gear. On the way to the hospital, the ambulance driver ran the sirens, telling her that even though it was rather chilly outside, his PPE was so hot and uncomfortable that he wanted to get back to the hospital as soon as possible. At her request, she was taken to Vrije Universiteit Medical Centre in Amsterdam. Her blood oxygen saturation level was found to be low, and she was put on oxygen. She was given antibiotics as a precaution. Her son began his journey back to Amsterdam.
She was placed in a general intensive care unit because without noticeable breathing issues, the doctors did not suspect that she had coronavirus. At some point she was given a nasal swab to test for coronavirus due to her low blood oxygen level since tests had ruled out other conditions. The result came back several days later. It was negative. She was asked whether she would want to be placed on a ventilator if it were necessary. She declined, knowing that a ventilator is a last ditch lifesaving effort that often leaves a person with permanent, reduced mental and physical capacity. She saw that the hospital environment was chaotic and crowded, and felt that last ditch efforts were better reserved for younger people. She says that she cannot remember much from that time except that she felt her body completely shut down, and she knows that she almost died.
I could no longer move and often wanted to say something, but I just could not, so I thought just let it be. “
At some point during her 4 day stay in ICU, another coronavirus test was administered, and this one was positive. She was moved to another unit specializing in internal medicine and would remain there for another 4 days. She said that there were adequate coronavirus tests for patients and staff throughout the duration of her stay, but that the staff found it difficult to deal with all the required and necessary personal protection equipment. There were many older people in this unit, including a couple in their 80’s who both recovered after being placed on oxygen. During the last few days of her stay in this unit, she discovered a community room for patients. There she met 2 other women and they shared their experiences. They shared stories of their pain; they cried, laughed a lot, and found this very healing. One 55 year old woman had been admitted to a Rotterdam hospital with her husband who also had corona symptoms. She woke up 6 days later at VUM, unaware of having been transferred there due to overcrowding. She had been placed on a ventilator and intubated. She is recovering very slowly, and was told to expect to need one month of rehabilitation for every day on the ventilator.
After 8 days in the hospital, M was moved to a special corona unit in a rehabilitation care center to recover. This unit was chaotic because it had been newly formed to deal with the crisis, and patients were arriving from throughout the Netherlands. While there she realized that she felt entirely disconnected from her body. She practiced breathing and consciously thought about each part of her body while thinking, “I have a stomach, legs, arms” while physically touching each part of her body as a way to reconnect. She found this very healing. At one point during her 10 day stay at the rehabilitation facility, she had a neurological incident and fell, with some of her previous symptoms returning. She remembers that half of the people in the corona unit were old, and many made noises and sounds out of fear. It felt to M as if she were in a hospital scene in a war film. Even though she had her own private room, she could still hear the voices, coughing and gasping for breath.
Upon arriving home after 18 days away, she still feels alone and a bit fearful because the severity of her symptoms were not initially taken seriously. She is worried about being contagious and still wears a mask when she is able to venture out. “People seem afraid of me when I am wearing the mask,” she says. Although the doctors told her that she is no longer contagious after 72 hours without symptoms, she remains skeptical. She looks forward to receiving a test to see if she has antibodies to the virus and a possibility of immunity.
I asked M about the financial impact of her hospital and rehabilitation stay. She replied that she would only be responsible for €385 ($421), the yearly deducible (called own risk here) under her private health insurance plan. If she had already incurred expenses toward her deductible for the year, that figure would be less. She will then have no additional out of pocket costs for the remainder of the year.
She feels very satisfied with the level of care she received at VUM and at the rehabilitation center, saying it ranged from 8-10 on a 10 point scale. “I have complete respect for the people who cared for me. There were wonderful doctors and nurses, but also many volunteers and medical students who volunteered when their studies were interrupted.” When she left VUM, she told the staff, “I am so thankful I was here. You saved my life.”
When asked what she would like people to know, she replied,
I’m used to the flu, I’m not afraid of the flu. It is not like the flu. It eats you up. I was near death. I still feel very weak and that my body remains very far from recovery. I also feel reborn. I am very thankful for having this illness, really. I feel love and happiness. It is not like the love and happiness of the ’60’s but it is still love and happiness. Maybe coming through this will create more of a world of love and compassion for each other.
Like our building matriarch, I most certainly hope so.
As a footnote, I would like to add that this is an illness that can strike suddenly. Needing to be in isolation and the inability to sit across from someone face-to-face for any period of time to determine their true condition is one reason that it can become so deadly. Several building tenants were checking on M, speaking with her by phone and texting. I went up to see her in person, from a distance, shortly before she needed hospitalization and did not see that she was in distress. Once admitted to the hospital, contact with friends and family is very limited. There are no loved ones sitting in hospital rooms, reporting on the patient’s condition and informing others. It is a very lonely time for a corona patient. I took great comfort in seeing whenever she checked her Whatsapp. It was one more day that I knew that she was still with us.