The last time I tried to wait until the pandemic was over, I headed south. My dog and I traveled nine hours from San Francisco to the Anza-Borrego Desert, which stretches over half a million acres near the Mexican border. Most of this area is untouched wilderness, and rocky washes that are home to deer, pumas, and golden eagles.
The place felt isolated. That’s why I chose it. I work as a doctor in the emergency room, hospital, and HIV clinic. I also take powerful immunosuppressants for autoimmune diseases, one of which has made the coronavirus vaccines less effective in my body. My co-workers tried to see all the COVID patients to protect me, but with the Omicron exploding in January, that became impossible. The woman who broke her ankle tested positive. The ancestor who cut his scalp did that too, just like the middle-aged man who wanted to detox. There was a shortage of COVID treatments, and I wanted to get through the boom alive. So I canceled work for several weeks, a privilege most people can’t afford. After being forced into isolation, I decided to spend a week feeling isolated.
At the time I would describe my journey into the desert, and epidemiological life on a large scale, as a respite. The moment case numbers plummeted and hospitals were supplied with treatments, I was going for walks in Japan. I was brave in the dating scene after a two year hiatus. I will spread with Doctors Without Borders. In the meantime, I reassured myself that I had to wait a few more months, even though the deadline kept slipping. My view was equally convenient and wrong.
Kurt Vonnegut is best known for teaching six basic models that support stories. In a video clip of one of his lectures, he draws on the board a time-axis and y-axis for the score of good luck, then traces a sine wave descending before it rises again. “We call this story ‘a man in a hole,'” says Vonnegut, “but it doesn’t have to be about a man, and it doesn’t have to be about someone going into a pit. It’s a tale—about fall and redemption, strength forged through trials, catharsis and ultimate victory—What people naturally say. And it doesn’t have to be about a man and a piercing. It could be about a scientist and a virus.
People in the United States have heard this story over and over again over the past two-and-a-half years, as the media and government have described the downturn in every rise or appearance of every treatment as the ladder that will carry us close to the pandemic pit. Until this redemption, we can plant rooftop gardens and sourdough starters to stave off our impatience. It’s less intimidating to rewrite reality into a reassuring plot arc – one with familiar surroundings and clear subtlety – than to imagine a never-ending story, or a story whose ending permanently reshapes our world.
But nearly eight months after I got back from Anza-Borrego, the bridge of my nose is raw from my N95 mask. yet another sub omicron It spreads, as one strain replaces the other. Despite amazing advances in vaccines and medication, COVID continues to threaten to hospitalize or disable me, and I don’t expect that reality to change imminently. As the mirage of normality fades, shimmering and unattainable, I’m still stuck in another desert, staring at the fact that the sense of closure won’t arrive anytime soon.
SARS-CoV-2 is the latest pathogen that is turning people’s lives upside down. My work as a clinician who specializes in HIV – a virus that severely affects my patients and yet is ignored by most Americans – has taught me some facts about epidemics. The first time someone asked me if HIV was “still a problem,” at a Christmas party years ago, I almost choked on my drink. But the question has a twisted meaning in a country where the idea of an end to the pandemic relies on little science and the affected communities.
The people I treat who gasp with pneumonia or get meningitis because they don’t have access to or adhere to HIV medications are always poor, and many of them are black or Latino. My acquaintance at the party was a rich, straight white man in his sixties. It could be located in a story where the guy jumped out of the hole. The tale is over, the credits rolled in. This conversation is why when someone says the coronavirus pandemic is over, my first question is always, “Who finished with?”
Although I have endured a small part of the ordeals of my patients, I am learning what it is like to embody a story that is less comforting than the one others tell. I walk past crowded bars. I browse through pictures of maskless crowds at concerts. I hear people use the phrase “during a pandemic” as if it’s over. After several false starts, the man in the dominant version of the story escaped from the pit after increasing the Omicron once and for all.
This narrative has real consequences, including lax precautions, precarious workplace policies, and woefully insufficient funds for the global effort to combat the coronavirus. It marginalizes millions of Americans: not only people like me who deal with high-risk medical conditions, but also survivors who face COVID long, frontline workers drained by exhaustion, loved ones mourning those who died, disproportionately people of color. I don’t want my fellow San Franciscans to stop eating out or traveling; Their lives will be more free than mine, a situation I accept as inevitable even if it saddens me. However, I hope the government will value my life by investing in preventing COVID transmission rather than issuing More tips for anemia. And in the middle of this policy failureI hope that people who are less afraid of the virus take the burden off the shoulders of the most vulnerable, by wearing masks on public transportation, staying home when they are sick until a rapid test turns negative, and keeping up with the latest promotion.
Too long after, I’ve stopped clinging to the Man in Hole myth, where I must pretend the epidemic is over – self-deception can get me to the hospital – or wait indefinitely for a ladder, watching the clouds roll over the desert lowlands as I lose Plans and dreams. I need a story to replace it, which is why I turned to my patients.
A few years ago, I treated a young man who contracted HIV after graduating from college. A pandemic that had never touched him before suddenly clouded his life, crippling him for months. Not looking for a job. He played video games all day and almost lost his housing. Then, six months after his diagnosis, he started bringing a notebook to visit us. In it, he formulated a plan. Nothing sweeping: Stop at a couple of restaurants to ask about jobs. Get glasses. Post a dating profile. A year after our time together, he worked in a cafe, had a beloved friend who knew his situation, had a long-awaited surgery, and began his graduation from school.
I started carrying a notebook recently. The plans I have are different from those I might have envisioned before the pandemic, but I share one advantage: They are possible despite the limitations I face. I rode my bike from Seattle to Vancouver for an outdoor vacation. I attended a wedding in an N95 mask. I made enchiladas with friends after we all did quick tests. I spoke on the radio about the grievances of pandemic politics, because adapting to my new reality does not mean giving up the fight for a better reality. This, too, I learned from people living with HIV, who have formed committees to lobby the Food and Drug Administration and the National Institutes of Health, demand their inclusion in policy decisions, and have been jailed for protesting against effective antiretrovirals, including one used to treat COVID.
I still meditate whenever I attend an event that is too crowded and poorly ventilated for me to stay in, or on a plane where the upside-down mask law reminds me of the nation’s disregard for my health. But working with it is a relief after spending so long stumbled. If I were to draw my life on the board in Vonnegut now, I would draw a steep descent followed by a slow, bumpy slope not yet close to the original precipice. It’s a less exciting tale than Man in Hole, and exasperating in its escalation, but it has one advantage: It’s true.
Some people visit Anza Borrego only after it rains, in ideal conditions, when a riot of wildflowers on the ground bursts with color. I have never had. People tend to assume that this is the time when the desert is alive, but in fact, even in the most arid conditions, bobcats roam, coyotes creep, and foxes raise their packs. When wild sheep cannot find water, they squeeze the cactus barrel and devour the wet pulp. These animals know very well that rain does not always come. During droughts, life continues.