An Interview with Grandma Gail
Tales of Covid
On Monday April 20th 2020, my grandmother, Grandma Gail, suddenly developed difficulty breathing, in addition to feeling achy and confused. She was admitted to a hospital in Berkeley, where they confirmed she had COVID, in addition to bilateral pneumonia. The next morning, I video-chatted with her in the ICU, and she seemed her normal self. It felt reassuring to see her in good spirits. Her black reading glasses rested on her plastic oxygen mask, and she was smiling and laughing. I wanted to keep chatting, but it was difficult to hear her with all of the machines whirring noisily in the background.
Her oxygenation rapidly deteriorated overnight and doctors intubated her and placed her on a ventilator. When I heard this the next day, tears streamed down my face. How was this possible? I could feel a wave of confusion and helplessness rise over me. The ICU doctor said they would intubate her for at least two weeks. I felt so far away, on the opposite coast, thinking about how my grandma was all alone in the hospital, without family by her side. We also learned that she had suffered a stroke. The next two weeks felt like an eternity, but she was a fighter and despite all of the odds, doctors were finally able to extubate her, place a nasal feeding tube, and give her supplemental oxygen through a cannula.
She stayed at the hospital for another week, but said she didn’t really remember her time there. In fact, she had no memory of ever going to the hospital. What she did remember were hallucinations: “Somehow, when I was in the hospital, I thought I was helping somebody in an herbal shop packaging up little things to sell,” she told me. “Then it turned into a hospital setting and there was a guy in green scrubs with a little hat who I thought was an old friend. I’m not really sure if that happened or not,” said Grandma Gail. Later she remembered thinking her room had become part of a furniture store and she remembered trying to get the attention of a nurse, but no one could hear her.
I told Grandma Gail how we video-chatted shortly before she went to the hospital and while she was in the ICU, but she said she couldn’t remember. She was also surprised when I told her how cognitively alert she was. “I’m happy that I don’t remember any of the scary stuff,” said Grandma Gail.
After being discharged from the hospital, Grandma Gail spent six weeks in a rehabilitation hospital. Though her oxygenation was stable, she was very weak and required a lot of physical, occupational, and speech therapy. “I got used to ringing the bell,” she said, “for somebody to come in and give me a bed-pan or take me to the bathroom.”
When I think of Grandma Gail, the first thing that comes to mind is her amazing cooking, like her puff pastry onion soup and pine nut caramel pie. She taught my dad and my uncle how to cook, and she has greatly shaped my appreciation for good food as well.
Food is so important to her, and so in the rehab hospital, she had to adjust, which was challenging. “I remember being impressed,” Grandma Gail said, “when a woman with scrubs came in with a robot-computer on a stand to take my food order, though none of it sounded good.” She remembered looking out her window one day, and realized that a bakery she loved, Neldam’s, was just around the corner. “I figured out that it was only 2 blocks away, oh my god, and I wanted a box of cookies but I decided I couldn’t do that.”
She ate in a room with three other patients, all spaced apart at their own tables and with their own attendants. One of the other patients was an elderly Chinese man who didn’t speak English and was also hard of hearing. She said, “I felt sorry for the poor old guy and then a couple days in, all of a sudden, they put one of those computer robots on the stand and they had linked to a native speaker of Chinese, who could speak to him, and it was so nice. It makes me tear up,” she said. She also said that the medical staff kept track of how much she ate. “You got points,” she said. “The more you ate the closer you were to getting out. So I ate all of this canned fruit and I was dying for something fresh. I finally got broccoli, and I hate broccoli, but I ate it like it was something from the French Laundry. And my last day I got a piece of fresh fruit, a half of a banana.”
In the rehab hospital, she was particularly fond of her physical therapist who brought her therapy dog to work with her. “Her dog …wasn’t on my agenda but at least we had something to talk about,” she said. The exercises were exhausting, but Grandma Gail said that she just kept trying her best. She went on a stationary bicycle, walked using the walker, and later practiced getting in and out of a cardboard car.
She said she liked the rehab hospital because she had outlet plugs on both sides of her bed and so she could have her phone and laptop charging, which was important, given that she wasn’t able to have visitors.
After a month and a half of being in the hospital, Grandma Gail was finally able to go home. They gave her a shiny red beaded plastic necklace and certificate, “Congratulations, you graduated!” Outside the hospital, my family gathered from a distance to celebrate her recovery. “They had the big parade,” she recalled. “I had my big Kleenex all ready. Of course it was wonderful. I was proud too.”
Now at home, she’s had a couple nurses and therapists come to the house to help her, and for the most part, she’s made a tremendous recovery. “The first one that came was a registered nurse,” Grandma Gail said, “and I showed off how I could go to the door to let her in and I don’t think I was using the walker, and so she freed me from all of the medical therapy.” The speech therapist was helpful because even at home, Grandma Gail had memory issues and so the memory games were useful. “My memory was really damaged when I first got out,” she said. “I had to ask what our phone numbers were... and in the kitchen I had to ask where the dish towels were.”
Now mostly recovered, Grandma Gail said “I’m trying not to face reality too much. I had video meetings with three doctors and one said, ‘we didn’t think you would make it.’ She wished the doctor hadn’t told her that, at least not so bluntly. “Those were doses of reality that I thought were a little inappropriately put,” she said. “I suppose I’ve always known that everybody dies and that includes me and each year I know I’m getting older. But I think I look pretty good for 77 and I don’t really think I have wrinkles. So those are realities but I’m trying not to focus on them because I feel good.” Reflecting on her experience with COVID, Grandma Gail said, “I’m trying to ignore the whole process, I’m trying to think of it as something unfortunate that happened to me, that it was a setback. You start hearing news reports that the antibodies wear off, so I’m being very careful, I like staying home and I have my hobbies. I’m hoping to live through this and go on with my life.”
Grandma Gail’s experience with COVID had a deep impact on me. The unpredictability of her illness and rapid decline, made me lose hope at times, but with the help and dedication of her healthcare providers, she persevered. Her experience inspired me to learn more about rehab clinicians who treated COVID patients like my Grandma Gail. This led me to create this summer project to interview PM&R clinicians. Hearing their stories from treating COVID patients in Philadelphia and New York City, gave me a better understanding of what my Grandma Gail went through and ultimately, I realized more than ever, how fortunate she was.
At the end of the summer, I visited Grandma Gail back home in California and we spent a wonderful afternoon catching up outside in my uncle’s yard. Her facemask covered her smile, but she laughed and joked just like before COVID. Seeing her in person, you would never know what she had been through, and I was happy to hear that she was feeling much better and even back to cooking. Next visit, I’m hoping to make her recipe for pine nut caramel pie and surprise her with it.
R. Mayeda is a second year MD candidate at the Lewis Katz School of Medicine at Temple University in Philadelphia, Pennsylvania.