Sadder Than Flooding: “I’m Sorry”

This is a rare, off-topic post. Flooding is one of the most heart-breaking things that families can experience. But this morning, I received two emails from my daughter-in-law, Dr. Aylin Ulku, that are even sadder. They describe health care delivery in the Four Corners area. The first email contained photos of doctors making rounds in a motel. The second was a link to a post by her colleagues called “I’m Sorry.” It describes the plight of a people and their caregivers in poetic terms. Make sure you read all the way to the end. Warning: Keep Kleenex handy.

Delivering Health Care in Motels from Sidewalk

Dr. Ulku is a professor of medicine at the University of California/San Francisco. She is currently helping to deliver COVID-care in Gallup, NM, as part of the University’s HEAL Initiative. If you’ve never been to Gallup, it borders the Navajo, Hopi and Zuni Nations.

She and her fellows currently work in four locations: Gallup; Fort Defiance, AZ; Chinle, AZ; and Shiprock, NM. In Gallup, which is the largest of those towns and on Interstate 40, she and her team are delivering heath care in motels.

She writes, “I attached a few photos of my colleague, Bassem (from UCSF) and Michelle (a Navajo nurse) as we make rounds on patients in the motels. We check in on their symptoms and about once a day transfer back to the ED (emergency department) as they get sicker. It’s amazing and complicated…an incredibly satisfying, but bizarre kind of community work.”

“This is the process in general: knock on door, find out how someone is doing, fill any meds needed and get them delivered, check oxygen, rarely examine fully with listening to lungs or examining wounds.”  

Bassem, one of Dr. Ulku’s fellows with Michelle, a Navajo nurse at the El Rancho Hotel in Gallup
The initial greeting
Checking on patients from the doorway
Health care delivery from a backpack

Why the motels? It seems many unhoused, unsheltered folks have no other option. Many live in multi-generational homes and are afraid of exposing loved ones. Some are not sick enough to be in a hospital yet, but are still symptomatic. And some simply don’t have a way home.

“I’m Sorry”

Two of Dr. Ulku’s colleague’s wrote this incredibly powerful and moving story published in Medium. Samuel Percy, MD, is an anesthesiologist and Carlie Field, MD, is an obstetrician and gynecologist. They also currently work on Navajo Nation.

Written by HEAL Fellows Samuel Percy, MD and Carlie Field, MD

Dear beautiful girl,

I’m sorry. I’m sorry I was the first face you saw when you were born. I’m sorry I was the one to welcome you into the world wearing a white space helmet with a motor whirring to keep any trace of you from touching me. I’m sorry you only felt the semblance of human embrace through the double-layered dullness of my sterile gloved hands. I’m sorry we took you away from your mother. I’m sorry your head first lay on the firm bed of an incubator rather than your mother’s warm chest.

I’m sorry you heard the harsh beeps of our machines instead of the delicate coo of your mother’s voice singing the lullabies she learned from her grandmother. I’m sorry you spent your first seconds, minutes and hours down the hall from her with strangers robed in disposable, blue, plastic gowns. I’m sorry we were the first to bathe you, scrubbing away any remaining signs of the woman who brought you into this world. I’m sorry they told us it was to keep you safe.

I’m sorry. I’m sorry there wasn’t running water in your house so your grandmother couldn’t wash her hands. I’m sorry your lights flickered off when food was more important than gas to power the generator. I’m sorry we were culturally blind to how deeply togetherness and family are woven into the bedrock of your community making physical distancing illogical.

I’m sorry your mother couldn’t tell you the stories she learned from your cheii. I’m sorry the hospital was two hours away. I’m sorry the rutted, dirt road washed out when it rained. I’m sorry your resilient grandmother had to know so much suffering. I’m sorry there weren’t enough jobs where you live. I’m sorry your uncle had to work in the city. I’m sorry he had a cough.

I’m sorry. I’m sorry Dr. Li Wenliang’s warnings were forcibly silenced. I’m sorry we knew this was coming and chose to do nothing. I’m sorry we didn’t act fast enough. I’m sorry we ignored the recommendations of public health experts. I’m sorry we didn’t take this seriously. I’m sorry we didn’t have enough tests.

I’m sorry the President of the United States called it fake news. I’m sorry spring break on the beach was more important. I’m sorry this wasn’t just like the flu. I’m sorry there weren’t enough masks. I’m sorry we couldn’t flatten the curve. I’m sorry we were too late. I’m sorry that 100,000 deaths was a job well done.

I’m sorry. I’m sorry I was the last one to talk to your grandmother. I’m sorry the virus was so infectious. I’m sorry she had a fever on the day you were born. I’m sorry she couldn’t catch her breath. I’m sorry there was no effective treatment. I’m sorry I was so scared, yet she was so brave. I’m sorry I had to place a breathing tube. I’m sorry I pushed her onto the waters of the Lethe, but couldn’t guide her to the other shore.

I’m sorry there weren’t enough nurses. I’m sorry that it was too hard to prone her. I’m sorry she was alone when she died. I’m sorry she stepped out of the world just days after you stepped into it. I’m sorry she was just one of 1,864 deaths that day. I’m sorry they called me a “hero.”

I hope. I hope you never let us forget. I hope the schools reopen and you learn what we couldn’t. I hope the cafeteria is bustling with the laughter of children at lunchtime. I hope you get a chance to play basketball. I hope fans crowd in and cheer loudly for your games. I hope they drill you a well for your home. I hope there are more jobs when you grow up and you don’t have to choose between food and electricity.

I hope you have children and grandchildren. I hope you sing them lullabies. I hope you tell them we tried. I hope you tell them we could have done better. I hope you know you were the light that kept us going. I hope people tell you about your grandmother. I hope you know she was proud of you. I hope they tell you she cried when she heard you were born. I hope you know she loved you.

In solidarity,

Your doctors

COVID In the Navajo Nation

Navajo Nation is the largest Native American reservation in the United States with approximately 170,000 Navajo people living within its borders. As of this writing, there are 1,675 cases of COVID-19 in Navajo Nation making it one of the hardest-hit areas in the United States per capita and the numbers continue to rise. Teams are working hard to control the virus, but because of poorly funded health systems, long-standing structural violence, and the high prevalence of comorbidities that increase susceptibility to COVID-19, the disease’s spread is unrelenting. Please consider making a donation to support Navajo and Hopi families during this challenging time at:

Posted by Bob Rehak on 5/8/2020

983 Days since Hurricane Harvey