I barely even feel the needle.
It is over so quickly that I begin to take it all in only afterward, as I claim a seat in the waiting area. There are a handful of us there, each of us newly vaccinated and waiting the designated 15 minutes before we can leave. I watch an environmental services worker flex his upper arm and shyly take a photo. A few internal medicine residents gaze out the window, bleary after a night shift. I feel a sudden urge to offer a congratulatory hug or handshake, but of course that is not possible. Our seats are too far apart for us even to talk.
I glance at my phone and open a message, an automated request to complete a mortality report for a patient who died of COVID-19 the week before. In our final conversation before he was intubated, I tried to comfort him, but he could barely hear me over the hiss of his high-flow oxygen. When he coughed, I flinched and hoped he did not notice. The survey asks if anything about this death was preventable, and I say no, because there is nothing we could have done differently — though clearly the real answer is yes. So many of these deaths could have been prevented.
My newsfeed is full of jubilant photos of doctors and nurses announcing their vaccinations. I consider taking my own photo, but then hesitate. Because just a few floors up, there are dozens of patients who cannot breathe, who are scared and alone, who might die simply because they shared a holiday dinner. I find myself, nine months into this pandemic, vaccinated and yet still on a pendulum swinging between hope and despair.
Outside, the snow falls. Already it feels like a long winter. Here in the hospital, the anxious adrenaline of the spring has given way to a heavy, lingering sadness. We are caring for patients who have sacrificed and taken precautions for months and now — bending under the pain of isolation, starved for human connection — might die simply because they decided to spend time indoors with people they love or to go out to dinner. I have been careful so long, they must have thought. Humans are inherently optimistic, notoriously bad at assessing risk. Surely this one small thing will be OK.
I recently cared for a man who loved Boston sports, whose wife had decided to have a quick meal with a friend. By the time she learned that her friend had symptoms of COVID-19, she had already passed the virus on to her husband. He died after weeks on a ventilator. There is a grandmother whose family took false comfort in a negative test. A father who welcomed a dozen people into his home for the holidays. Each casualty is made even more poignant by the celebratory vaccine selfies on my phone and the knowledge that had they waited, my patients might have lived.
And of course, our hospital is treating not just people with COVID-19. We also bear witness to the suffering of patients with cancer, with life-threatening infections, with complications from organ transplants. We see overdose and withdrawal cases in unusually high numbers, psychiatric illness pushed to its breaking point. A relatively young man was brought to our hospital after being found unresponsive in a hotel room, his heart barely beating. When we managed to extubate him and he started to wake up, he began screaming at his nurse and raging against his restraints. There are so many different kinds of pain for which we have no vaccine.
Early in the pandemic — watching people refuse to wear masks, assuming that youth or good health would keep them safe — I believed that fear was the only way to change behavior. If only you could see what it is to be intubated, if you could conceive of being suctioned through a tracheostomy tube while learning to walk again, you might make different choices. Surely, I thought, the fear that you might sicken your parent or spouse or child would be enough to motivate you to take precautions, no matter how lonely you were. But now, as people congregate because they are just so exhausted by the loneliness and the waiting, I wonder whether hope is actually a more powerful tool.
Maybe that is the real promise of the vaccine photos. It is not just a way to celebrate science or to encourage the public to get the vaccine when they are able. It’s also a tangible sign of hope, however fragile. For most of the country, the vaccine is still months away. And now, with headlines about the wealthy trying to pay to jump the line, and images of politicians getting vaccinated before many nursing home residents, it is so easy for some to fear that their time will never come. The vaccine selfies tell us to hold on.
When I work overnight, the hardest part is always the hour right before sunrise. In my exhaustion, my body’s ability to regulate temperature and my sense of time go haywire, and I often find myself reviewing lab reports while wrapped in a blanket from the blanket warmer, wondering why time feels as though it is moving backward.
I think of this now, touching the Band-Aid on my arm. Though we do not yet know whether the vaccine prevents us from infecting others, and we will continue to wear masks for the foreseeable future, we can envision a world where a family dinner or a hug will not cost people their lives. I imagine examining my patients in a way I have not since the pandemic began, a time when my body will not tense when they cough, when I will not leave the room as quickly as I can. For the first time in months, I feel time is moving forward again, and I can let myself believe that our current reality is not forever.
A nurse stops in front of me, asking if I have waited the full 15 minutes. I tell her that I feel fine, as if nothing happened, and she schedules me to receive a second dose in three weeks. I start to put on my jacket, readying to head out of the hospital and into the snow, and then I think better of it. I take out my phone, pull up my sleeve and take a photo.
Daniela Lamas is a critical-care doctor at Brigham and Women’s Hospital, Boston.