8 - Stories from a Pandemic: Insomnia
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What warning and context does the episode open with about mental‑health themes?
A quick warning. This episode of The Nocturnist includes themes of mental health crises and suicidal actions. Listener discretion is advised. Over the past few weeks, there have been so many news articles about healthcare workers as heroes or soldiers fighting the battle of coronavirus. For some people, this language may ring true. But for others, the metaphor feels wrong. One of the questions I've been grappling with a lot this week is who gets to tell this story and how? Can there be something more than the slogan heroes work here? Can we tell our stories while preserving the complexity of our inner lives, our doubts, fears, anger, resentment, our vices, our insecurities? Can we be not heroes? Can we be anti-heroes even?
You're listening to The Nocturnists, stories from a pandemic. I'm Emily Silverman, and this episode is called Insomnia.
Hey, it's Kim, ER doctor in New Jersey. I haven't sent anything for a while. I started to feel like this isn't really my story to tell anymore. Now the surge is ending here where we are and I think the last time I sent one of these was before the shift where I had to withdraw care from a patient while talking only to the family over WhatsApp. And somewhere around there, I just decided this isn't something I know how to talk about in any way that doesn't seem like I am making it about me and my experience. And it really, really isn't because after that, I went home and saw my family.
How does an ER doctor in New Jersey describe the shift from pandemic surge to personal insomnia?
We got a dog. We have a new pandemic dog. And things for me personally have really not been that different. I always felt distressed and dismayed about the things my patients had to face that I haven't had to face. And this pandemic has been no different. Now we're starting to have a little bit of our regular business again. And the weather has warmed up, which means that traumas are starting to come back in. And the people who are using drugs and alcohol to escape their difficult lives are coming back in. And it's not that different, except that now I wear a mask.
My name is Lakshmi Krishnan and I'm a hospitalist and a literary and cultural historian. I haven't shaken hands with a patient in two months. I just finished a day of clinical service and for the first time in two months felt this irresistible urge to touch a patient. What happened was that I'd been consulted to do a perioperative evaluation, but also she had multiple, multiple medical issues going on. And I walked in and she was just weeping. She's about 80 years old and she had come in with symptoms of cord compression, but she had had those symptoms for three weeks. And so, you know, by the time she came in, she had no lower extremity motor function, no bowel or bladder control, and the orthopedic surgeons weren't planning to do anything.
unless she absolutely needed cord stabilization. But they had just told her, it turned out, that she would likely not regain any function at all. And when I walked in and she was sobbing, I I was there with my face shield and my mask and, you know, all my PPE. I overcame all of these months of COVID programming and just felt like, you know, this woman needed a human being to touch her more than she needed a doctor at that moment. So I was thinking about this as I was also thinking about history and how we are all making meaning together. We're making history together, but we're also historians of this moment together, all of us who are living through this. Heath Whaloo, historian of medicine, has said, history, in a way, allows us to orient ourselves to where we are in the plot of
which chapter, which line. And this helps us orient ourselves in a way, if only to acknowledge our uncertainty, which in some regards brings a certain comfort. I think of how physicians and our patients were all in community together as historians of this moment. I mean, as physicians, we are writing micro histories all the time. The very act of getting a story from a patient or interviewing a patient is called a history and physical. So thinking about that and how we can make... meaning together amidst this crisis and how we're all historians of this and narrators of this moment.
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Chapters
7 chapters
1
What warning and context does the episode open with about mental‑health themes?
0:00–2:21
2
How does an ER doctor in New Jersey describe the shift from pandemic surge to personal insomnia?
2:21–9:15
3
What does the hospitalist‑historian say about being a “historian of this moment” during COVID‑19?
9:15–13:15
4
Why does a New York medical student compare her COVID‑CT scan view to shooting stars?
13:15–17:38
5
How does a pediatric ER physician process the suicide of a colleague and its link to COVID‑related stress?
17:38–23:18
6
What frustrations does a nurse share about COVID‑hotel housing for the homeless and workplace communication?
23:18–27:49
7
How does a medical student reflect on her empty locker and feeling unprepared for clinical rotations?
27:49–31:31