Life on the curve: stories of essential workers in times of war
“When a virus enters the human body, it’s in a race against time to hijack cells, reproduce and spread. Its survival depends on it, because once the body’s immune system detects the intruder an all-out microscopic war follows.” — Simone McCarthy1
“A war benefits medicine more than it benefits anybody else. It’s terrible, of course, but it does.” — Mary Merritt Crawford2
“Whenever a society is under considerable threat, planning must focus on the preservation of those key strategic assets that offer the only chance of victory. In 2020 the viral threat from Covid-19 has meant that most attention has focused on the protection of the health system” — Dr Andrew Connolly, Head of Department of General and Vascular Surgery, Counties Manukau Health3
Coming from a family of medical specialists and essential health workers, some who served in the First World War and the 1918 influenza pandemic, allows for an interesting outsider-insider vantage point on the concept that our fight against Covid-19 has been like a war.
On the eve of Aotearoa’s progressive move into lockdown to slow the transmission of coronavirus disease 2019 (Covid-19), I travelled from Wellington to Auckland to Northland to attend a family funeral with my brother, an infectious diseases specialist at North Shore Hospital.
As we drove up SH 1, I became aware of how different our perspectives on the current pandemic were. Mine was at best a position of media-fueled reckonings and speculation, with a dose of admiration for the communication expertise of government officials. His was the frustration and trepidation of someone who could easily find himself deep in an overwhelmed hospital system.
At that time in late March 2020 the situation in Italy was filtering through the media. Stories circulated of doctors forced to make triage choices reminiscent of First World War battlefields. Without enough hospital beds, people to care, or equipment to cope with rapidly rising numbers of sick and dying patients, lives were being lost.
It was strange to attend a funeral where nobody could hug each other. Yet the whanaungatanga kept me going through the weeks ahead. The day after our return to Auckland, the government announced a four-level alert system and plan to ‘help combat Covid-19’. By 2am the next morning, my flight back to Wellington had been cancelled.
I made it home just as a state of emergency was declared in Aotearoa. All but essential workers were asked to ‘stay home, save lives’. Not just their lives, but those of others. My brother and father in Auckland continued to leave their houses to work at the hospitals. The rest of us sheltered in place and within our ‘bubble’ of chosen close contacts.
As we lived through the next four weeks, I gained another new perspective. The scale and significance of historic global events are quite different when you’re living through them.
Staggering numbers rise around you: around 50 million deaths worldwide4 in the 1918 flu epidemic my great grandmother volunteered in as a doctor, 8.5 million deaths5 in the First World War in which her husband was a regimental medical officer, at least 910,0006 deaths in the Covid pandemic. Yet ‘one in one hundred year events’ are surprisingly mundane. In the thick of it, it seems you just try to continue on as humanly as you possibly can.
This realisation comes to bear on the following imagined moments from the lives of five people from my family who experienced historic global events as (or alongside) essential health workers. The stories are all true. And all fiction.
In constructing them, I drew from Ian Wedde’s concept of a ‘core sample’ approach to historical narrative: a research and narrative strategy that would make anyone at all, no matter where, the physical and cultural occupant of a geohistorical shaft extending from the air they stood in, through the ground they stood on, and of a view ‘as far as the eye can see’. You can get more detail about this approach in the background document.
By laying these ‘thick descriptions’ side by side, I hope you might start to find connecting threads that illustrate how our fight against Covid-19 has been like a war — but also some reassurance that others have faced similar difficult circumstances, despite being separated by 100 years in time.
Like them, we too will return to ‘normal life’ after experiencing the historic learning and casualty curves of our era, hoping that generations who come after are able to benefit in some way from our experience.
19:00, 31 MARCH 1918, AMMAN, PALESTINE: DR JOHN GRAHAM GOW
He does what he can and what he is able to do, focused and calm as each man is brought in from the hilly front a mile or so away. Continuous movement helps warm him against the bitter night cold. Everything is drenched: wounds, uniforms, bandages, blankets.
The land he moves on is layered with a history of ancient wars spanning as far back as biblical times. This battle against Jacko is just the most recent sacrifice to Moloch the hills have witnessed. Invaders, occupiers, settlers and conquerors have bloodied Jordan’s soils at various moments for thousands of years.
The Wellington Mounted Rifles are withdrawing from their position above Amman — a change in plans. The choice isn’t his. He moves quickly so the wounded can start their journey back down the line in the rain and they can get out. The more efficient he is, the better their chance of recovery. The more men he keeps from dying, the more likely a win against the Ottoman forces in Palestine.
But he’s not really thinking about any of that right now. Rather, he attends only to what’s in front of him and leaves the system to take care of the rest.
The young man on the stretcher will probably live. Having decided that — and it is a necessary decision — he can get to work, moving rapidly through the motions he has rehearsed countless times since being attached to the Rifles as their medical officer.
These artillery wounds are familiar now, even if unlike anything he’d seen before joining the army. This one is serious. He knows it’s bad before even unwrapping the sodden field dressing from around the trooper’s head. But it’s not so bad as to waste his effort.
There isn’t time in the hills to deal with anything intensively. He paints the wound with iodine and uses a head bandage to curb the flow of blood. Giving the boy morphine, he struggles to write M, for morphine administered, on the boy’s forehead through the red and the wet.
Drying his hands briefly on his trousers, he pencils “GSW - scalp” on yet another field card and wraps the string around a top jacket button. He signals to the carrier and hands the trooper on to be wrapped again in the freezing dank woollen blankets so he can be carted down the muddy cliff to the dressing station.
Then he turns quickly to deal with the next wounded body.
21 NOVEMBER 1918, SEATOUN, WELLINGTON; DR MAYSIE ALICE MARIANNE GOW
She pauses briefly in the doorway of the Seatoun school room. Everything in the makeshift hospital ward seems to be in order. Ten of the twelve donated beds have patients in them. Still ten too many, but surely the numbers must turn soon.
The nose and mouth of the girl whose bed she has been called to are an even darker shade of lavender than yesterday. Smiling behind her mask, she hopes reassurance might show in her eyes. But the young woman is so confused and restless she doesn’t notice.
The disease is probably going to win. Still, she will do everything she can. Miss Davenport’s volunteer nurses will bring comfort. Cold packs and warmth will be applied. Should she send a boy to let the family know the girl’s condition is worsening?
The school rooms they have commandeered for their campaign are so new they barely had a chance to be used before the schools were shut down.
It has been a long month — well, year really. Jack is overseas doing his bit and she is here doing hers. She has been inside more houses in the suburbs of Wellington’s South Coast than she could have imagined, and lost count of the number of times she hasn’t made it home around the bays in time to put Edith, James and Anne to bed.
But it’s good to feel useful. The war has also been useful in a way, though the news that it’s over now has barely begun to sink in. Goodness knows how they’d have mobilised people to help so quickly and efficiently without being in its shadow. Everyone seems so accustomed now to death and official instruction and the reshuffling of social life.
Eileen, the seventeen-year-old patient, is resisting the volunteer nurse’s effort to prop her up in the metal cot bed. Shoes tap vigorously on the wooden floorboards. She wishes the girl would just conserve her energy for the fight her lungs are battleground to. And then, just as she is thinking this, the girl is no longer with them.
Once again, the virus has won.
19:00, 4 MARCH 2020, SANDRINGHAM: DR NICHOLAS JAMES GOW, INFECTIOUS DISEASE PHYSICIAN IN AUCKLAND, NEW ZEALAND
He can hear his family celebrating the birthday with friends in the warm early evening outside. Only he knows that there is a second case of Covid-19 in New Zealand. On call, he needs to find out if the patient should be in hospital. The public health officials are waiting.
The bedroom in the small flat they live in — half of a century-old Sandringham villa — is an unlikely office. Clothes droop from the drawers of the manrobe. Posters from past travels sheet the walls. Near the window, a bicycle is attached to a cycle trainer for a race he’s been preparing for in Tuscany.
The woman answers. As they talk, he writes notes on an old conference pad on his small desk against the fireplace. They are both in their 30s. She has come home to Auckland from northern Italy and tested positive for Covid-19. He asks her about Italy, but really he needs to know how the battle with the virus is playing out in her body.
Half an hour later he is confident she won’t need to be cared for in the hospital and they’re both glad. Each new piece of history he collects tells him why this virus has established itself so effectively around the planet: yes, it can be deadly, but usually it’s nothing of the sort. It is, very simply, highly infectious. The perfect viral enemy.
Of course things can change, but he’s fairly certain she will be just fine. Her immune system has kicked in and is doing what it is designed to do. He makes the necessary calls to the Public Health officer and enacts his part in a timeworn public health strategy: diagnose, contract trace, isolate.
Among the relief it’s hard not to feel uneasy about what’s yet to come. The Kauri floorboards under his feet were laid just after the 1918 flu pandemic overpowered New Zealand’s public health system to devastating effect. His department — by and large — is now resourced and prepared for a seasonal flu response each year. But not a ripple and a tidal wave together.
A laugh from outside the room interrupts his thoughts and he folds up his notes. Slipping them into this pocket with his phone, he steps out to rejoin the gathering.
09:00, 26 MARCH 2020, DR PETER JAMES GOW, MEDICAL SPECIALIST (RHEUMATOLOGY) AT COUNTIES MANUKAU DISTRICT HEALTH BOARD
It’s remarkable how much can change in just a week. This morning’s train was empty as he commuted on the Southern line to Middlemore Hospital and then the road to the superclinic was almost entirely free of cars. His patients, like the rest of New Zealand, have been told to stay at home and limit their movements.
He’s pleased the first phone consult of the day has gone smoothly. He knows the patient well and they have already been working together to control her arthritis. It’s a bit uncanny being alone in the outpatient clinic room with all his usual equipment - exam couch, chairs, desk drawers with stethoscope and tape measure, computer systems, trolley with injection equipment. Just no patient.
This time last week everything was so uncertain. Despite the screening and the masks and the hand sanitiser, he worried the virus might slip through with people coming into the clinic room. Unlike the 1918 flu pandemic, he knows he is of an age that this virus likes to kill.
Today, there is no need for masks. He and his patient are both protected by technology, and in turn they are protecting those, like his son, who will be at the front lines of the response if the number of people infected by Covid-19 rises too quickly. This is much better.
When he was a medical officer in the army he learnt the fundamentals of a successful campaign: standard operating procedures, clear communication channels. The experience has come to bear on his team’s rapid move to caring for patients at a distance. Sometimes it feels like they have the wrong defence weapons: telephones have toll bars, videoconferencing isn’t set up yet, people are fallible. But they will adapt. They are already adapting.
Such innovation gives him a glimmer of optimism. Perhaps after all of this is over some of his patients might have their follow up appointments this way. It could work, they’ve shown now that it’s possible.
But he is cautious too. Beyond the carpark of empty spaces lies a road forged as a supply line during the New Zealand Wars. There’s a question of choice at issue and who chooses. Safety comes in many forms, including cultural, and not all of them are enhanced by being at a distance. For now though almost all of his patients: Māori, Pasefika / Pasifika, Pākehā, are happy to do what they have to while the virus is in the community.
An alert for his next appointment appears on his computer screen. He needs to finish dictating those notes.
10:00, 7 APRIL 2020, MAUNGAWHAU MT EDEN: CHARLOTTE CULL AND ALEX GOW
“Look, Alex, there’s Papa’s work, that’s where Papa is” she says, pointing towards the tallest of the North Shore Hospital buildings on the horizon. Alex, nearly one and a half years old, turns her face to follow the direction of Charlotte’s finger.
They have had fun riding up the maunga on the eBike. Around them at a distance whole families and households are out walking and Alex watches them all, especially the dogs. There is a convivial atmosphere up the mountain, as if in this singular moment everyone is on holiday and enjoying their time outside.
Charlotte reaches into her backpack to get out their food. The Autumn sun is warm in the sheltered spot she has chosen for them to eat morning tea in, and she can’t help feeling satisfied and relaxed. It has been incredible being free to ride in relative safety on quiet roads.
She wonders what Nick is doing. This past month has seen him working harder and under more pressure than ever before. People keep saying the extra time with family is a silver lining of the lockdown, something good to come out of the sacrifice. There hasn’t been so much of that in their household.
Even after Alex is in bed, Nick’s focus has been on understanding more about the virus. Sometimes it feels like their bubble includes not just them but every virologist who has chosen to podcast about Covid-19. The disease specialists are familiar voices now.
The grasses covering the maunga are dry and brown in patches. From their house they can just see the dormant volcano of Mt Eden and its carved terraces, remnants of the Māori defence system that protected ancient inhabitants from attack.
She feels lucky to be on the summit. There’s just a hint of haze in the view over the Auckland isthmus and to the harbours on each side. Handing Alex a crescented piece of mandarin, she determines to bring Nick up here on the weekend when he’s not on call.
It will be good for them all to do something together if they can.
You can find more information on the Background of Virginia's article and questions for generating core samples below.
- Last updated on: 24 Sep 2020 | File Size: 194 kB
Virginia has worked at the intersection of cultural heritage and digital technology since the early 2000s, including at Auckland Museum. She led the digital strand of WW100, New Zealand's First World War centenary programme and currently contracts to digital agencies and the GLAM (Gallery, Library, Archives and Museums) sector in Aotearoa.
This article was made possible by a Copyright Licensing New Zealand COVID-19 Contestable Fund Grant
Cite this article
Life on the curve: stories of essential workers in times of war. Auckland War Memorial Museum - Tāmaki Paenga Hira. First published: 15 September 2020. Updated: 7 October 2020.