Imagining a pandemic as a physician novelist

Writing a pandemic novel is sort of like running a mock code. You may feel a tinge of fear as you work through the actively changing scenario, but mostly you feel the excitement of the challenge. Yet when an actual patient is deteriorating before you, all you feel is terror.

In 2007, as I was traveling daily between Washington, DC and Baltimore on a commuter train, I read an interesting statistic that influenza pandemics occur roughly every forty years or so.  I found that fascinating, especially in light of the fact that the most recent influenza pandemic at that time had been in 1968. Forty years was coming up. I began wondering if the next flu pandemic was around the corner, and if so, what would that look like? That’s when I started imagining a pandemic.

My commute suddenly became an uninterrupted fifty minutes to write my first novel about – of course — a devastating flu pandemic. I completed the novel, but as a busy academic pediatrician, I lost steam during the process of trying to publish it. In fact, when the 2009 swine flu pandemic hit, which was, fortunately, a milder pandemic than anticipated, I felt that my novel was no longer relevant.  I pretty much shelved the novel and got back to my routine.

Then, in February 2020, as I watched the COVID-19 pandemic descend upon us, I felt compelled to revisit my novel. As I read it with fresh eyes, I critically assessed what I got right and what I got wrong in my imaginary pandemic.

In writing the novel, it felt like the ultimate intellectual exercise of planning for worst-case scenarios in the face of almost insurmountable obstacles. I did correctly anticipate some of the problems we’ve seen making headlines during our current pandemic, such as the shortage of personal protective equipment and dwindling medical supplies. I envisioned the overcapacity of the hospitals — not only lack of beds, but increasing lack of healthcare workers as they get ill or stay home to care for loved ones and thus, the consequent need for satellite care sites. School closings and travel restrictions – check. I also depicted the resistance of politicians to act; the predictable conflict of interest between public safety and economic pressures.

But there are some things that we are living through as a result of COVID-19 that I did not imagine in my fictional account. For example: the timeline.  As we are now four full months into this pandemic in the U.S., some experts estimate that we are still early in the game. As one doctor put it, we are only at about the twenty-yard line of the football field. My imagined timeline was much shorter. Another thing I didn’t foresee was the perception of danger dividing along political lines.  In fact, I imagined the opposite: that people would, in the name of self-preservation, view with suspicion any political down-playing of the danger of a global pandemic and insist on any means possible of protecting themselves. And among the most devastating consequences of this pandemic that I hadn’t imagined for my novel was the situation of people dying alone in hospitals without their loved ones. Not being able to hold the hand, give a final hug, say goodbye.

Undoubtedly, penning an imaginary pandemic is much less stressful than living through one. Living through a pandemic day by day has carried with it a chronic anxiety that I did not anticipate: not just the fear of contracting the illness, but the constant worry of pre-symptomatically transmitting it, thus second-guessing every errand, every visit to loved ones. As we all work through this unprecedented medical crisis, I hope we continue to make steady progress in treatment and prevention of this devastating illness. Stay safe.

Teresa Fuller is a pediatrician.

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