S1E36 - Summer on Frontline Nursing in a Rural Area
Margaret Hello and welcome to Live Like the World is Dying, your podcast for what feels like the end times. I'm your host, Margaret Killjoy, and also welcome back to the show. It's been several months since I put out the last episode and you'll be shocked to know that's because a bunch of stuff happened in my life which is, you know, everything to do with everything that's going on in the world. Um, maybe most importantly I moved and I now live on-grid in Appalachia instead of off-grid and Appalachia, and I'm very happy for the transition. It's pretty cool to have enough electricity to make this show. And also have an oven that works. I really like having an oven. And I also got a puppy, and I got a puppy who is rescued, so I've not—I spent several months where instead of sleeping or getting anything done, I had a puppy. I still have the puppy but now I get to sleep because the puppy is like five months old. So that's where I've been. And, yeah, welcome back to the show. This week I'll be talking with Summer who is my friend who is an ICU nurse in a rural area in in rural Oregon, which is not the most lefty area, and we're going to be talking about pretty much the—the politics of vaccination and some of what they've dealt with during the pandemic. And I think you'll enjoy it. And this podcast is a proud member of the Channel Zero Network of Anarchist Podcasts, and here's a jingle from another show on the network. Duh da duh da da daaaaa.
Jingle 1 The Final Straw is a weekly anarchist radio show. It’s fucking awesome, and you’re never gonna hear me say fucking awesome on our show because we’re FCC regulated.
Jingle 2 There’s a black part of my heart that just flutters when you talk like that.
Jingle 1 [Inaudible] talk than more yelling.
Jingle 3 It’s a weird sort of like nice thing, in a way, that also can get kind of frightening at times.
Jingle 1 Thefinalstrawradio.noblogs.org
Margaret Okay, so if you could introduce yourself with like your name, your pronouns, and then I guess a little bit about what it is that you do that is the reason I invited you to talk on the show today.
Summer My name’s Summer. I'm a nurse, I live in Rural Oregon. I use they/them pronouns and I've been working in an ICU and have experienced now working in a Covid ICU—full Covid ICU. And I come from a background of radical politics and we're here today to talk about some of that.
Margaret Yeah I guess I wanted to have you on because I've seen some of your social media posts about the hate that you've gotten at the—at the ICU that you work at and I know there's a lot of conversation right now about what do we do about the unvaccinated people who end up in hospital, and you know, combined with the—there's a lot of like news stories about, you know, the ungratitude of the unvaccinated folks and things like that. And I guess I just wanted to talk to you to get more of a firsthand idea of what it's like working at an ICU during Covid in a pandemic. I already set the Covid part.
Summer Sure, um, so to give a little context: like I said, I live in a rural area of Organ. It's predominantly conservative, a lot of libertarian bent, um, included in the state of Jefferson—if you're familiar with that as a concept. And we experienced a huge Covid surge in our ICUs August through October of this last fall—or summer into fall. Maybe even into November really. And so rural area with low vaccination rates. Like I said, a lot of libertarian politics. And during that surge we were experiencing some of the worst numbers in the country in terms of infection rates and it hit our hospital pretty hard. We serve, uh, like very wide rural area. We’re, um, the highest level trauma center within hundreds of miles. And so we get people from a really wide region of the state and even from Northern California. And our ICU just got flooded with very, very sick Covid patients. It's a fifteen-bed ICU and as soon as that filled up, you know, it really impacted the entire hospital system. And it ended up that our ICU and our step down unit were both full of critically ill Covid patients during that time frame, and we ended up having the National Guard and FEMA nurses present at the hospital to just help it continue to function and help it serve the Covid patients and the rest of the patients in the hospital who needed care. So that's the larger context of what was going on. And then more specifically in my experience, you know, the politics around the pandemic not only impacted, like, who's getting vaccinated and who's not and the numbers and how they grew so rapidly, but really, they impact and trust in the medical system. And there's already a lot of reasons for a lot of different demographics and populations to have distrust in the medical system. But right now we're experiencing that kind of expanding into different demographics and different populations. And the things that I think you're referring to that I've experienced was, you know, there was a day during our surge where the national news actually came into our ICU to report on what was happening in this rural area. And, you know, at that time the vast majority of patients we were seeing were unvaccinated. And that very same day there was a protest outside the hospital against the state vaccine mandate that had not been enacted but was upcoming, that would require all health care workers to be vaccinated, um, barring a religious exemption. So we left a shift where the national news was present, high Intensity, we lost like 3 patients that day in our small ICU I think, um, to walk out of the hospital to hundreds of people across the street protesting the vaccine mandate. And then, you know, of course mixed in there are antivaxxers are—you know, generally antivaxxers— more far-right folks mixed in. It was a pretty tough day, a pretty emotional day for a lot of us walking out from some really intense cases in the ICU to a public that is completely undermining your lived reality, you know, just on the other side of these doors, right? And I think that that's, you know, that's a thing that's been seen at different areas across the country, that tension that's escalated between healthcare and the public. And I think there's so many things that we can say about that. But really, I—you know, this question of like vaxx versus antivaxx, um, it's something I've thought out about quite a lot, obviously. And I actually had a friend somewhat recently who, um—a mutual friend I believe—asked me whether I still have compassion for unvaccinated patients. You know, going off of his experience of having healthcare worker friends who are kind of just totally disillusioned around vaccination rates and taking care of these patients who didn't take what seems like the obvious step to take care of themselves.
Summer And the answer to that is like, yes, I definitely still do have compassion for these people, and um I can understand not—I can understand the frustration. I'm still frustrated, right. It’s still easy to get really angry. But for me it's the same as any other patients that I treat, whether it's an OD, or a DUI, or people coming in with exacerbations of chronic illness. It's not really my job to judge why someone's in the hospital. It's not my job to moralize their suffering. And if you're in a Covid ICU, that is like a hellhole of suffering, let me tell you. These people are suffering in a major way and experiencing a huge trauma. Not just the patients, but families as well.
Summer I also, you know, have to contextualize it in this much larger situation where we have a government that is, like, face planting, a public healthcare system that is face planting on managing a global pandemic in our country, and this huge amount of misinformation that's out, both about, you know, a vaccine, but also about a virus and what that is, and about a pandemic and what that is, and what it takes to protect yourself from one another. And so I have a lot of compassion for people who, their world is just a different reality. It's a reality where the facts don't line up, right?
Summer And a lot of us experience that now, right? Like, what is reality? Sometimes you can't even have a conversation with someone about facts, about what's real and what's not, and I experience that a lot talking to family members in healthcare at this point.
Margaret Yeah. I mean, it's interesting comparing it—kind of, like, subtly comparing it to harm reduction, right? I feel like that was actually one of the most, you know, that was like the way of putting it that really got to me, like, when you just set that just now is because I—yeah, I do think of the like, well obviously these people are making decisions that I don't, right? Um, and yet that's a decision we've made at least in terms of the opioid crisis to just not have any judgment towards, and it's kind of interesting. Also because when you talk about the suffering that people are facing, right? Like, it comes up every now and then that someone who is kind of terrible dies, right?
Margaret And then, in some ways, especially if they have a lot of like political power or whatever, everyone talking shit on that person who's died. Whatever, I don't I don't care. But on some level there's a certain amount of, like, well can't ask accountability of the dead. You know, like, um, like say—so for example, someone dies doing something very like heroic and good that we all agree is a good thing, but they have a long history of doing bad things. There's kind of a like, well, but they can't do anything about that now, right? There's no way for us to ask for them to do anything about that. And so, maybe even the people who survive who aren't vaccinated who end up in the hospital—I mean I guess what we're kind of saying is, like, get vaccinated or face the consequences. And they were like, “consequences, please.” And then they face the consequences. So on some level—
Margaret —like what more can you ask? They’re suffering, you know.
10:20.19 Summer Yeah. But even in in my regards, some people don't really understand—many people don't really understand the consequences. Not only have many people not really seen what an ICU is, what a ventilator is, what someone's body looks like after weeks on a ventilator. Um, but in their version of reality, the truth that they've been presented, this whole thing isn't real for some of these people. And I'm not exaggerating. Like I have met—I have talked to family members at the bedside of their loved one who has an 80–90% chance of dying—because those were the rates we were seeing in our ICU during that surge—80–90% of our intubated patients were dying of Covid—who says, “I just didn't know. I just didn't think this was real. I didn't think this could happen.”
11:14.96 Summer “If you were going to get a vaccine, which one would you get.” Like, those are conversations I've had with people, you know, and it's—that's what really for me is so heart-wrenching is, like, the dawning of knowledge upon these people in the worst way possible. Like, that shouldn't be the way people have to understand the truth is by watching their family member die because of what they've all believed. Um, and I mean, I've witnessed that regret from family members for sure, and I—this isn't to, you know, I'm not like a flawless person or something. I also get super fucking frustrated and I've had family members yell at me on the phone about Ivermectin, um, when I'm like, that's not—there's no evidence to support that as a treatment in severe Covid cases. Like that's, like, become this, like, this sentence I've repeated so many times. And it's—that's super challenging when you're working with a team around the clock that is like monitoring literally everything that this person's body is doing, from like every milliliter of urine they’re producing, to all their blood work, to the pressure that's programmed into the ventilator to keep their lungs open, and then you walk out of the room and there's a family member on the phone yelling at you about how, well there's no evidence to support vaccination, and you're staring at their loved one unvaccinated on a ventilator. You know, it's like this this dissonance.
Summer Um, like I—it's like you're reaching across a span that's really great in those instances, you know, because you don't have a common understanding of what the world is right now.
Margaret Right. It's funny because I kept waiting, you know, like hearing stories about that—obviously I don't experience them—but hearing those stories, I keep kind of waiting for it to, like, break through and for people to be like, oh okay, like, my cousin died and now all of my other cousins are getting vaccinated and I'm going to and, you know what, I'm going to actually tell my friends at the bar that we should get vaccinated, especially if we keep hanging out at a bar. And like, I kept like waiting for that to happen. And at this point I've completely given up on that ever happening because of—
Summer Well it does—it does happen sometimes. And I'm not trying to be, like, a blasting ray of hope, because it doesn't happen a lot, too. You know, but I have seen—like I have cared for a patient who was on a ventilator for over 60 days and then you know, was brought—like he's, the patient's awake now and can talk and whatnot. And any team member, any—whether it's a physical therapist or a nurse or anyone who walks in the room, the patient immediately now asks, “do you have the vaccine.” And because of the experience that this person has had, they’ve completely changed their mind about vaccination, of course. And at our at our hospital you have to be vaccinated to work there at this point, so it's kind of a like moot question, but I do see people turn around in a really big way. But it's just so unfortunate that they have to have what to me looks like one of the worst experiences I could possibly imagine in order to come to terms with the reality that we're living under, you know?
Summer And I get it, you know? I get the root of where people are coming from is distrust of the government, distrust of the media, distrust of healthcare. Like, uh, relatable? Like yeah, I get that. I also don't trust those things, you know?
Summer And, you know, depending on what background you come from, you have even more reason. not to distrust those things, especially healthcare. And so I can't, you know, stand on my moral high ground and pretend that I get it and I'm right and they're wrong and I'm smart and they're dumb, you know. Like that doesn't really get us anywhere when the actual reality that I'm faced with is a person in front of me who is deeply suffering, who we're going to try our best to take care of.
Margaret Yeah. I, you know, I'm sure you get this daily and maybe it's annoying, but it's like, I can't imagine being able to do what you do, you know, and then, like, maintain enough, um—yeah, okay, like how do you maintain enough faith in humanity to go to work? Is that too blunt of a question?
Summer You know, I go to work. I don't know if I maintain faith in humanity.
Margaret Ah, okay.
Summer But I keep going back somehow. And it's been Hard. It's been really fucking hard. And if anyone's listening and you are close to anyone who's working in healthcare, especially if they're working and an ICU, like, I can't emphasize enough just taking care of your friends, and even just asking, hey man, shit sounds rough. How are you doing? Like, that goes a long way, you know? And yeah, how do I keep doing it? Honestly it's like—and I guess this ties into some of the topics you kind of mentioned talking about today—um, it's the team that I work with that really does make a big difference. And, you know, going into nursing as like a queer person with this radical background, I felt really alienated from my co-workers. I kind of had this, like, mindset that I was like an alien walking into a foreign land and I didn't want anyone to know I was an alien, you know. And I still feel that like every day of my life everywhere I go but—
Margaret This is unrelatable. I don’t know what you’re talking about.
Summer Yeah, you have no idea what I mean. Um, but over time I've developed relationships with people who I probably would never have five years ago, and, um, the type of solidarity that I experienced in the workplace might not be like #radical or something, or #anarchy, but um, those bonds are really important and really powerful, and I know that my co-workers would show up for one another in so many big ways, you know, like, it's not called mutual aid there, but it sure as fuck is. The way that I've seen people show up for one another, especially in these crises. And, yeah, it's—that bleeds into so many other things about nursing and mental health and the crisis that's happening in nursing right now.
Margaret I mean, we could talk about that. I'm curious about that.
Summer Yeah, I think that you know some people are kind of—who aren't in healthcare are kind of aware of what's happening, but I think a large number of people aren't really aware of—
Margaret Which is that everyone's rushing to join the field because you all are well-respectcted, well-paid, and taken care of? Loved by society?
Summer Yeah—and yeah, not facing these like ruptures of, like, what is real on a daily basis.
Margaret Yeah, that’s right.
Summer Yeah, exactly it's going great.
Margaret It’s utopian.
Summer Become a nurse, everyone. Um, no, but there is a—there's a huge crisis happening right now in nursing and there already was this like nursing shortage, right? Like when I was in nursing school they would talk about the nursing shortage. And really what it was was, like, a lot of nurses were retiring at retirement age, and what I see as the biggest barrier wasn't that no one wanted to be a nurse, it's that—it's twofold. It's like we have an aging population with complex chronic health conditions, so more patients, right? And then we have people who want to be nurses, but we have educational institutions that are trying to make as money as much money as possible, and limiting the number of people who can access degrees in nursing. And we maybe don't have enough educators. Maybe, you know, probably a lot of stuff that I don't know about or not qualified to talk about. But and that was already the baseline when I entered the field of nursing, and then you lay on top of that this huge pandemic that is just totally changed everything, changed what nursing looks like. And like, side note, also a lot of healthcare workers have died of Covid. And it's not like an extreme number, but I think the number from the World Health Organization last October was between like 80- and 180,000. I believe that's worldwide. So—and I don't know what percentage of those are nurses—but like, you know, that does play a role, fear of that probably plays a role, and then it's extreme burnout and trauma. Like, you know, I mentioned earlier that during these surges—and probably these numbers differ from hospital to hospital—80–90% of our patients who were put on ventilators for Covid were dying. And, you know, we're pretty used to dealing with people dying in the ICU. It's kind of, like, what we do is try to prevent people from dying. But inevitably people die. Um, but when you have 80–90% of the people that you're taking care of dying no matter what you do, no matter how hard you work, no matter what interventions you try, it is demoralizing to say the least. You know it's awful.
Summer It's truly awful. Um, and it's like an already high-stress job that then you add that on top of, you add the public discourse on top of that, you add the politics, you add the family's yelling at you about whatever treatment they heard about from Joe Rogan or, you know, whatever. It just creates this stress level that's, I think, unprecedented and really difficult to manage. Um, and there's that narrative of, like, the public not caring about nurses, or the public not understanding what they're going through, but even bigger is like policies that reflect a lack of care for human life in this country, which, you know, our job as nurses is to preserve human life. And then we're faced with the government, healthcare—or public health policies that don't value human life. So there's like that dissonance going on.
Margaret You talking about the, like, the way the CDC keeps changing, like, what's being valued or whatever?
Summer Yeah, I mean just all of it. The way that, um, both presidents who have been elected or serving—or whatever the fuck you call what they do during this pandemic. The way that it's been managed, the way the way capitalism manages this pandemic does not reflect a care for human life, right? It reflects the care for capital. And that just—when your job is to preserve human life and you see all these policies coming down that you're like, what the fuck, what the fuck, what the fuck? Like, this doesn't line up with what we're supposed to do. Like, this doesn't line up at all. And then you have, you know, places that lack appropriate PPE for nurses, like, these policies that don't reflect I care for healthcare workers. It is, like, the whole picture is a big labor crisis, because people of course are going to be like, the fuck am I doing here when I could do x, y, z thing, right? And, like—
Margaret You should try podcasting. You don't have to leave the house.
Summer I know, I’m thinking about it actually.
Margaret Okay, cool.
Summer And I am lucky in a lot of ways. Like, I live on the West Coast, I am unionized, my pay proportionally is a lot greater than some parts of the country, like some parts would rule south where nurses are getting paid garbage, right? And don't have a lot of the protections that I do. And, I mean, I can keep listing all these things. Like you mentioned the CDC, like, growing lack of trust in the CDC as an institution, as a healthcare worker, because they just say garbage that is not evidence-based. They tell you you're supposed to, like, work your job based on policies that have no evidence behind it. There's just—everything's starting to feel more and more arbitrary, right. Um, and it's gotten to a point where, like, I hear my coworkers in the break room talking about the different psych meds that they're trying. Or like, the different anti-anxiety pills that they're trying, and the different dosages that they're trying, just to manage, like, their job. Now, off course, that's not everyone. I'm not trying to be like overly-dramatic. But it's definitely a trend. And then the—you know, the other side of that is, like, you have people just leaving the field entirely. But you have a shit ton of people who are going to be travel nurses and, like—a travel nurse, for people who don't know, it's an RN who can pick up a contract. Hospitals around the country do this, and have done it since before the pandemic. You pick up a contract for a certain number of weeks for a certain pay. You work that contract, you move on. Um, people do this for short periods of time, for long periods of time, but during the pandemic it's been totally amplified, because you started having these crisis contracts, some of which were funded by the government, to send nurses to places that were really impacted by the pandemic and lacking staff. And you had these huge, huge incentives—like huge pay bonuses—for working in these extreme conditions. And at first you saw that, you know, in places like New York and whatnot with big surges. But now pretty much everywhere is hurting for nurses, and they will hire travel nurses for up to, you know, 4 or 5 times what staff nurses are making at that same institution. So you work under these conditions for long enough, your management tells you for long enough that they can't do—they can't give you PPE or they can't give you a retention bonus, or they just can't, they can't, they can't. Of course eventually people are going to be like, well fuck this place, I'm going to go make 4 times as much 2 hours away or next state over. And so it's turning into a situation where we have more and more travel nurses in hospitals, and less and less staff nurses. And like, that in itself doesn't sound that problematic until you think about, like, what's the difference between a nurse who's been at the same institution for 10 years and one who's been there for 3 days. It's like a commitment to that institution in a certain sense, right? At least a commitment to the community that they're serving in maybe some way, and knowledge of the way things work there because every hospital is going to be a little different. So it does, you know, in some senses pose a safety concern. Um, and in some cases people who are getting travel contracts are maybe not necessarily qualified to work in the positions that they're getting hired to. And I've seen that happen before. People are chasing the money, and I don't blame them right? So anyway, that's like a lot of talk. The whole crisis. But it really is becoming a crisis. At our hospital I see people who I don't think of as, like, labor organize-y or, like, radical by any means, who would describe themselves as moderate talking about this stuff in terms that are getting more and more pressured. And I see people who are talking about leaving who I would have never imagined would leave. And we have management telling us, we can't pay you more because we have to pay all these travel nurses. Well, if you paid us more we might stay and not become travel nurses, right?
Margaret Can I just become a travel nurse and stay here? Actually, do people do that?
Summer Yeah, um, no, they try to prevent you from doing that.
Margaret Oh, okay.
Summer But I have people that I work with who even took travel gigs north like 2 hours, and so they're still living where we live, they just drive 2 hours to work and make 4 times as much.
Margaret Yeah, yeah. One of the things you were talking about earlier, you know, watching the nurses like trust the CDC and the government stuff less and less. And it ties into that thing that you were talking about earlier about how a lot of people have good reasons not to trust the government, and so that's like something that we can all—I think anyone who's thought through most things would have reason to distrust the government, right? Any analysis of history, almost regardless of your background, but obviously some backgrounds more than others. There's good reasons to not trust the government.
Summer I can think of like 5 reasons not to trust.
Margaret Like a little list?
Summer Top 5 reasons not to trust them.
Margaret Yeah, totally. No, this is good. You’re going to be a good podcaster. Better than me. But the thing that works—that it comes down to for me—and it helps that I know people like you. I know medical professionals. You know, my joke for a long time is that the way to get health care in this country is to date a doctor and then stay friends with him. Um, because that's how I had my health care for a very long time, is that my ex is a doctor now. Um you date one boy, you pick the right one. Anyway. Um, and yeah. But the thing is this like—okay, so I don't trust the government. What I trust is people. And so, like, people are like, well why do you trust the government telling you what's good for your health? And I'm like, no, I trust my friends who are doctors. And it's not even like I trust doctors as a category at large, because I also understand why people are nervous around that. And it is this position of privilege where I am around people who have made those choices or have access to those choices to become medical professionals. But it's like, no, I trust you, like I trust you—it's just interesting to me. I don't know like how to—this is my solution. This is how we get, um, you know, all the nurses just go to the people and you'd be like, look hey, don't listen to the government, listen to me. I don't know.
Summer A flawless plan.
Margaret Maybe, everyone to listening, trust us! What could go wrong? Trust the voices and the headphones. Unlike Joe Rogan, don't trust Joe Rogan.
Summer Yeah, don’t trust that voice in your headphone. Yeah I really get it. Why not to trust institutions, why not to trust, uh, what feels like big government saying, now do this to your body. You know, it’s the good thing to do. But, and before the vaccine came out, you know, I had my own, I'll be honest, I had my own hesitations about whether or not I would get it. But the moment that it was made accessible to me I was at work and I got an email that said, hey, you can make appointment. I picked up the phone immediately and made an appointment. I kind of surprised myself with how, like, my response to it. Like how ready I was to get the vaccine. It was pretty early on, it was last December, um, but part of what really changed it for me is kind of what you're talking about. Like not thinking about it as, like, the government made a vaccine or, you know, Pfizer made a vaccine, but thinking about the individual people who worked on producing that vaccine and, like, you know, we've all met science nerds, right? That's like, they're passionate about their nerd-dom around science and I was just imagining people like in these labs working their fucking tails off to produce something. And, you know, whether they do it for money, or glory, or fame, or out of, like, a care for people, who knows? But, I don't know, for some reason that comforted me, thinking about people like pouring their hearts and their minds into this project. But, I mean, that kind of like brings us back to talking about vaccines, right?
Margaret Which vaccine did you get?
Summer Um and I have Pfizer. Yeah. Does that mean—is this like a horoscope reading? Does that mean something about me?
Margaret Yeah, probably. We need to come up with that.
Summer My sun and moon are and Pfizer. Um I just—I've been thinking a lot about this like vaxxed versus unvaxxed thing. And especially in the Biden administration, and how so many liberals—probably more or less well-meaning liberals—thought that, like, Joe Biden was going to turn us around in terms of the pandemic. And what we've seen is, like, definitely not. We have not turned this thing around, you know? Like not even close. By no means have we turned it around.
Margaret Well, I mean, you know, there's like a million people a day getting Covid. Oh yeah, nope. I see what you mean.
Summer Yeah, yeah. And ultimately it's like, I just take issue with this really neoliberal response where this control of a global pandemic is being placed on the actions of the individual, right? Whether or not the individual makes the like “good” or “moral” choice to get vaccinated, and ultimately to me it feels like this fascist tendency. Like we've, like, identified an internal enemy which is the unvaccinated, right? And like those are the people responsible for all of this, for the economy failing for—like what does that narrative sound like, you know? And like this is all to say, like, yeah, I'm provaxx. I'm vaxxed. Like, I think it's a good Idea. You should probably get vaccinated. But I don't, you know, we're talking about like a global issue here and whether or not your neighbor’s vaccinated, ultimately like there's bigger fucking questions of like why there's been such a failure in public health to manage this pandemic. There are countries where this isn't the reality, you know?
Summer Their numbers right now are like in the dozens, maybe the hundreds. Like, that could have been our reality if this had been managed differently on a policy level, and I'm not even like a fucking policy nerd, you know? I'm just like, wow y' all did bad. Like this has not worked out. And the hyper-focus on the, like, choice of the individual, just like it does with green capitalism, it pulls our attention away from these larger structural issues and institutional responses to the pandemic. Like, are we really—like, don't question Joe Biden, question your neighbor, you know. Don't be mad at like the CDC, be mad at like the guy out on the street. Like, it's just a really ineffectual way to manage this. And it also—like the narrative around, like, well if only they'd get vaccinated. It's just like writing off the deaths of these people as inevitable and as, like, not worth our care, or our time, or our thought. And I don't think—I mean, maybe I can think of some people who like “deserve” to die of Covid, but I don't think the vast majority of people who are dying deserve it by any means, you know.
Summer And um—and we're at a point too where like even vaccinated people are getting sick, so it becomes, like, this really big question, right?
Margaret Yeah, and I guess—I guess it's like people are putting their faith—even if they're not putting their faith in government, they're putting their faith in like Fox News or whoever it is who's, you know, telling them not to get vaccinated.
Summer Right, yeah.
Margaret Instead of putting their faith in themselves and their own decision making. Yeah, no, that's interesting. You know, okay, so like one of the reasons that, like, you know, green capitalism—it's like the—well, if you'd only change your light bulbs to LEDs a little bit earlier, we wouldn't have climate change, everyone knows that. If you, Summer, hadn't changed—had changed your light bulbs, still hold you responsible for this. And, you know, and so it's like we all see how that's bullshit, and I can see how that that makes sense about this. But it is interesting because some of the—some of the ways it seems like that countries are handling it successfully do challenge some of my anti-authoritarianism on some level.
Margaret And so it would be less about giving your neighbor the choice, and in some ways it is about like vaccine mandates. It's like, well, if you want to keep working at this thing that you do, you need a vaccine. And I actually don't have—like people ask me a fair amount as, like, a sort of public-facing anarchist or something, people be like, well what is the, you know, anti-authoritarian response about vaccines and stuff. And for me, it's like fairly easy. It's like, well, I don't want to get sick and I don't want to get other people sick, so obviously I take the thing that's available to me that can minimize my chances of that and, you know. But if you're talking about on a policy level, like what does that look like? What does that mean?
Summer Yeah, I don't—honestly, I don't know. It's something I've thought about a lot too because I don't want to come across as, like, everyone should do what they want, because I obviously don't feel that way. Like, that's not limiting—that's what we're doing and it's not limiting suffering. It's not preventing people from dying. It's not preventing people who are medically fragile and don't deserve this from dying, you know? Not that—I don't want to come across that way at all and, like, have you have you read Climate Leviathan”
Margaret I have not, but I once listened to a podcast where they discuss the basic concept. So I basically have read it.
Summer Well, it just it creates this like interesting…w hat would you call it… like, this categorization of different ways that governments could respond to the ongoing climate crisis, right. And there's like climate Mao, which is kind of—resembles like the way a country like China might respond to the climate—or is responding to the climate crisis. And I've been thinking about that in terms of, like, the pandemic.
Margaret So using, like, top-down authoritarian control.
Summer Yeah, yeah. But like left-wing authoritarian, I guess. And in China the way that they're dealing with pandemic right now from some of the stories I've read is, like, people who have tried to travel there and you test positive and you are forcibly put into isolation, you know.
Summer You know, you're given treatment and you don't really have a choice. Is that good? Ugh, you know, doesn't make me feel good. And then you have a country like ours which is more of, like, neoliberal, that, you know, we're seeing what that response looks like. Like, freedom to the individual and then like what fuck happens then? It's a shit show in its own way, and all the policies are geared towards, you know, maximizing capital instead of valuing humans or human life.
Summer And then there would be like a right-wing authoritarian response, which I don't know what kind of example to give for that. But then there's the, like, what is the response that you're talking about? What do we come up with that's like an antiauthoritarian leftist response to a global pandemic, and I don't know, really. But I do know that, like, things that come to mind are like, we talk a lot about informed consent in medicine and I don't think that people have the right education and right information to make informed decisions around a lot of this. That's like a huge issue, right? Like, our education system, our public health system, our media and the way that—you know, back to what we were talking about earlier, the way that like there's this split in reality, the reality that people are experiencing. Like, people are not making informed choices about their health when they choose not to vaccinate—often. Sometimes they are, but often they aren't, right. Because they don't have access to all the information—or not being given all the information in unbiased manner. So that's one of the things I think about. And then, like, global vaccine equity is huge, right? Because we can't pretend this is just a national issue, like that's absurd, viruses do not, like, acknowledge borders. Like, why we treat this as if it's, like, in an enclosed space ,right, that is called the United States when, um, the border is, like—yeah, it has like very real and fucked up implications in the world. But it's also a concept, right? And like, we need to acknowledge this as a global problem, or else, you know, we're going to keep getting these variants, we're going to keep getting more waves of Covid. So, yeah, I don't really have like a solid answer of, like, how do we deal with this in an antiauthoritarian way. But there's things we can do better, that's for sure.
Margaret I had this like huge moment of, somewhere between disappointment and fear, like I think there was, like, a news story that broke about, like, Russia, like, hacked some of the people researching a vaccine and stole their research or whatever. And everyone's like, oh, damn you Russia. And I'm like, wait, what? It wasn't freely available? Like, you like to imagine that when there's a global pandemic all of the smart people who specifically study that get together and say, like, okay, what's the best plan? And then they all figure it out together and we can have our Star Trek moment where we realize we’re all going to fucking die unless we do it, right? And something about, like, climate change and carbon emissions and stuff, I see how that like screws the economy—I'm completely in favor of this approach to climate change, mind you—but like I could see the argument for it's really more complex than that and it has all these implications. But I just like can't see a defense of intellectual property for vaccines and for medical care. You know, I just, I cannot fathom— especially, even from a self-interest point of view of like as you said, the, you know, vaccine does not respect borders. And so, like, I'm glad I have my like third shot—my booster shot—but it like kind of irritates me that there's, you know, plenty of people who've never had access to it at all, you know, elsewhere in the world.
Margaret I mean, I think that would be part of anti-authoritarianism, right? Is that you have this like, well obviously we don't respect these like borders or capitalism enough to say that, like, you all can, you know, hide the intellectual property of how we take care of ourselves. But it does get into interesting questions around, like, when you when you bring up informed consent, right. Because you're like, okay, well—I'm almost afraid to get into these kinds of—it's such a murky territory. But it's like, okay, if you have a community of people where they're like, oh, we all agree we're not vaccinated and it might fucking kill us and whatever, you know? But in some ways the consent—like, do I consent to allowing people who have not chose to be vaccinated get near me, you know? Like, what direction does the consent go? Like, I don't know the answer to that, but part of me thinks that the, you know, in the same way that we use informed consent with sex around STIs, right? And like, it's not to say that someone who has STIs like shouldn't have sex, it's just that you just need to have an informed, consensual sex. And like all sex, you know, because it's not like it's like a binary where some people have STIs and some people don't. I’m not trying to like, you know—people don't always know and then there's all these things that people have that—this is why it's so messy. And like, so, I'm not trying to be like, oh, if you want to hang out in Plague Village in Plague Town you can, right? I don't know, it gets—it's really complex and I just—like, I actually almost appreciate but mostly begrudge how much all of this challenges, I think not just like my ideological position, but like all the ideological positions that anyone who's actually thinking clearly comes into this with. If you came into the pandemic with a clear ideological position and it hasn't been challenged at all by the pandemic or climate change, I think you're lying to yourself.
Summer Yeah, or you’ve just like—maybe if you're a capitalist you're still just like, yay capitalism, you know.
Margaret I'm going to Mars, fuck all you!
Summer Yeah, yeah, definitely. I mean there is a lot of nuance and I think it's made a lot of us pretty uncomfortable, right, to be like, should the government tell us not to leave our houses? Like maybe, is that a—maybe that's a good idea? That can't be a good idea. You know, like, it is really uncomfortable.
Summer And it's uncomfortable to be an anarchist or an anti-authoritarian and be like, well, the government should definitely just give me money to stay home. Because then it's like, oh, like—well, you know what—I don't have to explain it. But like, I think there is a lot of discomfort. There's a lot of weird ground here and like, it's—I think that, ultimately, it's just hard to imagine a widespread anti-authoritarian response to something when we live under capital and we live under this extreme—in this extreme situation, in extreme circumstances where we have very little control over something That's so widespread and overarching.
Margaret I think that is the answer.
Summer Yeah. That's not just you like no control, right? Like, we do have some control over our day-to-day lives, over what risks we're willing to accept, how we share information and resources and all that. Yeah, but some of it just feels very, oh yeah, so icky.
Margaret Yeah I mean but it also gets to the level of, like, well, for example, something someone could do is stay being a nurse in the ICU. You know? I'm not trying to convince you to stay your job, you do whatever you want. But like, you know, I feel like that is a—you know, because so much of the response—or like, all the mutual aid organizations that popped up, you know, is like, in some ways that is our response. Because we don't control society, but we do control ourselves and we do control, you know, collectively control smaller organizations and things. Which might be too Pat of an answer.
Summer I'm sure I'm sure there's like people more creative or smarter or something than I am who have a really great response to, like, what could that look like. But if—I know in my life for me right now it's just become—like my circle's gotten smaller in a lot of ways and I just try my best to take really good care of the people that are closest to me, you know. When my friends get sick with Covid I, like, bring them food, and I bring them care boxes and whatnot. And that seems kind of like mundane or simple. But for me, coming from my like ICU nursing position, that's kind of the best I can do. And help people understand what's going on, too, people who I'm close to who are like, wait, what the fuck does this—wait, what's happening with this thing? Like, not that I'm an authority, but I do have some room to speak from here. So.
Margaret Well, is that no okay question to ask you? This will probably come out maybe a week from when we record it, so maybe everything will have changed. But like, what the fuck is happening right now? Is that something I can ask you>
Summer Oh god. You mean with like Omicron, or?
Margaret Yeah, and like, you know, there's a lot of discussion right now about, like, do we throw our hands up in the air and say, everyone's going to get it anyway?
Summer Oh god.
Margaret You know, both like in terms of, like, what kind of response is like appropriate—or even like what response like you take in your personal life, or like the people around you take in your personal lives that you respect, you know?—Whose choices around it you respect. Everyone listening do exactly what Summer is about to say and don’t think for yourself.
Summer Oh my god. Everyone who's listening, do not do as I say. But I think I have a couple of responses to that in terms of, like, what's going on right now with Omicron and, you know, we're seeing a ton of breakthrough infections. We probably all know people who are getting Covid right now. Do we just, yeah, throw our hands up in, like, let nihilism take over and let everyone get sick? No, that is a horrible strategy for managing a pandemic. That's a terrible—
Margaret Oh, interesting.
49:57.48 Summer A terrible strategy and, you know, it does kind of bring me back to policy because so much of Biden's campaign or whatever, the dialogue around it has been about vaccination. And vaccination, yes, that's a tool. But that's not—I guess what I'm thinking of is there was like a statement that Biden made at some point that was like, we have such a great vaccine program and rollout and we’re, rah rah, we're doing the best. It's just those damn unvaccinated people. And it's like, if we have this many unvaccinated people, is our vaccine campaign really that good? No, it's not. It's not good. It's not going well, you know, we could do better.
Margaret We’re doing great in the war except for the enemy that keeps winning.
Summer Exactly. Yeah, it's like, what the hell? And I, you know, I think that like just throwing our hands up and saying, well everyone's going to get sick, it just fucking sucks because I think people are riding on this notion that, like, well, Omicron seems to confer less severe disease. Which, yeah, that's great, right? But if more people are getting infected—we're playing a statistics game, right? If more people are getting infected, then a smaller percentage can still be a bigger number of people who have severe disease, you know what I'm saying? And in like a place that's, like, where I live, where our resources aren't extensive in terms of like ICU medicine, our ICU is 15 beds. It only takes 15 people with severe Covid for us to be completely overwhelmed in a hospital that's already completely overwhelmed, in a hospital system that's overwhelmed, in a health care system that's overwhelmed. And so even if people—even in another situation where the people coming into the hospital don't have severe disease, they just have bad enough disease to come to the hospital, you're still dealing with a healthcare system that is, like, teetering—and I mean it, like really teetering. So everyone getting sick is not a great solution. I think that like, I can't tell anyone—
Margaret But what if we do it all at once?
Summer I can't tell anyone what to do, but in terms of what I do in my life is like, you know, I've all along assessed what risk feels appropriate for me and it's a harm reduction thing, right? It's like, we can't expect people to make the decisions that we would make for ourselves. We can give them the best information possible and the resources and hope for the best, you know, hope for the best outcomes. And I'm not going into indoor dining. I have friends that I see, a lot of them are nurses. I do a lot of outdoor activities so I'm able to see people outdoors a lot. I'm still having some dinners with friends, but I live—I also live in a rural area where, like, transmission isn't quite the same as it is in like big cities, right? So probably some people would take issue with some of the activities I participate in. But that's why I'm saying, like, not everyone should do what I do. But, I don't know, you just, you really need to think about the impact, right? Like, it's not not a big deal if you get sick, and I'm saying that with this assumption that whoever’s hearing this has, like, a level of health and immune function that I do, and a lot of people don't, you know. Like I think we, like—“we” being, you know, maybe me—not trying to make assumptions about you—but a lot of us think, oh, this this isn't conferring severe disease, and we're not thinking about our friends, our community members who are really compromised at baseline, who are disabled at baseline, who are chronically ill at baseline, and who maybe aren't “useful” to capitalism at baseline. So it's easy to write off their illness and their deaths as insignificant. It's only affecting people who have chronic illness, you know, like we hear this narrative a lot. Like, 40% of Americans have chronic illnesses. 40%!
Margaret Oh, that’s a high number, yeah.
Summer Yeah, and not all of those are gonna, you know, make it so you get severe Covid. But I’ve treated patients who their, you know, their chronic illness was hypertension. That's what they came in with, and they're intubated now, you know. And I'm not saying this to like fear-monger but just to, like, there isn't some “other” that is the chronically ill that is the immunocompromised, like, people all around us have these things that they’re managing at baseline. So all of us getting sick: bad plan, was the summary of what I just said.
Margaret Yeah, yeah. Well no, it's—I mean, it's interesting because it talks about the—when you're talking about, like, okay because people hear, okay, Omicron is less likely to cause severe illness. But as you pointed out, more people are still ending up, you know, we're still seeing a spike in severe illness like hospitalizations and death right now as a result of it. And it is—I think it's because, on an individual level, every individual is safer getting Omicron than Delta, potentially, right?
Summer Yeah, potentially yeah.
Margaret And so, any individual, especially probably those who kind of had in the back of their heads like, well, I'm healthy, I'll probably survive, you know, anyway, going on. Then hear this like reassurance. But yeah, we don't—we don't tend to think of ourselves at scale. We tend to think of ourselves as us, or at least I do way more than I would like to, you know?
Margaret No, it's interesting. [Laughs] “Interesting.” What a wonderful word for what we're dealing with. Okay, well we're—we're kind of—we're coming up near an hour, but I guess I wanted to ask, do you have any final thoughts about Covid pandemic, you know, why people should go become nurses, or not become nurses, or anything to impart upon our listeners?
Summer Um, I guess one thought that I have is, you know, I know a lot of us come from communities like DIY communities or communities that really value that ethic, and I also value that. But I just, like, want to remind people that, who are treating symptoms at home if they do get Covid or whatever they're treating at home, that if you're going to, you know, use herbal, or nontraditional, or traditional remedies to treat things like this, you just also have to have—you have to be judicious, you know. A lot of us have laughed a lot about people using Ivermectin or something like that. But I've treated a patient who was treating Covid at home with tonic water and homeopathic remedies, and I think it's easy to scoff at that, but like, one person's tonic water and homeopathic remedies is another person's, like, tinctures, right?
Summer Like these just are coming from different cultural backgrounds and situations. And that's not me writing off herbalism by any means, I just want to remind people that, like, in any situation, whether it's first aid, whether it's—we're talking about Covid. There's a point at which we can't DIY anymore, you know. And I just want to like throw that out there because, um, it’s unfortunate, right, that we have to rely on institutions, but they're there for a reason. The ICU is there for a reason, and we can't DIY the ICU. So um, yeah, and just to have compassion for people who are trying those other remedies that seem absurd to you, because your remedies seem absurd to somebody else, you know.
Margaret Yeah. Well, join us next week when we talk about how to set up a DIY ICU. No, no, no, that makes so much sense. And one of the things that I feel like I've learned a lot by talking to people for this show is kind of this, um, like, the institutions that run society are bad, but society is good—or like, the concept of having a society is good. Like DIY is great, but not everything should fall on you, or even the do it ourselves. Like, you know, we actually do need to learn to expand the “ourselves” in do it ourselves. And like, I don't know, I think one of the things that gave me the most hope that you said during all of this is talking about coming into the hospital system, you know, as a, like a queer weirdo, and then being like, oh, I'm not going to get along with anyone, and then like having these deep connections with people outside your usual bubble. I think that that's, like, so important and one of the things that gives me hope is that, you know, there's actually this like—these larger structures that are still just made of people that we can all work together and figure things out.
Summer And, I mean, a lot of those people— I get why we should be skeptical of anyone in a lab coat or whatnot. But a lot of those people really do fucking care, and they really want to do their best even if they fuck up sometimes. So, I'm not trying to be like, woohoo, trust all nurses. But like, some of us are, you know, we're doing all right.
Margaret Yeah. Okay, well do you have any either, like, personal or like any projects that you want to shout out to draw attention to while you have the moment?
Summer I wish I did. I was for a while working on a project around here called Rogue Harm Reduction providing Narcan and STI testing for free, and Narcan training and whatnot. I haven't worked on that project in a while. I got pretty burned out at work, as you can imagine, so I took a step back. But that's a project I'll shout out to, you can look them up on social media. They're great people doing great stuff.
Margaret So they do still exist and people can go support them?
Summer Yeah. Margaret Awesome, well thank you so much. Thanks so much for listening. If you enjoyed this podcast, please tell people about it. It's the main way that people hear about it is word of mouth or, I guess mostly word of internet mouth at the moment. And, you know, you can feed all the algorithms that run the world that probably shouldn't by commenting, and posting about it to all the social medias, and doing all of those things—they have kind of a vastly disproportionate effect compared to what you might think. Every comment and every thumbs up and every subscription and all of that means that more people will run across this content. And if you want to support the show more directly, you can do so by supporting Strangers in a Tangled Wilderness, which is the publishing collective that publishes this show which I'm part of. And you can do that by going to patreon.com/strangersinatangledwilderness. I used to be supported by a personal Patreon, but owing to various things in my life, specifically that I have a nonprofit job now, I no longer am supported by that I'm supported by my nonprofit job. So instead the Patreon supports a bunch of different people who are making all kinds of awesome content and I'm very excited for people to check out Strangers in a Tangled Wilderness and all the stuff that we're going to be doing in 2022? Yes, that's the year it is. It’s a new year. I'm still not very good at that. And I want to thank all the people who support the show, but in particular I want to thank Nicole and James and David and Justine [inaudible], Sean, Hugh, Dana, Chelsea, Eleanor, Mike, Starro, Cat J, The Compound, Shane, Christopher, Sam, Natalie, Willow, Kirk, Hoss the dog, and Nora for making this show possible. All right, that’s it and I hope you all are doing as well as you can with everything that's going on, and take care of yourself and take care of each other.
Find out more at https://live-like-the-world-is-dying.pinecast.co