TORONTO, ONTARIO

[Jennifer Chan, RN is 5 ft. 1 in. tall, very petite with long straight black hair and a pixie-doll face, but this woman is made of iron. Fresh from nursing school, she’d been working for the Queen Mary Hospital for three weeks before the Pandemic struck. She labored tirelessly for the entire epidemic in both the hospital and later in alternative care sites. Her experiences during the Pandemic didn’t discourage, but instead confirmed, her love of nursing. She says she felt like she truly made a difference. Now that the Pandemic is over, Chan is looking forward to a long, hard-earned vacation and going back to school to gain a master’s degree in nursing (MSN).]

    The whole thing seems like a bad dream now. I was one of the new kids still figuring out how to find the bathroom. Three weeks later, I was in the middle of a pandemic, part of the so-called “thin white line.”
    One morning, on the tenth day of the epidemic, we stopped taking patients. We were filled up, another nurse told me. From now on, we would continue to triage patients out front, but send most of them to newly formed fever clinics while taking in the worst cases as beds became available due to discharges. They also kept a small reserve of beds so the hospital could continue to treat the occasional critical case such as a heart attack or trauma. You have to give them credit for that. No matter how bad things got, they always tried to remain a real hospital, not just a flu hospital. But I was wondering what the flu victims were going to do if all the hospitals closed.
    Later that day, two women from the Pandemic Response Center came by and asked for volunteers to set up an alternative care site that would be staffed mostly by retirees, students and volunteers. An epidemiologist from Health Canada’s pandemic response team would be heading up the facility.
    I immediately volunteered.

Nurses at a Calgary hospital put on personal protective equipment before beginning their hospital shift during the Pandemic. Hospital staff worked under extreme conditions, with highly stressful 12-hour shifts in hot and suffocating masks and gowns, wards filled with flu patients, and quarantine procedures that produced overwhelming feelings of isolation.

    It’s not that I really wanted to leave that badly. I loved the people I worked with and knew that if I left, their jobs would get a little harder. When things got really bad, you still wouldn’t quit because other people depended on you. The Pandemic welded us into a team, and I loved that feeling. We were fighting against the odds, and in many ways we only had each other to count on. Outside of work, we were increasingly being treated as lepers by friends and family——some nurses told me that even their own kids were scared of them——which brings me to why I left to help start the new facility.
    I was still living with my parents and planning to do this until I got on my feet financially. When they saw Queen Mary’s on the news, they packed a suitcase for me, put it in the garage and then locked me out of the house. They said: “Quit right now, Jen, and we’ll let you back in.” I kicked and screamed but they wouldn’t let me in. They were on the other side of the door, crying, pleading with me to quit. They didn’t want me or them to get sick; they didn’t want to die. But I wouldn’t quit, even though every day during the Pandemic I went to work thinking, “Today might be it; I could die.”
    After I left home, I checked into a motel where I could easily get in and out of my room without being noticed. I lived each day afraid the manager was going to find out I worked for a hospital and throw me out. On the street, sometimes people would yell insults and threats at me because I’m of Chinese descent and the Pandemic started in China. Eventually, I went to stay with another nurse and her husband, but almost immediately it started to get weird. I would catch him staring at me intensely. Don’t get the wrong idea: He wasn’t interested in me that way. Instead, he was literally looking at me with murder in his eyes. If his wife got sick, I realized that he would blame me and might even hurt me in some way. I lived in fear in their house, and I wanted out.
    So the Pandemic Center women walked into the hospital and said if you volunteer to help set up and run the new fever clinic, you have the option of living there with free room and board. The Army is going to guard it to keep you safe, they told us. We have been authorized to take four nurses from this hospital. Now who wants to volunteer?
    I realized that if I said yes and ended up living in a fever clinic, not only would the Army be keeping unwanted people out, they would probably end up keeping the wanted people in. The government was clamping down on all those people who walked off the job, and it was against the law to quit now. I thought: It won’t be long before you see nurses working at gunpoint. But it seemed safer to be in a hospital 24/7 than have to pass back and forth between the hospital and the real world. You look at me like I’m crazy, but listen to this. Like an idiot, I wore my uniform home one night, and during the drive a man got out of the car next to me at a red light and started begging me, then trying to bribe me, then threatening me, to come to his house to help his wife who was sick. A man and a woman saw what he was doing and ran over. I thought they were going to help me, because the guy was hysterical, but they demanded that I get out of the car. They started screaming at me that their mother needed my help and that I was a goddamn nurse and that it was my duty to do what they said! Somebody started punching my windshield until their skin broke, leaving a bloody smear on the glass. I had to floor it and run the red light to avoid being kidnapped. Of course, there wasn’t a cop in sight, not in those days.
    As I left the hospital with a few other nurses who’d agreed to set up the new facility, I realized I’d been craving a new environment to work in. Those fluorescent corridors had been starting to drive me crazy. And things had started to fall apart. Doctors would end up in screaming matches over whose patient would be next on a ventilator. There was often blood on the floor from patients bleeding out. People slipped on it. They’d walk through a puddle of it, too numb and tired to notice, and track it through the hospital. Antivirals kept disappearing from the drug lockup. People were taping cardboard over all the air vents.
So I left, hoping to make a fresh start. And walked straight into a madhouse.
    We were bussed, still wearing masks and gowns with an armed guard in the front row, to a public high school in the Southwest. There were supplies and equipment everywhere, still in boxes. The Pandemic Center had stockpiled 200-bed field hospitals, advance treatment centers, casualty collecting units, trauma kits, mini-clinics, mobile feeding units, reception center kits, you name it. Using these materials, you can set up a temporary hospital virtually out of the box. Gradually, we started to get the place into shape——cot after cot made up in nice neat rows. We collected everything in the school itself that we could find that might be useful. For example, they sent us a lot of forms but no pens or pencils, so we scavenged them out of the school supplies. We found a few things in the nurse’s office, and learned how to use the PA system. Volunteers and retirees and medical and nursing students wandered around until a few nurses who’d come from Telehealth assigned them duties. A few doctors, scrounged from local private and group practices and the Army, were in charge of the place; the famous epidemiologist never showed up. We had no resources for psychological counseling, but a number of priests and ministers came——including a rabbi and an imam——and they were a huge help whether you needed somebody to talk to or change a bedpan. They were humble people and willing to do anything to help. A group of us nurses claimed a classroom and that’s where we bunked. Just like the hospital, they put a school bus out front for triage, and a tent in the back for staff, although most of us weren’t leaving, as we had committed to live onsite. One of the military doctors was a real whiz with triage. Soldiers guarded the place. For some reason, seeing these guys in their helmets and camo gear walking around with machine guns didn’t reassure me. If anything, it made me more anxious, if that’s possible.
    By the end of the week, the site accepted 200 patients.
All day, all night, the gym was filled with noise——layers of it. A horrible general moan that never seemed to stop, punctuated by sobbing or retching or an occasional scream of pain or terror. People cried out all the time in delirium——enraged snatches of dialogue, pleading with some friend or relative, a shouted warning, or sometimes one long monologue that didn’t make any sense. Somebody thought it would pump up morale by playing these easy listening CDs over the PA system. The music came through with this tinny sound and just sunk into the noise like some nightmarish underlying soundtrack. To this day, if I hear one of those songs, I start shaking and bawling, even though I never cried once during the entire epidemic. Weird, huh?
    It was like being in Hell.
    For the worst cases, Avian Flu is agony. It not only flattens your lungs, it can attack other organs. For some people it’s not just a respiratory infection but a whole body infection. The frontal headache is worse than the worst migraine. The eyeballs hurt everywhere at once, the eyelids even hurt, sometimes the ears get inflamed. The lower back becomes so painful that mere contact with the bed can be unbearable; people would lie for hours with their backs sharply arched. People licked their lips with thickly coated tongues with a bright red tip. Blood dripped and pooled everywhere from vomiting and coughing and the classic nosebleeds that occurred in about half the patients we saw in the hospitals. With the nosebleeds, you had to be careful because sometimes it would squirt up to several feet. The place stank like fever, like sweat, shit and death.
    When people turned blue, that usually meant they’d had it; some died within hours, others lingered for days, choking and coughing up as much as two pints of pus a day. We had beds and medicine and we could keep our patients hydrated, but we had no ventilators, and the hospitals kept telling us their ventilators were all in use. I remember at Queen Mary, where we had too few ventilators and too many people needing them, how some doctors, crying bitterly, had to choose whether to keep somebody on a ventilator who was barely clinging to life, or take him off and put another patient on it who was stronger and had a better chance to survive. In the gym, we didn’t have that choice.

Two volunteers listen to instructions from a nurse at an alternate healthcare site established in a Montreal school gymnasium. During the Pandemic, Canada’s “thin white line” of 600,000 healthcare workers attempted to treat nearly 8 million victims of Avian Flu; the so-called “fever clinics,” staffed largely by volunteers, expanded the capacity of the health system, easing pressure on it and enabling it to treat as many sick as possible.

    Without the ability to provide supplemental oxygen to patients, we could only make some of them as comfortable as possible as their lungs slowly bled out and they drowned in their own fluids. About one out of seven or eight of our patients died like this.
    Sometimes, when a patient died, his lungs would burst, which would create air pressure that formed little air pockets under his skin, usually in the neck but sometimes all over the body——it’s called subcutaneous emphysema——and the body would crackle and pop as we rolled it onto the gurney for removal.
In the worst cases, their fingers and genitals turned black and smelled as if the body had started to decompose before dying.
Some people recovered but could barely move, they were so tired. Some people ended up with organ damage. We had a bunch of people who went blind, wound up permanently confused or were forced to live with other permanent side effects from the virus attacking the brain.
    We kept the patients nourished and hydrated, removed their waste, cleaned their sheets, gave them medicine, tagged the corpses for removal, day and night, over and over. Nurses and ministers constantly walked among the cots tending body and soul. Our volunteers constantly changed bedpans and dragged bundles of bloody sheets to the laundry and gave patients bed baths and prepared meals and mopped up blood and phlegm from the floor. The nurses and students constantly drew blood and started IVs and dispensed meds and provided respiratory suction. Over and over and over, day after day after day. Then a doctor would complete a death certificate and a body would be bagged and put in the school’s music room to await pickup.
    Two of our people gave up due to the stress and tried to kill themselves. One ate two whole bottles of antivirals. We had to physically subdue a med student who had accidentally pricked himself with a needle after drawing blood from a patient and had started screaming and thrashing about.
    Near the end of the week, we were treating a few Americans. They weren’t tourists, but people from Michigan who came over because they thought we had better healthcare and that it would be free. When are the Americans going to catch up with the rest of the modern world and get a public health system? I heard that something like 15 million people got sick but were uninsured down there. A lot of them came over here and helped crush a health system already broken by the Pandemic while using up our antivirals. And then they have the nerve to blame us for the flu, like we invented it! Remember when that idiot on that right wing cable news channel started calling it the “Canadian Flu”?
    Anyhow, we took care of the Americans in the fever clinic as best we could, and once it had filled up, another person from the Pandemic Center came in, got us together and asked for volunteers to help set up another healthcare site.
    I volunteered.
    The next site was a hotel that had been commandeered in the Northwest. The supply situation was even shoddier than at the school gym, but in many ways we were in the lap of luxury. We put two patients in each room. The constant grating noise of suffering went away. The hotel had comfortable beds and plenty of linens. Some of the hotel staff volunteered to come back to work and cook us meals and do the laundry.
    The best part, however, was that we all got our very own rooms. Every day, there was some place where I could go, take off my mask and gown, have a hot bath, and breathe.
    But even there the days started to blur together again until the hotel filled to capacity and the Pandemic Center sent people again to ask for volunteers. The next assignment was another hotel, a nice one I had always wanted to stay in, so I went.
And then another, this one a “step down” healthcare site for stable patients transferred from acute care facilities. The work was much easier there. It was a challenging experience for me anyway because I turned out to be the only registered nurse onsite.
    Overall, I worked at five healthcare centers during the Pandemic.
    Eventually, I heard that the number of new cases had started to go down. Over the next three weeks, the number gradually fell off to almost nothing. Our clinic continued to take new patients from the hospitals, however, until we were full. These people were in recovery, and it was heartbreaking to see how the flu had ravaged some of them. Some would never be the same again. Some were still so weak they couldn’t even feed themselves, and they would stay that way for months. Christmas came and went.
    On the first day that we heard that Toronto had reported no new cases, the staff sort of drifted together. We stayed masked but, on impulse, we each put a hand on another person’s shoulder or back. A simple touch was something we had not been allowed to do to another human being for weeks unless they were sick with the flu. Nobody said a word. The epidemic was over, and we had made it. In this way, we celebrated what we called No Intake Day, a date I intend to celebrate every year for the rest of my life.
No Intake Day is just two days before New Year’s.
    You know, I’ll never forget the people I worked with, the doctors and nurses in the thin white line. I’ve never met stronger people, and they helped me stay strong so that I could keep at it every day and never give up and go on helping to save lives. They are all heroes to me——more than that: They became my family. The sad thing is that to this day, because I worked in so many places and we practically lived in the masks and gowns, I have no idea what most of them look like or even their last names.
    They have no names or faces. But I will always love them.

return to top