Special Section: Palliative Care
AMAZING GRACE IN NAVAJO NATION Jessi Humphreys, MD Driving onto the reservation in New Mexico, we avoided the recent snow turned to ice on the edge of the red dirt road. It was late morning as we walked into the house, passing a fluffy white dog, medical cooler slung over our shoulders. As a volunteer doctor working at Gallup Indian Medical Center, I joined an amazing medical team tirelessly caring for patients in Navajo Nation, one of the hardest hit areas in the country with COVID-191. The team was braving a snow storm to bring the vaccination to patients too frail to travel to clinic. Winding through the house, past richly woven blankets on the couch, we found our patient, an 89-year-old grandmother, swallowed up by her cushy chair. “Ya’ at’ eeh Shima,” I tried my best attempt at the impossibly beautiful Navajo language. “Hello Grandmother.” She finished her oatmeal out of a Nightmare Before Christmas Jack Skellington mug, eyes glued to the inauguration on the screen. Her daughter refilled her coffee and sat on the bed in the room, watching enrapt with us. As soon-to-be Vice President Kamala Harris stood to take her oath, I knelt to the ground and pulled on purple medical gloves, ready to prepare the vaccine for our patient. I froze, as she said “that I will bear true faith and allegiance…” holding the COVID-19 vaccine vial in my hand. Overtaken, and breathless, we watched the screen together. Tears ran down my face and my chest quivered as I silently sobbed, my nose running under my thick N95 mask. I joined the room in wiping our eyes. All of us glanced up at the clock face on the wall, emblazoned with an American flag and eagle in midflight. We knew one day we would tell our children where we were in this moment. We bowed our heads and prayed for the patients who already lost their lives to COVID-19. As a palliative care doctor, I help carry patients and their families through serious illness. It has been a disorienting year, caring for hundreds of patients, but I have been lucky to work alongside true heroes in New York, San Francisco, Los Angeles and New Mexico. The deaths have been overwhelming and I can now only remember bits and pieces of this fever dream. The poet who read her daughter a final poem through a phone I held up to her to say goodbye; the young father leaving four children under eight years old behind; the grandfather who touched his silver braid and then my own silver part, showing me how his grandson pulls on his hair when he sits on his lap; the young woman with developmental delay whose only contact with her family was a doll they dropped off, to be snuggled in her hospital bed in the dark. I’ve cried too much, and I haven’t cried for everyone yet. I unpacked supplies and mixed the vaccine, drawing it up with a small needle, laying out our band aid and alcohol swab. We answered questions and ensured there were no contraindications. 30
I prepared my patient’s arm, and gave her the shot, running through the simple motions like the Nutcracker ballet I performed countless times as a child. She smiled and told me she didn’t feel a thing. She might have been lying to me, but I loved her for it. Around our patient’s mirror were dozens of snapshots of grandchildren. A beautiful girl in a green soccer uniform. A toddler in a reindeer fleecy on Santa’s lap. Maybe she would see them all soon. On the screen, President Biden said, “We must end this uncivil war,” and I unfolded my patient’s shirt down over her band aid. We are doing our best. We sung Amazing Grace together, patient beside provider, human beside human. Even muffled by masks it was perfect. As we walked out of her room, I touched a Cracker Jack sticker on the wood, placed next to The Lord’s Prayer and a handwritten sign that said: “You are safe Grandmother. You don’t need to go anywhere. We love you.” There are few moments in life that are both quiet and shatteringly enormous. Perhaps after my son came into this world, I felt that. Perhaps the first time I knew a patient’s spirit was leaving her body, when I knelt down bedside her bed, sitting with her last breath. Perhaps the moment I became a doctor, was handed a stethoscope and felt the enormity of the responsibility and honor. But in this moment, I felt it. The layers of grief, and relief, and every ounce of intensely painful unbridled hope. I drove away in my car to the words of Amanda Gorman on the radio as she commanded even the air particles around her, hoping my son will grow up studying her words, that our children might lead us out and up. I believe vaccinating this beloved grandmother was the beginning of many more grandmothers, that we will begin to care for the true tapestry that makes up our country. Tears burned my eyes as I drove, and I sent her love. And above all, I sent hope. Hope. Hope. From this tired doctor on the edge of breaking, hope. Jessi Humphreys, MD, is Assistant Clinical Professor, MSP, UCSF Division of Palliative Medicine.
References 1. https://www.nytimes.com/2020/12/27/business/economy/the-place-hit-hardest-by-the-virus.html
SAN FRANCISCO MARIN MEDICINE OCTOBER/NOVEMBER/DECEMBER 2021
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