The Phone Call
April 16, 2020: 27,158 new U.S. cases; 632,548 total since January 23, 2020; 27,012 deaths.
“You know, my kids keep telling me I need to move on,” he said. On the other end of the phone, his voice scratched, a tangible marker of his 82 years well-lived and thousands of cigarettes well smoked. He took long, breathy pauses between sentences, puffed his cigarette—he was in no rush to say goodbye.
I looked down at my checklist of things to ask each patient. Any symptoms of cough or trouble breathing? When did your sore throat first start? Any past medical history? Who is living with you? Scanning the sheet, I couldn’t find a question or symptom or text box or space for what was bothering him: loneliness.
“What do they expect? I loved her for 53 years of my life,” he continued.
Joe had gotten tested for COVID-19 three days prior. As a healthcare professional checking on patients isolating at home, I was tasked with giving Joe a daily call until we received his results.
“How does anyone turn off a love like that?” he asked, his voice—desperate, earnest—searching for answers. I sat still, silent, staring blankly ahead at the bare wall in front of me, the phone brushing my right ear, my eyes—desperate, earnest—wishing I knew.
“Joe, how is your breathing today?” I eventually said.
“When she died—”
The depth of his pain revealed itself, his broken-heartedness far outside the bounds of 1 to 10. I set down the checklist on my desk, the boxes on the sheet remaining as blank as when I had first dialed Joe’s number. I leaned back in my chair, transferred the phone from my right hand to my left, crossed my legs, and strapped the phone against my ear.
“It was all so sudden. She was fine the day before, but she went downhill quickly. We had just celebrated our anniversary. Fifty-three years together, 47 of them married. Isn’t that something?”
“That sounds very special.” I smiled through the phone, ignoring the time ticking away on the bottom of my computer screen, ignoring the elongating list of names piling up on my call sheet. Each call, originally scheduled to be five or ten minutes, was never five or ten minutes. Life always took quite a bit longer.
“She was the most remarkable woman. She could make you laugh like a little kid. We would go on the best adventures together, just the two of us…” Joe’s voice trailed off, his sadness tugging at my ear. “I bought her roses the other day. I stopped by the farmers’ market on Saturday and saw them. The most beautiful bouquet of red roses you’ve ever seen. Red roses were her favorite.”
“I’m sure she would’ve loved them,” I said. I recalled my grandpa bringing red roses to my grandma. She, troubled by arthritic knees, would saunter over to him, as if gleefully pain-free, take the roses, place her hand on the side of his face, and kiss him softly on the lips.
“It’s been six months since she passed,” said Joe. “Not a day goes by that I don’t think about her.” He coughed; I chose not to mark it on my symptom sheet. Based on our previous conversations, I had learned the character of this deep, steadying cough. Not from illness, and not from cigarettes—that one rattled so loud of mucous that, each time I heard it, I assumed he had coughed up an entire pack of Marlboro Reds. No, this cough came from somewhere much different, a place nobody but Joe had visited. But it always arrived right on time to our conversations, showing his vulnerability the door to leave. “My kids have to suck it up. If I never move on to someone else…well, to hell with them. How lucky I’d be to keep buying her roses until the day I get to see her again.”
Call duration: 47 minutes.
August 27, 2020: 94% efficacy of vaccine based on early clinical trials; 70% vaccinated needed for herd immunity; 95% confident of statistical significance.
“I’m scared about what I might do,” said Ryan. I’d been on the call with him for 45 minutes, listening to his diffident tears. “Tuesday nights I usually go to AA meetings down the street. I see the guys, I talk to them, I, ya know, get a little extra motivation to make it through another day. To make it to the next meeting.”
It was Tuesday at 4:30 pm. There would be no meeting tonight. There had been no meeting last Tuesday. Or the Tuesday before that. Or the eight—or was it 18—Tuesdays before that.
“It sounds like going to meetings is really important to you,” I replied, hoping the validation would keep his solitude company, understanding that it never could.
The phone was silent, the two of us waiting, though we weren’t sure for what. We kept waiting like that, a bit longer than any call I’d ever had. Waiting, together.
“I live alone. I spend most days just playing video games on my computer, passing the time. Sometimes I eat, sometimes I forget. The only time I left home this week was to get COVID tested for a little cough I had. It’s gone now, don’t worry.”
“What video games do you like to play?” I chimed in.
“Call of Duty, mostly. I know some people criticize it for the guns and blood, but I think it’s cool. I try to play with my friends sometimes, which is fun.”
I could tell by the changed inflection of his voice that his crying had subsided. His breath was smoother, brighter.
“That’s great that you’ve found a way to connect with your friends! I’m sure they enjoy playing with you, too.” My voice grabbed at this connection Ryan had formed, even if entirely virtual for the time being. This opportunity for human contact, no matter how small, lifted my back just slightly out of my chair, pulled me just a bit further into the phone, my hopelessness tasting just a hint of sweetness from its long-forgotten antidote. Because Ryan and I both knew there was nothing we could do over the phone for his substance abuse. Nothing we could do, except stall him from pouring a drink.
“Yeah, but they’re not always online.”
“Can you call them?”
“I don’t really like talking on the phone.”
“But you’re talking on the phone right now.”
“Yeah, but you’re a stranger. Talking to friends requires so much effort. I can only get through it with a few whiskeys already in me. But if I wanted, I could just hang up on you and it wouldn’t matter. No offense.”
“None taken.” I understood the sentiment. My body was still metabolizing the alcohol from the night before, when I spent my Monday night feigning normalcy with friends over Zoom—so many fatigued faces, all alone—as we convinced ourselves the solution to a global pandemic could be found at the bottom of a bottle of bourbon. I rubbed my pointer and middle finger in circles around my right temple.
“I’m going to get off the floor now, try to take a shower. See where that takes me.”
“That’s a great plan, Ryan.”
“See if I make it until Tuesday.”
“All you have to do is wait a bit longer.”
Call duration: 56 minutes.
November 2, 2020: 70% hospital capacity in N.Y.C.; 7% positivity rate in the U.S.; 47,175,018 cases worldwide.
“My husband…well, my husband is such a sweet man.” Silence. “Was such a sweet man.” Lisa’s voice was soft, angelic. A light whisper that drew me into the phone. “We got sick at the same time, but Albert didn’t tell me. All he was worried about was how I was feeling, how I was coughing so much. When we went to the hospital because I wasn’t getting better, he didn’t say that he hadn’t slept the night before. I thought he was just up late in his office working. Albert does that sometimes…did that sometimes. It wasn’t until the drive home from the hospital that he told me he had spent the night on the couch.”
Lisa’s voice broke, followed by a few shallow breaths, her choking back an unraveling. I listened quietly, lost for words to give. My mind had spent the past week lamenting the empty space next to me in my own bed. Between travel restrictions and respiratory droplets and the unknowns of what, or who, was safe, I didn’t know the next time I’d feel anyone beside me. A dear friend, or a loving partner; a bed made for two, now indefinitely occupied by one. The sadness overpowered me most nights, wrestling my arms and my legs and my rationality into submission until I eventually succumbed to it altogether. If I was lucky, I’d fall asleep, hopelessly defeated. And then, I’d wake up, hopelessly defeated—but alive.
Lisa took a deep breath. “He…he wasn’t trying to work that night. He was trying to breathe.”
I felt gratitude as the air entered in through my nose, traveled down through my trachea, filled the spaces of the tiny alveoli deep in the crevices of my lungs. And I felt regret that it was the first time I had ever noticed it. Noticed my body. Noticed my surviving, working, still breathing life, no matter how plagued by loneliness.
“I’ll never know if I was the one who killed him,” Lisa said. “If I was the one who gave him the virus. That’s one of the hardest things: the not knowing. Not knowing why. Not knowing what we still had left for us. Not knowing what song he would have chosen for the father-daughter dance at our daughter Katie’s wedding. Not knowing what nickname he would have given to our granddaughter, Victoria, who was born just last week. Not knowing if I told him ‘I love you’ enough.”
“I’m so sorry, Lisa,” was all I could trickle out of me.
I don’t remember when the line went dead, or how we said goodbye. But I knew we were done when all I was left with was the sound of my tears hitting the checklist on my desk. Drip, and drip, and drip.
Call duration: 1 hour, 9 minutes.
When I called back a few days later, the phone rang, and rang, and rang, before going to voicemail. On the recording, a man’s voice—animated and booming—talking so swiftly it took only a single breath:
“Hi, you’ve reached Lisa and Albert at home. Unfortunately, we aren’t available at the moment, but we’ll give you a call back as soon as we can. Cheers!”
December 29, 2020: 37,000 U.S. children 12 and under experiencing parental death due to COVID-19.
“Either I go to the hospital and leave my kids at home alone, or I stay and hope this cough goes away before work on Monday,” Peter said. Between sentences, he took deep breaths and coughed up a pink-tinted glob of mucous. “Never more than a teaspoon’s worth at a time,” he would tell me. Peter, a single dad of four kids who all tested positive for COVID-19 three days ago, was getting worse with each passing day. I had called him every day since his diagnosis, urging him to go to the hospital, knowing this was a case the doctors warned about.
“I know you want to be with your kids, but I also want you to get better,” I said. A memory of my niece pierced me: her shoulder-length blonde curls tied up in pigtails as she wobbled naked in her diaper across the kitchen floor, no care in the world except chasing the cat. She grasped for the animal, laughed uncontrollably, her body tumbling to the tile floor. Each time she got up and tried again, with a smile stretched across her face—joy.
Peter took a pause, one that echoed through the line. “This thing will have to kill me for me to leave my kids. If I go to the hospital, it’s only because I know that’s where I’m going to die.”
Call duration: 17 minutes.
December 31, 2020: 65 years and older; 1.88 deaths per 100 nursing home residents in the U.S.
“I turn on the television in the morning, if I can reach the remote, or I FaceTime you.”
“Our chats are my favorite part of the day!” I assured my grandmother, smiling at her radiance on my phone screen, a radiance so full and so lively that I almost forgot about the oxygen cannula tucked into both her nostrils. A radiance, with traces of illness always waiting in the shadows.
My grandmother had been isolated in her senior living home since the pandemic was declared mid-March 2020. She had no visitors, no independent mobility, and, ever since my grandfather died ten years ago, no red roses on her nightstand. She had nothing, nothing but the television, the phone, and me.
“Most of the nursing staff is out sick or quarantined. Do you know what’s going on here, beautiful? They don’t tell us much. I wish I could change the dang channel.”
I heard the voices of a game show in the background of the call, muffled shouts just beyond her. “And we have a winner!” “Come on down!” “Take a spin at the wheel!” She must have been watching the same channel since yesterday, at least, sleeping through the night while the voices on the television celebrated and cheered for random strangers. The thought of her stuck like this needled me, but the thought of her stuck listening to the news—to the horrors of her neighbors, her friends, her—that thought would have broken me open, my hope for all of us spilling out.
“I don’t know, Mimi. But I want you to be safe, okay? How are you feeling? Any trouble breathing? Are you taking your medication? Have you tried getting out of bed today? Has anyone brought your food?”
“Don’t worry about me, sweet thing. But if you could see if they could find a remote for me, that’d be great!”
I worried. One day, I worried myself sick. I spent the day at home, body incapacitated by fatigue, nausea, a sense of doom. “It’s not COVID,” the doctor would later tell me. I knew COVID was to blame.
Call duration: 8 minutes.
March 11, 2021: 365 days; 1,672 calls; 25,080 minutes on the phone.
I avoided therapy for weeks. What was there to talk about? That people were dying and there was nothing I could do about it? I didn’t understand how my psychiatrist could solve that problem for me, over the phone. But either I kept dragging my body through each day as my mental health languished, or I paid a stranger to listen to me cry.
“It’s the numbers,” I told her. “The numbers don’t stop.”
“What about the numbers?” she asked.
“In medicine, you know, it’s all about the numbers. We base our processing, our decisions, our trusted opinion on where the numbers come from and what they mean.”
“Okay,” she said.
“Like, a prognosis, for example. Patients always ask for a prognosis. How many months, how effective, what are the chances, how many treatment options are there. It’s all numbers. But do we ever give a qualitative account, a truly substantive description of what that future is? Do we ever tell patients, ‘Your prognosis is more memories spent with your loved ones around a family dinner table, laughing and spilling wine, as you hold the hand of your soulmate under the table, like two teenagers just feeling the first butterflies of love?’ No, we don’t say that. Because that would be insane. So, instead, we just say, ‘Your prognosis is that you have at most six months left to live.’ It’s more practical. But is that all there is? Just more and more numbers?”
“Why do you think you’re so aggravated by numbers?” she asked.
“I mean, I get it. I get that the easiest way to represent things in the news is by counting all of the ones, adding them up into sums, and bundling them into a simple, digestible number to flash across the screen. I get it, I really do. And honestly…” I stopped for a moment, feeling myself diving deeper into my unconscious, the territory where pleasantries ended and my humanity began. “Honestly, sometimes it’s easier to look at a faceless number than to look at the pain on faces.”
I wondered if she was judging me. I wondered if I had taken her too far off her checklist. I wondered if she, too, was quietly grateful that this was a phone, rather than a video, call.
“I’m going to be honest with you, okay?” She always prepared me in this way, asking whether I was ready for the truth. I never was.
She went on. “You feel things. Deeply. You feel each and every story as if it were your own. For you, though humanity is extraordinarily immense in number, it is exceedingly intimate in practice. Every interaction, conversation, smile, hug, dream, gift, glance, wave for you is important. They all mean something. Those tiny moments, they fill you up. It’s what makes you, you.”
“Yeah,” I replied. I stared at the blank wall ahead of me as I held my cell phone in my hand, nodding my head as her words poured out over the speakerphone, completely fascinated by how healing it was to have this person tell me…about me. Because after a year of reading number, after number, after number of lives lost, I finally heard from one I really needed in that moment.
I breathed deeply, bringing my life back into me.
“And that’s beautiful, it really is. But Kelsey, if you tried to feel every single thing that was happening in the world right now? If you tried to internalize and embody and fully honor all the pain that is creeping in from every direction? Well…”
She sighed heavily, hearing her own words as they escaped her mouth. It reminded me how human she was.
“If you tried to do that, I don’t think you’d survive.”
Call duration: 45 minutes.
September 14, 2021: my birthday; my friends and family; my life well lived.
“HAPPY BIRTHDAY TO YOU, HAPPY BIRTHDAY TO YOU, blah blah blah, you get the rest. I miss you!” My mom’s voice shouted at me on the other end of the phone. “I hope you get my presents in the mail. I sent them yesterday; I hope they get to you! Did you hear about Laura? Oh my god, Kelsey. Her hair looks INCREDIBLE. She did it HERSELF, did you know that? I could never pull off purple hair like that. I’m too old. Gosh, you’re getting so old too, I can’t believe it! When will I see you next? You have to come home in October for your cousin’s wedding! I hear they are getting a live band for the reception. I’m sure it will be beautiful, just beautiful.”
I beamed, alone in my room, admiring her ability to carry on a conversation by herself. I imagined her cackling laugh and her trademark dance moves. She flooded a dance floor whenever one presented itself. Her voice soothed me in a way few others could, her presence so comforting despite the vast distance between us.
1,012 miles. A big number. But one that a phone call always made smaller.
I told her thank you. I told her I loved her. I told her to please call me tomorrow. I needed to give my next patient a call.
Call duration: I completely lost track of time.
I picked up the phone, dialed another series of numbers that, when pieced together, might have made something happen. A voice might have sounded in an ear. A conversation might have painted a picture. A life might have emerged out of nothing. A story—someone might tell me a story about the time they were alone, and how happy they were to hear my voice.
I picked up the phone. Another series of numbers that, when pieced together, might have resulted in something different altogether.
But always a story—always.
Ring. Ring. Ring. Hello, I’m looking for any 1, is any 1 there?
Kelsey Clayman is a medical student at Columbia University Vagelos College of Physicians & Surgeons. She is interested in narrative medicine, mental health, and their intersections with emergency medicine.
© Variant Literature Inc 2021