Listen, the last stroke of death's noon has struck
The plague is come,' a gnashing Madman said,
And laid him down straightway upon his bed.
His writhed hands did at the linen pluck;
Then all is over. With a careless chuck
Among his fellows he is cast. How sped
His spirit matters little: many dead
Make men hard hearted. Place him on the truck.
Go forth into the burial ground and find
Room at so much a pitful for so many.
One thing is to be done; one thing is clear:
Keep thou back from the hot unwholesome wind,
That it infect not thee.' Say is there any
Who mourneth for the multitude dead here?
Christina Georgina Rossetti (1830-94)
Copyright 2020 Interesting Literature
Never have I loved you more
Whether you are square or round,
Oval or diamond, rectangle or egg-shaped,
Textured or flat, oatmeal-filled or pure,
Free-standing bar or liquid-pumped,
Never have I loved you more.
For years I hoarded you,
Furtively shepherding you into my suitcase
During hotel stays,
Occasionally sharing my stash
With overnight guests
But that was on a generous day.
And now, when I look at you,
Visibly shrinking by the day,
Knowing that you are the best defender of my life
You, soap, COVID slayer:
Never have I loved you more.
Robert A. Phillips, MD, PhD
With an acknowledgement to all of the staff at Houston Methodist, whose longstanding commitment to meticulous hand hygiene provided the fundamental platform for our ongoing successful strategy to combat the COVID-19 pandemic and provide the highest possible level of care and safety to our patients, our community, and ourselves.
TWO PLAGUE POEMS
The more things change, the more they stay the same. The better we understand disease and pestilence, it seems the less we know. The two poems for this quarter's Poet's Pen feature perspective on scourges. Written over a century and a half apart, the poems bookend events that challenge us and point to a knowledge gap that is great. The awakening and social polarization caused by SARS-CoV-2, the virus that causes COVID-19, begs us to remember great pandemics of the past for insight and solaceinsight into what we might do to combat the devastation and solace as we realize there will be an end to the devastation one way or another.
As Phillips implies, handwashing remains a mainstay of our attack on the present challenge. In his mirthful work he gives praise to soap, one of the few things we know today that helps combat virus spread. He also acknowledges the importance of health care workers who are so vital to manning the ramparts. Conversely, Rossetti's sonnet focuses more on a pandemic's tragedy. We've studied the worst historic epidemics in the United States, including smallpox, yellow fever, cholera, scarlet fever, polio, and AIDS. The humanitarian toll taken by COVID-19 today is similar to that noted throughout history. There is a plethora of plague literature with Daniel Defoe's classic example, A Journal of the Plague Year (1722). Poetry in particular has weighed in, and, as Phillips demonstrates, still does. We should reflect on these works to help us through our current pandemic.
The more things change, the more they stay the same. The Poetry Foundation website says that Christina Rossetti became one of the Victorian age's finest poets.1 Many of her poems were said to be morbid, so a focus on plague is not surprising. She herself was in chronic ill health and this likely influenced her view of the plague years. Her sonnet focuses our attention on the precipitous presentation of that scourge with a victim's rapid withering and frequently death. It reminds me of COVID-19 patients, intubated, prone, and on a ventilator and then dying despite heroics. Her lament in the last line Who mourneth for the multitude dead here? is linked to the earlier image a pitful for so many. Her prescient lines Keep thou back from the hot unwholesome wind, That it infect not thee speaks to today's masking and social distancing policies.
Phillips' poem, however, is not from someone observing from a distance; he is in the midst of the fray today as the chief physician executive of Houston Methodist, an eight-hospital system in Houston, Texas, which as of August 6, 2020, had treated over 5,000 patients hospitalized with COVID-19. This caused me to reflect on our profession as I prepared to speak at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University White Coat ceremony. Schools of medicine today generally have a White Coat ceremony of one sort or another to welcome new students. They have become tradition and signify, with somber dignity, the beginnings of a unique and noble way of lifea profession where we sometimes must run to the flames, or into battle, and not scramble to hide meekly from the danger, frustration, hard work, or challenges. We accept the risks made more apparent by today's pandemic. Much of plague literature, and specifically Rossetti's poem, addresses the pathos of scourges and forces thoughts of our patients, profession, society, our families, and the humanities. It can be frightening and discouraging at times, but because of our training, role models, commitment, and tenants of medicine as a grand profession in general, we prevail with great satisfaction.
History teaches us that the COVID-19 pandemic will end, that end will not come easily, many will perish, and the future will look different than the past. But even more, it teaches us that we can endure. Yes, the more things change, the more some things remain the same. Our profession's greatest tenant of humanitarian care in times of crisis will never change. As Phillips would say: WASH YOUR HANDS AND USE SOAP