We are not all in the same boat

‘We are not all in the same boat. We are all in the same storm’- Damian Barr

I didn’t think about the pandemic as a storm prior to hearing this poem. I’ve heard people say on multiple occasions that we’re all in the same boat since we all had to make changes to the way we live in 2020. We all had to do our part to physically distance. We all had to make sacrifices. We in fact are not all in the same boat. The pandemic and physical distancing has meant so many different things to different people. For some, working from home was a way to save time and money on commuting. It was a way to reconnect with roommates or immediate family or even nature. It was a vacation. For others, it meant loneliness, uncertainty, job loss and fearing when the next bill would be due.

While listening to this poem, I remembered a patient that I cared for during my Internal Medicine rotation. She had several congenital conditions and with modern medicine, had survived to adulthood. She was developmentally delayed and so her mother was her primary caregiver and medical decision maker. It was clear that she and her mother were very close. Her mother was also very protective of her. Afterall, she knew how to take care of her daughter best. When my patient needed to be hospitalized, per policy, her mother wasn’t allowed to stay with her. While these changes were created to reduce transmission, I started thinking about how dehumanizing they were. I thought about how scary this must have been for my patient and her mother. Her mother was the reason she was still alive. She advocated for her daughter and took care of her daily needs while fighting to make sure she got the care she deserved. I remember thinking about what boat they were in. Was this her first hospitalization since the pandemic began? Did their family get to bond during the time they had together or were they burdened by job insecurity and bills that were piling up? One thing was clear now: their boat was a life raft. They were struggling with new hospital policies, struggling with feelings of frustration and struggling to get quality care. Fortunately, the hospital was able to make an exception so my patient’s mother could be with her during her hospitalization.

While this was a case with a positive outcome, I remembered a story that a resident shared about the bond she forged with a young boy who was receiving chemotherapy. She got to know him and his family overtime. She watched him begin school, make friends and become a big brother. The treatments he was undergoing helped and eventually he was in remission. They were in a boat that offered hope. Unfortunately, the cancer came back and during the pandemic. The boy could only have one family member stay with him at a time. When his mother would spend the night at the hospital, his father would sleep in their car in the parking lot, in case there was an emergency overnight. The boy couldn’t have visitors like he did before. He couldn’t do the things he used to. While the care team, the boy and his family fought as hard as they could, they came to realize that nothing more could be done for him. When they made the decision to stop all treatment and take him off life support only one family member could be there. While the family petitioned for an exception to be made, none was granted. The time came, and his family decided that his grandfather would be there. The rest of his family had to stay in the lobby. This family’s boat was crushed by the storm. Their care team did whatever they could to weather the storm, but it wasn’t enough.

While the patients described above were hospitalized and undergoing treatment, they weren’t in the same boat. For one an exception could be made, while it couldn’t be made for the other. I realized that we aren’t in the same boat. The boats that we are in can also change. A week before I wrote this piece, I had a conversation with a neighbor who was describing that she had been “isolating” since March. At the beginning she felt indifferent. The physical distancing wasn’t a big deal for her as she wanted to protect herself and people she cared about. During our conversation, she started to cry. Her birthday was in October. Then there was Thanksgiving and Christmas. For all these celebrations, she couldn’t be with her family. Her daughter would bring her a food tray, one with the appetizer, one with the main course and one with dessert. For my neighbor, the worst part of it was that her daughter only lived 4 blocks away and yet she couldn’t celebrate with her. She couldn’t hug her grandchildren. She went from being in one boat to a completely different one filled with sadness and loneliness.

If this was my poem I would write:
We are not all in the same boat. We are all in the same storm.
Our boats are ever-changing. Our experiences are dynamic.