Stories of COVID-19: Decisions, Part 2

In Part 2 of Decisions, we’re sharing two more stories of difficult choices, one from a physician and another from the director of a public health laboratory.

In our first story, medical doctor Matifadza Hlatshwayo Davis must make a difficult decision about whether to work home while pregnant during the pandemic.

In our final story of this episode, Myra Kunas takes on the significant task of directing the Minnesota Public Health Lab in May -- a task that becomes even more complicated after the tragic murder of George Floyd, when protests and riots take over the streets surrounding her lab.

Listen to Part 1 of this episode here.

Story Transcripts

Story 1: Mati Hlatshwayo Davis

So it's March 2020 and coronavirus is upon us. I'm an infectious diseases doctor so I'm running around, going to meeting after meeting because we're faced with leading the charge. I'm also trying to stay up to date with scientific articles but there's scarcely any data. I'm trying to answer all the texts coming into my phone from panicked family members and friends, some I hadn't even spoken to in over 10 years.

Mati Hlatshwayo Davis is a clinical instructor at Washington University School Medicine and an associate program director of the Division of Infectious Diseases fellowship program. She is also the Lead HIV Clinician, the Graduate Medical Education Coordinator, and the Outpatient Parenteral Antimicrobial Therapy supervisor at the John Cochran VA Medical Center.

But I'm also seven months pregnant. And let's just be very clear here. This is not the radiant glowing, oh-look-at-her-she's-so-beautiful seven months. This is the I feel fat, I'm very wide, my back hurts all the time. Not a day goes by that it doesn't hurt and I really need someone to take this baby out of me immediately. Thanks.

On top of that, I'm grappling with how to reconcile my pregnancy and my work because, like I said, there's no data and no conclusive recommendations. Thank God for my obstetrician, Dr. Philpott because he makes it black and white. He's like, “No seeing patients for you for the rest of your pregnancy.” He's like, “You have higher risk. You're an infectious disease doctor.”

So I'm like how do I do this? I have to figure this out with my bosses. So we come up with a plan for me to focus the remainder of my time on telehealth. I inherit this new hotline which is basically this phone that doctors at the John Cochran Veterans Hospital can call in, tell me what's going on with a potential patient, and then I let them know if they're eligible for one of the very few tests we had at the time.

This decision to work from home, not simple for me. Not easy by any stretch because throughout my career, I've dealt with micro and macro aggressions of many kinds. This started in training. “You're only here because of affirmative action.” Then I'm an HIV provider. “You're valuable in this space because you're black and the patients are black.” Gee, thanks.

And then there's the common, “When's the doctor coming in?” 20 to 30 minutes after I've been doctoring. I mean it's just like what? So it's not surprising that I'm anxious. I'm anxious about this. I'm anxious about how my work plan is going to be received by my colleagues.

Let me walk you through one example. So it's a typical work day I'm sitting in my office and there's a knock on my door. One of my colleagues who I'm friendly with, very friendly, asked to come in and run something by me.

We're chatting. Everything's chill. And somewhere in the middle of this conversation he jokingly says, “I wish I was pregnant so I didn't have to work.”

Huh? I mean, who says that? I'm almost looking around like, someone else heard that, right? But I'm completely caught off guard and I do what I normally do when I'm backed against the wall with these random-ass micro and macro aggressions that come with being a woman, being black, being an immigrant. I laugh.

I laugh along to hide the awkwardness. I don't want to be seen as sensitive. I don't want to be perceived as playing some sort of card. So I just laugh and wait until later in the day when I'm talking to one of my female friends and colleagues and I tell her what happened.

And I mean thank the Lord, she responds the same way. She immediately recoils and verbalizes her disgust. So I knew then I was like, okay, my reaction was valid.

And this is the sort of thing that made my insecurities flare as my new work plan developed over the coming weeks, because I would always remember the sentiment behind hurtful comments like that. Not to mention I'm isolated now, right? I'm working from home so I don't feel like I'm on the front lines. I don't feel like I am and that sucks, quite frankly.

That was short-lived, though, because nothing could be further from the truth. That phone, it was something else because it rang day and night. Everyone wanted a test. Everyone believed they needed one. And they were pissed. They were highly frustrated. They were angry and they were scared for themselves and for their patients and so they weren't always nice about it.

I only had a handful of tests to approve a day but people were coming in from everywhere with symptoms or believing that they'd been exposed. It was a nightmare. And as the pressure mounted and the calls kept coming, I wasn't always the most patient. So I realized very quickly, very, very quickly that I would trade my old schedule in a heartbeat. And that quite frankly, I am on the frontlines. Bump what you heard. I'm on the frontlines.

I'm also doing telemedicine, though. It's not just this phone. I'm writing grants. My research kept going. I'm writing policies for the Division of Medicine and there's countless other Zoom meetings that I'm a part of. So those two months, some of the hardest of my career.

I'm not sleeping. Every day I can hear my toddler and nanny running around the house and I can't be with her because I have to work. I hurt. My back hurts all the time because I have the biggest belly known to mankind at this point. And I'm uncomfortable so this was hard. I mean, there's no way to put it other than this was really, really tough.

And I don't feel comfortable talking about it with my peers or my supervisors. It's one of the really ugly realities of being the only black physician in my department is that I don't have the same shared experiences as everyone else so I don't always feel comfortable talking about things. Certainly not things like this because I've been counseled before not to complain because I'll be seen as an emotional woman. And if I talk about it, I'll be seen as a problem. And you can't do that as a black person so I just put my head down and work. Work harder.

Then finally, the oasis of pure joy came in the middle of all of this. On May 16, 2020 at 2:00 a.m. I feel fluid between my legs. You'd think it would be obvious but no, not to me. I panic. I'm in denial. You know, you wait for this day for nine months and then it comes and you're like, “Hell, nah.”

I wake my husband up and he says, “It's time to go. Let's go. It's go time.” Still in denial over here. So he's like, “Please, just call the hospital. Speak to a doctor. She'll tell you or he'll tell you it's time to come in.”

So this poor woman on the phone at 3:00 a.m. is trying to tell me, “Yes, ma'am, you should… yes. Let's, yes, get in the car.”

I'm like, “Okay.” But as soon as I get off the phone, Google. And I'm like, “But babe, look at these articles. I could stay. We have time.” Ridiculous.

Mati, with her two beautiful children!

Anyway, finally about an hour later, I hop in the shower, check our go-bag and drive myself to the hospital while Jesse, my husband, stays at home with Aneni until our babysitter can come to be with her.

It's so hard to describe just how incredible of an experience this day is for me because literally from everyone, from the administrator at the front desk to every nurse on every shift with me over the next 24 hours are just the kindest most positive people. I have the most peaceful experience.

And I have to say, Dr. Philpott had my back and he fulfilled a promise that he made to me weeks ago. It was Black Maternal Health Week and I'd been flooded with statistics about black women dying from childbirth and pregnancy complications left, right and center. I'm sitting on the edge of my chair in his office. We're speaking. It's the end of the visit, the part where he's like, “Do you have any questions?”

And I'm insecure. I don't want to talk about it. Me and him usually have a very light, joking banter and this was serious for me. This was scary for me. I sit there and I look him in his eyes. I have tears welling up but I don't want to cry, and I tell him. I tell him everything I've been reading. I'm telling him about how black women are dying at these higher rates than white women and how scared I am that will be me.

And he listens. You guys, he just he's so good, man. He listens. He looks me in my eyes and he simply says, “I got you.”

And he meant it, because on this day, on the day that I got to have our baby girl, he came in from home on his day off, joking and laughing, and walks in the room and I think he could see Naniso's head literally there and he's like, “Oh, shit. Let's do this.”

And three pushes later, like a G, she comes out. It was incredible. It was smooth. It was beautiful. I was filled with gratitude.

Mati, with her whole family.

So we submerge ourselves into our new normals as parents of two. I've got a three-and-a-half old and I've got a newborn who chows every two hours. I mean she doesn't miss meals, guys. It’s every two hours. So I didn't think that anything could rock me from this bubble that we were in.

And then George Floyd happened. I couldn't watch at first. I'm not going to lie. I was like, no. I'm not watching. You can't keep doing this to black people where we just continue to have trauma after trauma after trauma. And on top of that, I've just had a baby. Can I have this moment. Like come on, man. No.

So I'm not watching. And I didn't trust it. I didn't trust it to be more than pain on behalf of the black community again, meeting this fleeting righteous indignation with the selfies and the hashtags. Nah, man. You can keep it.

But as the days mounted, the movement intensified. The protests grew and they spread across the nation, across the world. I couldn't believe it. It was different this time and I can't tell you why. I don't know if it was the visual, if it's the knee on the neck, if it's the pandemic. I don't know. Maybe it's all of it.

But I do know that one night I put Naniso down. She's beautiful. She's peaceful. She's in her crib and Jesse is sleeping next to me on the other side and I pop them in. I pop the headphones in and on my phone in the dark I watch it.

I watch in horror for 8 minutes and 46 seconds as a black man is murdered. Murdered in broad daylight. I feel sick. I feel sick to my stomach. I'm sad. I'm scared. I'm pissed. I mean, what the fuck? And I'm tired of this shit. And I feel hopeless and I can't go back to sleep. I just lay there until two hours later Naniso starts crying again to be fed.

It's that day that I was done. I found my voice. I stopped questioning myself. I stopped questioning the validity of my experiences in society as a black immigrant woman. No more. I'm going to speak out against injustice, against systemic racism that's impacted my professional and my personal life for years now, about my very valid experience. Because my voice matters.

That's what I know now. Because black lives matter. And because who I am and what I bring to the table, they all matter. We need to hear these stories from people that look like me, people that sound like me. And as much as this isn't easy for me, being exposed, being vulnerable in this way, I won't be the extroverts’ extrovert anymore that just laughs along through micro and macro aggressions. I won't do it.

What I pledge to myself today is that I will use my voice to tell my stories. Stories of strength and of pain and of vulnerability and my truth.

Story 2: Myra Kunas

Memorial Day in Minnesota signals rebirth after a long winter and, really, just something to look forward to. And this year of COVID is no different. But I find myself spending Memorial Day working in the lab, building yet another multi-million dollar budget to help my public health labs’ response to COVID.

Myra Kunas has been the interim lab director for the state of Minnesota Public Health Lab since May 1, 2020. She has worked in private and public labs since obtaining her Masters of Science degree in Earth and Ecosystem Sciences from Tulane University.

My 10-year-old son has joined me today to help assemble COVID collection kits by stuffing Ziploc bags with cold packs and it feels wonderful, absolutely amazing to have him working by my side after so many distracted and distant hours since this all began.

So, hi. I'm the interim director at the Minnesota Public Health Lab. I took over this role when my former boss retired at the end of April. And Minnesota's first COVID case was reported on March 6, which just happens to me my birthday, so happy birthday to me.

My first month as director has already been the biggest, most unpredictable challenge of my professional life. But in this moment with my son, I feel really good, almost like confident and strong that I can lead my division through a pandemic.

A few hours after my son and I wrap up our work, George Floyd is killed by Minneapolis police 10 miles away from my lab. The video of the killing hits social media the next day, followed by local and national news reports. I read the reports but I can't bring myself to watch the video. I can't watch another black man die for no reason.

My family and I regularly drive past the memorial where Philando Castile was killed by police a few years ago and it's heartbreaking and frustrating to realize how little has changed while I feel so much has changed for me.

The protests and memorials for George Floyd quickly begin to spread across Minneapolis and Saint Paul where my family live. Two nights after George Floyd is killed by Minneapolis police, the unrest escalates to riots, looting and multiple building fires in Minneapolis, three miles from my house.

The next morning, the helicopters and sirens are just constant at my house as we all tried to just remain calm and focused on school and work.

Just after one, I get a message from a co-worker that says a mob is heading to the capitol, which is a block away from my lab. I take some time to make some calls and confirm that, really, it's actually quite quiet on the capitol complex, which momentarily calms my nerves. But then less than 30 minutes later, my deputy commissioner calls to ask how fast I can get everyone out of the lab.

Capitol security is reporting that riots are starting in Midway and the crowds are heading to the capitol. If staff stay, their safety cannot be guaranteed. I tell her after everything my team has gone through, the long hours of manually processing COVID samples seven days a week, balancing work, our new normal, a statewide shutdown, school closures, separation from those that we love, I just cannot put them in harm's way. Of course we can shut down.

I don't even know why but I tell her that I live really close to the Midway shopping area and she immediately says, “Get out of there. Do you have some place safe to go?”

And you know those moments when your heart starts beating so hard you can't hear or think? When she told me to get out, I didn't really hear anything after that.

My husband and son pack bags to head to our friend's house in the suburbs while I communicate the shutdown of the state public health lab during a pandemic four weeks since I took on the interim lab director job. Almost everyone was able to shut down and get out in 45 minutes. A few refused to leave. They're so devoted to getting testing out the door and I told them just leave before dark because there was no way in hell I was going down to get them out of there.

A photo Myra took of a boarded-up shop in St. Paul.

We decided to keep the lab closed until Monday. We've never closed for three days straight, not even when our lab flooded six years back. The rest of the day is spent talking with my division leadership about a response plan, keeping up communications and trying so hard to answer all of their questions. What if nothing actually happens? Who made this decision to evacuate? And on and on.

At some point, on one of the calls I realized my hands are shaking and I can't take enough deep breaths to make them stop. My friend pours me a tumbler of whiskey and I toast one of my teams over a video call as I take a drink with shaken hands.

Meanwhile, my husband and son are talking about what's going on back home. My husband is fixated on Twitter, updating us on the situation. My son has questions about why looting and burning would be part of a protest. We tell him that sometimes when problems have been ignored for so long, people need to resort to more violent measures to get their voices heard. As bad as the destruction seems, buildings can be rebuilt. People like George Floyd and Philando Castile cannot.

I finished my day just after 10:30 and my mind just won't stop spinning between the news and work and the sheer guilt of not being there with my neighbors, but eventually I do fall asleep just out of pure exhaustion.

The next day feels like a cleanup day at work. We go back to our house. No violence made it to the capitol, but both Saint Paul and Minneapolis burned the night before. The looting came within four blocks of our house. There's smoldering buildings all along University Avenue. The Chinese restaurant that we got take out the week before is destroyed. The Turf Club, the music venue just up the street where we spent countless date nights, was looted, set on fire and then flooded when the sprinkler system went off.

Curfew is put in place and the National Guard is deployed to the city streets and the capitol complex specifically. Everyone in Saint Paul and Minneapolis are preparing for another night, boarding up the storefronts, posting signs “Locally-Owned, Black Lives Matter, Black-Owned.”

The National Guard caravan of sand-colored military vehicles rolled down University Avenue and it felt and looked just like New Orleans after Katrina. As curfew came, I stood outside on my front yard with my neighbors as we shakenly just made small talk to pass the time, and then suddenly, it was just quiet. For once, it was quiet. But I was scared for me, for my city and for my staff.

Monday morning I returned to work, the building which shares the loading dock with the National Guard armory and so there's literally military vehicles outside our back door. There's concrete barricades all around our building, countless armed guards stationed throughout the complex, including snipers on all four corners of the armory roof. And at some point, the National Guard blockades the streets next to the building, which makes my team really uneasy.

A photo Myra took from the window of her lab, showing military vehicles outside and a sniper on the roof.

As crazy as it sounds, all I wanted to do is tell my staff to just work and stop worrying about the military, but that's crazy and I didn't do that. One of my leaders comes to my office and asks if I know what's going on. I have no idea what's going on, but I say, “I don't know. Let's just go ask them.”

I grab my mask and we head up the sidewalk, and as we get closer and closer to a man and woman in full fatigues holding rifles, I can feel my body just wanting to run back to my lab door. I don't want these people and their guns here. I don't want to go ask them what they're doing. But my team is scared and this is the only way I know how to get some sort of answers, so I continue.

When I ask about the change in position, the guard seems to not even understand the question, as if randomly barricading a road is just normal. As she struggles to hold multiple lunches in Styrofoam containers, chips and a rifle, I realize we are all just doing the best we can in the jobs we chose.

I walk back to the lab and tell staff that it's all going to be fine. The military are there just to help keep the peace. I don't know if I believe it myself, but I say it over and over again.

I'm the boss of 150 people and I've been the boss for exactly one month. I need to be there for my division and my family when they're scared. I can tell them what I want to believe even when I'm scared too.

I don't know what's coming next. The summer is almost over. COVID is showing no end in sight and systemic racism continues to live on. I continue to have hope for change that needs to come to Minnesota, for black lives in our community. But what I do know is I'm so much stronger than I ever believed and I can do this.