It was mid-March when the games stopped. Seasons were cancelled, events were postponed, what we had come to think of as untouchable totems of our schedules were felled by something barely 100 nanometers wide.
Those changes did – or they should’ve, at least – put into perspective the place that sports hold in our society. Wonderful as they are, the pandemic rendered them rightly secondary, to health and safety. Cheers were reserved for healthcare workers as they changed shifts. Home bandwidth shifted from streaming sports to remote schooling. Everything – everything! – became a Zoom call.
The interruption by the COVID-19 pandemic forced us to reconsider which aspects of sports are most valuable. When it was safe to return, what would we prioritize? What about the experience was most important to preserve?
In a year of diminished competition, and a year in which the importance of competition diminished, it would be disingenuous to reach the end of 2020 and assume we could do what we normally do: Pick a Sports Figure of the Year, as we have annually for some three decades.
As we truly appraise what about 2020 was important, the answer is not a player or a team. Instead, we want to use this space to tell different stories. Our survival in 2020 was due to millions of healthcare workers, in roles we may not even have known existed last year. Many were once athletes, the skills they learned on the field or court still serving them in a much more dire battle. The following are their stories from a harrowing year.
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The metaphor, when Louis Argentine deploys it, rings truer than most.
“We’re almost like the leadoff hitter,” Argentine said. “We’re the first person to step into the batter’s box and start the game. We’re the first person to see those pitches.”
Argentine has stepped up to the plate, literally and figuratively – first, as a baseball standout at Garnet Valley and then Ursinus College, now as an emergency room doctor at Chestnut Hill Hospital. The second baseman was a table-setter on the diamond. Years later, his leadoff position applies when someone visits the ER.
With the powers of retrospect, Argentine figures that COVID-19 arrived in his corner of Philadelphia sooner than anyone knew. He spent February waiting, working normal shifts as the pandemic raged in China and then first crashed ashore in American cities like New York and Seattle. Cases then that were flu-like may have been COVID-19, thought testing capacity didn’t allow a definitive diagnosis. But by mid-March, as civilians bunkered in at their homes, Argentine’s ER ramped up for the first wave.
The caseloads have ebbed and flowed since. Argentine’s job is inherently unpredictable. Anything can walk through the emergency room doors … like say a respiratory disease that homo sapiens have no history with and modern medicine has no record of. So while Argentine called 2020 “challenging” on several occasions, that reality was imbued with a certain professional inevitability.
“For an ER doc, it’s kind of been business as usual,” he said. “This is what you train for. You’re ready for these unpredictable things. You’re ready for pandemics or these surges. It’s why you go into this field. You certainly don’t want to see anything like this, but it’s why a type of person goes into this.”
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Where some only hazard guesses at a fuzzy start date for their pandemic experience, Maureen McQuade’s is rock solid. On Saturday, March 9, the respiratory therapist at the Hospital of the University of Pennsylvania received a call her team expected but still feared. A patient with respiratory distress, low blood oxygenation, who tested negative for the flu – this was HUP’s COVID-19 patient zero.
Whether or not a COVID test yielded a positive, waylaid by disastrous early delays in testing nationwide, they would be treated as such. Which meant … well, McQuade and her colleagues didn’t quite know.
“The first thought that goes through your head is, oh crap, is he positive?,” said McQuade, a three-sport standout at Ridley and a Cabrini lacrosse player. “… Having the unknowns was so scary.”
At that juncture, mask mandates weren’t in place, the virus’s manner of transmission still under investigation. Despite no requirements to do so, McQuade donned her N95 masks and face shield, playing it safe on what was then a hunch and a dose of common sense, before admitting the patient.
Brittany Henderson’s first day of COVID-19-related work sticks out, too, if not as dramatically. The Ridley High grad (nee Bissell) who played soccer and lacrosse before a career in the latter at East Stroudsburg, is a nurse at Chester County Hospital. She does outpatient work with post-surgical cardiac patients.
On a Monday, that unit, which brings a high-risk population to a facility treating COVID, was shut down as too risky. By Tuesday, Henderson traded a stethoscope for a headset, manning the COVID call center. It was designed as virtual triage, helping the public determine if symptoms suggested coronavirus, trying to cut down on unnecessary ER traffic. Henderson, with other underutilized or elective specialties, shifted roles, connecting with specialists if they didn’t have an answer.
It provided Henderson a front-row seat to sample how the community absorbed the first wave of fears.
“The conversations were more questions than answers and people wondering, what symptoms are symptoms to be concerned about, people wanting to know if they should rush to the hospital,” she said. “It was a community being really scared and unnerved.”
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The objective realities of time and place have influenced the subjective experience of the pandemic. Where you are in the United States, by a complex combination of forces and demographics, informed when you encountered COVID-19 first. It may have influenced how the threat was perceived.
Emily Cliggett could palpably sense the switch flip. A former field hockey player at Villanova and Central Bucks South, Cliggett visited family in Pennsylvania in the second weekend of March. When she returned to work, as a registered nurse at Memorial Sloan Kettering Cancer Center in New York City, the world felt like it had changed.
“It was definitely a haunting feeling,” Cliggett said. “It was like, OK, we’re going to have to go to work, it’s time to put your love for the profession to the test, and now looking back on it, I think that has really helped me, and I think I’m in a completely different headspace and confidence.”
At the prestigious cancer institute in Manhattan, Cliggett works with immensely high-risk patients, essentially an ER nurse at Sloan’s urgent care center treating exclusively oncology patients. She feels lucky to be at Sloan, where the staff warded off the darkest days of the early spring, when waves of cases sparked horror stories as hospitals in New York City were overrun and tragically understaffed.
Cliggett, a 2019 Nova graduate, has colleagues with more decades of experience than she has years. But COVID-19 has had a leveling effect. The training isn’t in any books, nor in any long-ago drills she missed. It has humbled populations and inspired camaraderie, its pressure exerted on professionals of all ages.
“It doesn’t feel like I’m in this alone,” Cliggett said. “I know if my patient gets sicker, it’ll still be OK because everyone’d jumping at the first sign of any emergency to help, and we kind of owe that to COVID and these uncertain times because that’s when those people come together and reach out for a hand to help.”
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While Cliggett and her colleagues battened down the hatches, Chad Tarr found the opposite conundrum in his emergency rooms. Where, he wondered, were all the patients?
Tarr has practiced medicine in a plethora of places for two decades. From residency in Atlanta to the Indiana hometown of his wife, Swarthmore Athletics Hall of Fame swimmer Skye Fulkerson Tarr, Tarr has helmed ERs across the country. The last two years, he’s worked as a locum tenens physician, taking shifts in disparate, primarily rural, hospitals that are short on doctors and the resources to attract and retain them. In 2020, his work took him to eight hospitals, from Missouri to Georgia, dropping in for strings of three to five shifts, sometimes up to 24 hours, before moving on.
In these tiny towns – in Mexico, Missouri, and Bedford, Indiana – Tarr spent the early part of 2020 wondering where his routine cases were. Stay-at-home orders dampened the flu and cut down on car accidents. But what about the strokes? The heart attacks? Were people waiting, maybe dying, at home for fear of the virus?
Eight months later, the conditions have changed drastically. In his most recent shift, Tarr estimated that 60 percent of his patients presented COVID-related symptoms.
“It’s there,” Tarr said. “It took a while to get there … but it’s hit small-town America.”
Tarr, an All-Delco guard at Garnet Valley who played basketball at Swarthmore, has felt the shift in perceptions. It applied professionally to him, in learning how to treat the virus, how to identify its spread, particularly within essential workers. “We know how to treat it now, we know how to protect the patients,” Tarr said.
His travels have also shed light on how the epidemiological reality can skew. In one day’s work, he can go from lodging in a town that strictly adheres to mask-wearing and social distancing to grabbing lunch in a town where it’s a free-for-all to working in a hospital with rigorous rules, all in the same 10- or 20-mile jaunt.
“It can vary from town to town,” Tarr said. ” … If you went to different Walmart’s across the country, you’d probably see different levels of people adhering to mask mandates.”
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Before the questioning shifts that way, Cliggett has already hinted down the path. She’s a former athlete, as is the conceit behind the conversation. But that fact isn’t trivial, not is it set dressing to her professional career.
Her athletic past reveals itself eagerly. It’s in the progression of nouns she uses about the staff at Sloan Kettering, which has changed from team to family over nine months. It shows in the huddle Cliggett describes before that first shift in March. And it’s in Cliggett’s approach each day, not in a superficial way but in a deep, intrinsic way of grasping the world around her.
“I know most people don’t relate it back to being on a team, but that’s kind of where I’ve found my comfort zone, to be honest, because I’m so used to leaning on my teammates, seeking out my coaches for advice, whether that was high school to college, or going to my professors for extended help,” she said. “It’s such a close-knit group of who your friends are and who you live and breathe with every day, and you start to pick up patterns of one another. And especially during those first few months, you don’t have anyone else to lean on. … It seamlessly created this bond that I’ve noticed this entire life, whether you’re having a bad practice or a bad game or you’re not in the mood to show up for practice, you still have to be on, and that’s exactly what happened.”
A team approach to healthcare isn’t, unlike this coronavirus, novel. But COVID-19 accentuates the need to work in lockstep. Protocols and procedures have changed dozens of times as more information has accrued. The transmissibility of the virus means that everything a patient needs – bathing, feeding, transport, the choreography of keeping infected patients away from non-exposed groups – must be more precise. Those practitioners, then, must be on the same page.
That team isn’t just doctors and nurses, but dozens of ancillary roles just as vital to a patient’s long-term prosperity, within and outside the hospital’s walls.
Bridget Spayd knows the feeling of being what sports parlance might label a role player in this scheme, one no less important to the overall success of delivering top care. Spayd (formerly Cahill) and her husband Dan were athletes at Upper Darby, playing softball and lacrosse, respectively. They work with geriatric clients at facilities in Montgomery County, Bridget as an occupational therapy assistant, Dan as a physical therapy assistant. Their remit is getting elderly patients, either those discharged from extended hospital stays or in assisted living, ready for the physical and self-care challenges of living independently after a major medical event, like a stroke or fall and fracture.
“I think more now than ever, there’s a great balance between the nursing staff and the therapy staff and everybody,” Spayd said. “It’s a team approach – dietary, housekeeping. These people who are always like, ‘thank you first responders, and doctors and nurses’ … there really is really more to the team than those two positions. Everyone needs to do their job to give the best quality care.”
McQuade, the respiratory therapist at HUP, is in one of those positions that has come to the fore. Her department is in charge of the machines that keep the most critical patients alive, from ventilators to BiPAP breathing apparatuses. They oversee intubation and extubation of patients and have been at the forefront of implementing new techniques as treatment directives have evolved. McQuade delves into topics like prone breathing and virus aerosolization with a staggering passion.
Those threads converge at the notion of how much closer the nursing and respiratory staff have become during this crisis, a near merging McQuade she calls, “becoming best friends.”
“I’ve always looked at medicine as a team sport,” said Dr. Marina Zambrotta. “But what I think the pandemic has done, is it’s helped others see it that way.”
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Zambrotta faced something unfamiliar back in March. It just wasn’t the new struggle she’d expected.
The trickle of cases at Brigham and Women’s hospital in Boston had become a torrent. The Rhode Island native, who enjoyed a stellar softball career at Haverford College, was finishing her third and final year of internal medicine residency. COVID-19 was squarely in her department’s wheelhouse.
But the specter of the virus, the quantity and magnitude of the unknowns and their consequences, gave Zambrotta pause.
“It got to a point that I never really imagined seeing, which was starting to feel uncomfortable in the hospital,” she said. “I never thought I’d be scared to walk into the hospital and do the work that I’ve spent so long training to do.”
The reason was something McQuade knew well: Neither faced the pandemic alone. They did so while pregnant.
When McQuade fielded the call about HUP’s first COVID-19 patient, she was 12 weeks pregnant. Zambrotta was in her second trimester when case counts skyrocketed.
Their experience underscores a side of the pandemic lost in the graphs, the anger at restrictions, the tickers on network news that click over like macabre slot machines. The figures correlate to people: People dying, people working, people whose lives are irrevocably changed, people with hopes and fears … and families.
Every healthcare worker has someone they want to be around but can’t, for fear of infecting them. Argentine’s idea of normalcy is golf with his grandfather. Both Bridget and Dan Spayd contracted COVID, Bridget being asymptomatic and revealed only via an antibody test after the fact. Dan’s building hit a COVID peak in late spring, while one at Bridget’s facility was less intense and more recent. Henderson’s battle with COVID came in December, throwing her for a loop for seven days before recovering.
For Zambrotta and McQuade, their family situation urged professional tradeoffs. With knowledge of the virus’s effect limited and academic studies on expectant mothers nonexistent, what could they do?
The answer, though obvious to them, wasn’t easy. Zambrotta turned to virtual work, video-calling as fellow residents did rounds bedside while she consulted remotely and shifted responsibility to research and administrative duties. McQuade, with experience in neonatal care, shifted to the nursery unit (not that intubating pregnant mothers suffering COVID was much easier emotionally).
Zambrotta gave birth in July, McQuade in September, and both have returned to their original roles. But within the team context of their workplaces, the change weighed heavily on them.
“I had to sit there and watch all my coworkers battle this pandemic, and I felt so guilty that I couldn’t be right there with them,” McQuade said. “Being an athlete, you want to be there with your team. You want to help them fight, you want to help them win, you want to help them beat this thing they’re up against. And I felt like I was letting my team down by not being there. But I also have to protect this little thing that’s growing inside me.”
“At first, I felt guilty for making that decision, especially seeing how emotionally and physically burnt out my colleagues were at the height of the pandemic, just going in day after day and being so overwhelmed not just with the death and the sickness, but being overwhelmed by the emotional burden of patients,” Zambrotta said. “… Initially, I felt like I should be there. This is why I became a doctor.”
The mental fatigue weighs on all sides, something that persists through the admittance peaks and valleys. Henderson, the Chester County Hospital cardiac nurse, sees patients two to three times a week for up to 36 visits, a long stretch to build connections. One of the biggest risk factors in heart disease abounds in the pandemic: Stress.
So in addition to the strictly medical aspects, Henderson is helping patients target the collateral damage of a changed world. That means helping elderly clients navigate Zoom, not just for clinical check-ins but so they can see loved ones. It means precision in cleaning and distancing at the rehab facility, not just so patients can get the exercise they need but the physical connections to others that we all require.
Spayd’s view is necessarily expansive, given occupational therapy’s holistic approach. Her building has been largely spared by the virus, but residents aren’t immune from the attendant challenges.
“It’s kind of combatting the depression and the loneliness that the residents are experiencing because they can’t be with their loved ones and their families,” she said. “I try to always look at the glass as half-full and them not being with their families, we kind of have to act like their families, where seeing them every day for eight hours a shift, having nurses and CNAs and therapists and activity staff members be in their life every day. I know we can’t take the place of their families, but it’s nice to know they have a lot more support and love on a daily basis than somebody who would be alone.”
When Zambrotta’s in the ICU, it’s, “always the bottom of the 9th with bases loaded and a full count.” The medical care she provides, minus the nuance of the virus, is materially the same now as before.
But her patients, especially lately, are increasingly young and otherwise healthy. Their families aren’t allowed in the building. Which means Zambrotta and fellow physicians aren’t just providing medicine. “They’ve taken on the role of the caregiver at the bedside, that just needs to sit there and talk, and it’s not even about COVID or talking about medicine or about how they’re doing, but it’s talking about life and talking about their family and making them feel more at ease, which is something that I’ve always tried to do as a physician, but I think now it’s needed more than ever because people are just so scared and alone at the hospitals,” she said.
Through all the challenges, the healthcare workers to a person shared another sentiment: Optimism. There’s a light at the end of the tunnel. Many have undergone the first round of vaccinations in recent weeks, allaying some of the risk on the job. And there’s a profound sense of hope for better tomorrows.
“I guess what I really want people to know is that even though your loved ones are away from you, there’s other people that are stepping in to take care of them and loving them,” Bridget Spayd said. “We’re all in this together and trying to get the job done and hopefully make it through this and come out on the other side a little better.”
