Life Under Quarantine in Città Della Pieve

Quarantine, Day 17, March 26, 2020

Dashboard

Città Della Pieve

COVID-19 Confirmed Cases – 15

COVID-19 Confirmed Deaths – 1

Italy

COVID-19 Confirmed Cases – 80,539

COVID-19 Confirmed Deaths – 8,165

COVID-19 Recoveries – 10,361

It was Chianti’s third birthday yesterday.

Happy Birthday Chianti!

I wanted to throw him a party but didn’t because I knew that all he wanted was to be able to defy social distancing and wrestle with the dog in the valley beyond the closest exit from the city walls. He keeps pulling me in that direction when we go on walks. Then he implores me to let him visit through modulated and increasingly audible whines that are almost heart-breaking.  I decided to put off a proper birthday feste until I can invite his dog friends for some truffle’ d beef cupcakes and a great big romp in the public park – after quarantine is lifted!

As we enter the third week of quarantine, Prime Minster Giuseppe Conte has further tightened restrictions for the second time in the last 48 hours. Fines that were 206 Euros jumped to 3000 Euros for breaking quarantine. In Red-zone, Lombardy, the fine for gatherings of more than two people at one time is now 5000 Euros! Sicily essentially closed off to the mainland cancelling all ferries and flights to isolate and contain the virus.

To my right, in the bedroom, is my noise machine emitting the sound of rolling waves.  I used to turn it on only at night to help me sleep, but now I leave it on all day to calm my nerves. COVID-dread is my constant companion. The sound makes me think of the beach. I first started using a noise machine in my apartment in Alexandria, Virginia, to drown out Jim’s snore and to trick myself into thinking I was on vacation. I got addicted to it. I also liked the fantasy fulfillment it provided. When I hear the waves, I think I own a beachfront home that otherwise, I could never afford.

To my left, outside the door of the apartment, I can hear the wind whistling loudly. The duet symphony of the waves and wind sound like a nor’easter. I could be back on the Atlantic Coast during hurricane season. I’ve been out with Chianti. We did our morning walk, a shorter one than usual because the wind was relentless. It was just too hard to put one foot safely in front of the other. We had to hug the ramparts for protection. It’s not snowing today like it was last night. The sun is out, but the gusts are violent. I was not motivated to go out. It was very cold. I didn’t see another soul in town.

Crazy wind on the walk

When I left the apartment to carry my garbage to the depot behind Città Della Pieve’s massive K-12 school complex, the wind caught the plastic bag full of water bottles and it ripped. Plastic bottles flew everywhere.

On the way back home from the dog walk, I noticed the flags at the entrance to the school pavilion tousling madly in the wind. The European Union flag was tattered at the edges, but it flew freely, intact, a dark stamp of blue and yellow against the lighter blue of the sky. The sliver of the Italian Flag was only periodically visible, twisted as it was around the flagpole. I noticed that the lines used to hoist it had strangled it. Only the green tertiary portion of the Italian Flag was visible. I then noticed a tiny tail of red that waved angrily and made a racket whipping against the flagpole. Was this in protest of Italy’s plight, I wondered?

Because of the time difference, I call my friends who are marooned in Australia quite early to catch them. They can’t get back home to Città Della Pieve. They are stuck down under because L’s father lies inert, but still living, in a hospital bed. Back in England, R’s uncle has died of COVID-19. He died in less than a week in London Heart Hospital. After two COVID-19 tests administered at the hospital came back negative, the uncle who had had quadruple bypass and pacemaker six months ago, died after one week of complications related to COVID-19. He was 80 years old. R’s parents were made to wait in the car park during the entire process. They were unable to see the uncle. A hospital administrator called to tell them when the uncle died. R told me his parents were devastated and shocked, “You’d think there would be a window they could look through or something. That was a week ago, just at the start of it in the UK.” I point out that the contagion is so bad that countries have learned from the mistakes of what was initially allowed in Italy. Compounding the emotional context, R’s mother is very ill and now stuck at home in the UK. She has stage-four lung cancer and a kidney condition. They have a caregiver who comes daily three times a day to feed and care for them. Family members also bring them food that they leave in the garden. They can’t leave their home for any reason. They have no contact with anyone except the caregiver. L’s father, who was dying a month ago, which prompted R and L to leave Italy in February to fly to Australia, has stabilized; he will die, but it’s a matter of uncertainty when, at this point. Hospitals in Australia need to clear space for the tsunami of COVID-19 patients that they are expecting. So, L’s father will be transferred to a hospice facility for the end of his life whenever that will be. L’s Australian-displaced-Italian-origin family will not be able to visit “en masse” like they did in the other senior facility before L’s father almost died. In the facility where he is headed, visits are limited to one at a time. In Australia, the measures have not reached the Draconian levels that they have in Europe and the United States, where no visitors are allowed at all in senior care facilities to cap the spread of COVID-19 to employees, health workers and residents.

Dr. Maggie Mulqueen, PhD, Psychologist, of Brookline, MA was interviewed on the PBS Newshour on Sunday, March 23, 2020. During the broadcast, she covered the subject of the plight of the aging population, those with mental health issues and domestic abuse victims during the Coronavirus Pandemic.

Dr. Maggie Mulqueen, PhD, Psychologist

She opined that the most dangerous enemy of aging is a lack of purpose. Purpose is what increases our self-esteem. Without it, we turn inward and isolate. Simple daily tasks demonstrate “purpose.” Making one’s bed, washing the dishes, cleaning one’s home, and keeping up personal hygiene are all examples of simple “purpose.” If these small daily tasks are not performed, it is a non-negligible danger sign.  She suggests video calling instead of audio calling to check on loved ones to verify personal hygiene and home conditions. Imposed isolation is a byproduct of social distancing for people who live alone. This is not only true for the elderly, but for anyone who has been forced to isolate alone, at any age. The more people are estranged, the more the lack of purpose is accentuated, and the more loneliness is amplified in their lives. This is particularly true for the elderly and the depressed. For this reason, it is critically important to connect with older loved ones – and those who suffer depression from loneliness – during this pandemic.

To lessen the burden on an over-taxed health care system, whether that be in the United States, Europe or Australia, it is important to alleviate undue stress on the system. If we can dissuade our loved ones from overreacting to what are often non-life-threatening emergencies to free up the health system for the growing weight of COVID-19, we have done a small, but significant, part in helping. Sometimes the elderly raise a red flag solely because of a feeling of isolation, real or perceived.  I explain….

V’s mother, 83, suffers from acute depression and wild mood swings, a by-product of a form of Parkinson’s and a lifetime of mental illness. V’s father is primary caregiver. He is a robust 82 -year-old who continues to work, volunteer and exercises regularly. However, the emotional toll of dealing with a sick wife who is bed-ridden and depressed is taxing. V equates her father to a saint. He has the patience of Job. Since V’s mothers’ condition is accompanied by paranoia, she fears her closest kin, her husband. She threatens to call 911 regularly. Recently, she called 911 to report a life-threatening situation. She reported that she feared her husband was going to harm her. She feared for her life. The paramedics arrived. They must heed these calls because it is the law; they must respond to a 911 call. However, many of these calls signal distress. When they come from elderly people who are either extremely lonely or fear being alone, the calls are frequently bogus. In this case, it was a blessing. V’s mother was suffering an ITU urinary tract infection that was serious. She was hospitalized and subsequently transferred to a rehab center. Now she can’t leave and can’t receive visitors because all rehab and senior care facilities are on lock-down and not allowing outside visitors because of the Coronavirus Pandemic. The risk of virus propagation is just too high. V’s mother now blames the extended family for her “prison” sentence.

Marguerite, Jim’s late mother, lost her husband, Bill, 25 years before she died. They had lived in Beach Haven, NJ in a house by the Bay after buying a business there and moving from Arlington, Va. Marguerite then lived with her older sister, Loretta. They shared a house in Mclean, VA., minutes from Jim’s law firm at the time. Loretta felt out of sorts one night and went to bed early. She suffered a heart attack in her sleep and died. It was a big shock for Marguerite as they had been living together for 8 years.  When Jim was first married and his girls were young, Marguerite was a frequent babysitter. She saw her granddaughters up to several times a week and participated in their upbringing. She moved to Old Town Alexandria, where she was just minutes from her granddaughters. There, she was close to Natalie and Hadley, and of course, her son, Jimmy. But once the girls left the DC area, and moved with their mother to Texas, after the divorce, Marguerite’s life changed. She lost her purpose and loneliness set in. She started relying more and more on her son, Jimmy. When Jim re-connected with me, Marguerite started to rely on me as well. As she aged, her asthma was aggravated by panic attacks. When she became very panicked, she would reach for her inhaler, but would not use it correctly or would be too impatient for it to soothe the asthma attack. She started to call 911 on a regular basis. There was one week during which she called 911 four times. Four nights, Jim and I, or Jim, alone, ended up in the emergency room. A friend from his old neighborhood was chief physician of the ER at Alexandria Hospital. Jim recalls seeing more of him there than he had in all the years he’d spent in the neighborhood. Marguerite was on a first name basis with the paramedics.

My mother used to threaten calling 911. She resorted to emotional blackmail with me in the last cognizant months of her life. My mother and I were incredibly close. I can say now in hindsight that she was my most steadfast friend. She was always my best friend, but after she died, I realized just how much she was my everything friend. The hole in my life she left will never be filled. However, the blackmail she levied on me at the end is not forgotten. I had moved back to the United States from France where I had a very good life because she was sick with Parkinson’s and Alzheimer’s. It had become too much for my father to handle alone. I was the only one who could help. I never regretted it. I’m happy that I was able to reconnect with my parents and be with them again on a daily basis after a 20-year hiatus, at the end of their lives. My mother had suffered from my long absence acutely. When Daddy passed away from lung cancer very abruptly, I became the sun of her solar system. It was suffocating at times, and wrongly, I felt strangled and wanted to escape. I suppose I resented her for the weight it levied on my life, for all the sacrifices I had to make. But while I felt those emotions inside, I was overwhelmed with love for her and a determination to keep her alive and feeling as comfortable, safe and as happy as possible. Conflicting emotions were pulling at me like riptides before a hurricane. I was with her at least three hours a day. Often, I’d spend the night. She never called 911 herself. The caregivers I ultimately hired did many times and the reasons were always justified. Mumy did get emotional mileage out of the 911 calls however, attempting to bank pity from the one daughter in her arsenal, the one blood relative whom she could hang on to as a lifeline.

My father died nine months before my mother.  I was primary caregiver to both parents before my father died. I hired a qualified, live-in elder-care nanny to live with them. My father was difficult with the two ladies that alternated shifts. He hated having strangers in the house. After some jewelry went missing, both ladies were replaced even though we were quite certain of whom the culprit was. This incident felled both parents, especially my father, who had lung cancer. He felt emasculated by it. He also became sicker and visibly aged. He died a month later. Even though he had never been an easy man, my mother felt very alone with him gone, even though she adored her new “nanny.” I hired my cleaning lady to take over. While this doesn’t sound like it was a wise decision, I am convinced that Emmy was an angel sent from Heaven (and I have a complicated relationship with Heaven).  The relationship was mutual. Emmy’s brother drove my mother to the doctor, Emmy did basically everything else, but I was still present every day, once in the morning once at night. The three of us often had “meals” together. My mother didn’t eat actual meals, she grazed on Ensure, apple sauce and the occasional piece of cheese. She never drank water even though she was dehydrated. She drank orange juice with a splash of cranberry, tiny sips; a small glass would last the entire day. Usually she drank out of the same glass, one that was blown glass with stripes of overlaid glass piping in the form of flowers and reeds. I still have that glass. It was her favorite glass.

I have several relatives who are elderly. One, my Uncle Pierre, who is in his nineties, has excommunicated me from his life because I was not a good enough niece.  I didn’t communicate enough with him, so he chose to exclude me from his life entirely. It makes me very sad because, growing up, he was my favorite uncle. I fear he will die not having accepted a call from me in the past two years. And then there is Patricia, with whom I am very close. I have been a very bad correspondent with my cousin, Pat, too, since I’ve been in Italy. Life gets in the way and priorities are compromised. Pat is my mother’s first cousin who lives in Washington D.C. She’s in her eighties. My mother would have been 100 on her last birthday last November. Pat was the last of her generation, a tiny tot when my mother was a young woman in Paris during the Second World War.

Pat is French, but she was whisked off to Switzerland for most of the German Occupation where she attended boarding school and lived on holidays with my grandmother and her mother. My maternal grandmother was responsible for Pat’s education. She has lived in America for eons, from before I have active memory. I don’t remember a family Christmas without her. She gave good presents and never asked me the same stupid rote questions that my Uncle Richard asked over and over during the interminable holiday family dinners.

When my mother became very sick, Pat visited her regularly on Sundays. She would sit for hours with Mummy and talk even though some days conversation was so limited with my mother as to be nonsensical, even non-existent. Pat was present. I always loved Pat, but those last years of my mother’s life made me honor her. I should be a better caregiver to her, she has no other relative in America.  She’s so independent and self-sufficient that it’s hard to feel needed. Maybe that’s a cop out. I should be better about it.

Last year, Pat had a serious hip operation that had her out of commission for months. She refused medication because she’s strong and determined. She did not want to become enslaved to a cocktail of pharmaceuticals like so many of her peers. The pain medication she refused might have made her road to recovery less bumpy, but she chose to grit her teeth and take the pain.

When Pat was back on her feet, she started taking walks around her neighborhood in Northwest DC concurrently with her physical therapy. She’s an unbelievably strong person. She was in a hurry to get fit again to start playing croquet with the team she’d missed so since she’d been laid up. As she was crossing Wyoming Avenue, at the crosswalk, on the corner of her apartment complex, a car made an illegal turn and hit her. She was knocked to the ground and a portion of her calf was torn off. The driver sped off. Luckily, it was during the day and people on the opposite corner came to help her. She was whisked to the hospital and underwent surgery. She has since recovered and is now in Florida. For a month she’s been playing croquet daily with her teammates. She tells me the game has “social distancing” built in. They are on a field that has the dimensions of a tennis court.

Tomorrow, she flies back to Washington. I worry about her. I tell her to tie a scarf around her face when she flies tomorrow. She must protect her nose and mouth on the plane.  She had a hell of a time finding a flight back. Flights are fewer and planes now fly half-empty to space passengers at an appropriate distance. I still worry however since planes appear to be one place people are catching the virus.

Dr. Mulqueen urges loved ones and friends of the elderly or socially isolated to do video calling or facetiming. In this way, one can monitor day-to-day living habits of those we love. Any change in habits is a red flag when one is forced to live in isolation. Since social media affords one a window into loved ones’ homes, it is best to use the new technologies at their optimum visual capacities

When we retire or are forced out of activity due to aging or job loss, we no longer have children to care for or jobs to occupy us, isolation ensues. The isolation causes a lack of purpose. This happens primarily among older people, but not only, and is amplified and multiplied by itself. During this time of imposed isolation, those of us who are not elderly or prone to depression are better equipped to feel empathy for those who are.

Another cause of depression in the elderly is a lack of touch. Since most eldercare facilities in most countries have been closed to visitors since outbreak of COVID-19, residents are suffering acutely from a lack of touch. The best antidote to touch in these times are virtual visits via social media.

Dr. Mulqueen is most concerned about an uptick in domestic abuse during this time of social distancing. Since most cases of domestic abuse are detected at school by teachers or other parents, she worries that many cases of abuse of children and spouses will go unnoticed – and possibly for quite some time. Only at the end of the crisis, will we realize the full scope of the abuse that certain victims may have endured.

And now it’s time for dinner. Tonight, I’m fixing fettucine with truffle sauce. yum.