In the Midst of a Crisis, Our Actions Impact the Outcome

Posted by Andrea Altomaro on March 30, 2020
Spoiler Alert: This post discusses events in Season 9 Episode 1.
Ctm s9 01 005 used in andrea blog
Credit: BBC / Neal Street Productions

Editor’s Note: The opinions expressed in this blog post are solely those of the author.

A highly contagious disease is tearing through the city, spreading quickly from person to person, causing serious illness, and requiring health care facilities to be placed on isolation precautions or closed altogether for decontamination. People who aren’t showing signs of illness are found to be carriers, and must be isolated. Cases can range from mild to severe, even causing death. I never fail to be surprised at the similarity between present-day situations and the fictitious (but often history-based) storylines of "Call the Midwife."

Oddly enough, the day that I watched our season opener of "Call the Midwife" is the day that the first cases of coronavirus were officially diagnosed in my home state of Michigan. I couldn’t help but feel a bit unsettled as I took a break from reading through my hospital protocols and scanning through CDC guidelines to watch this episode, only to find myself deeply entwined in the storyline of the diphtheria outbreak in Poplar.

A major difference between our current outbreak of coronavirus and this diphtheria outbreak portrayed in "Call the Midwife" is that diphtheria is a bacterial infection, and can be treated with antibiotics. This doesn’t mean that it doesn’t have serious health consequences. The membrane that Dr. Turner first identifies in young Terry’s throat is a defining characteristic of diphtheria infections, and can lead to breathing problems, suffocation, or death. Heart problems and kidney failure can occur from diphtheria. 

Early identification, isolation, and treatment are necessary to help contain the outbreak and help those affected overcome the illness. Diphtheria bacteria, however, can live on dry surfaces for weeks, as Dr. Turner said. This is why quick identification of places that sick people had been was necessary, so that proper decontamination could be done. I appreciated that Dr. Turner acted quickly to contain those who were sick, shut down areas that were potentially contaminated, and worked to find the source of the outbreak. He didn’t downplay the seriousness of diphtheria, but he didn’t panic, either. He used the evidence-based information he had to try and help as many people as possible, while minimizing transmission.

Coronavirus, or COVID-19, is just that - a virus, meaning that there is no treatment available other than supportive care for people who become sick. A major concern is the transmissibility of the virus; coronavirus is airborne, spread through droplets when someone coughs or sneezes. It can be spread when someone who is carrying the virus touches their face, mouth or nose, and then touches someone else, or potentially a common surface that someone else will come into contact with. While many people will not become noticeably ill from the coronavirus, they may become a vector, or someone who can pass along the virus to others. 

The relative ease that coronavirus can be transmitted and the possibility of many vectors in the community is probably the main part of this current pandemic that has me carefully studying our guidelines, reading preparedness plans, and of course, washing my hands (and my kids’ hands!) regularly. We are also following all the guidelines for social distancing, because this is our only chance at stopping the fast-moving spread of the virus.

I could go on and on about important preventative measures for coronavirus, but I’ll refer you to keep abreast on the current guidelines and recommendations from the CDC and World Health Organization. Because this is a new virus, guidelines are changing frequently, and we are always learning new information.

Pandemic crises aside, I also found myself drawn into the story of Brenda Donnelly, the woman who is going through a crisis of her own. In a moment of panic, Brenda places her newborn baby in the rubbish bin outside of Nonnatus House. Whenever you hear about an abandoned baby, people may be quick to say, “I just don’t understand how someone could abandon their baby!” However, when someone is scared, desperate and alone, they may make decisions that seem extreme. 

Brenda has dealt with hardship all her life. She grew up an orphan after her mother passed away and was married at a young age to escape that life, and hopefully have a real family for the first time since she was young. However, her husband was abusive, and she found herself divorced and alone. Her pregnancy was not planned, and in a moment of panic, she placed baby Primrose outside of Nonnatus House, where she would be found by Fred.

The thing was, Brenda didn’t place Primrose in the bin because she didn’t love or want her. She was scared, and in that moment of desperation, she did the only thing she could think of. As the hours and days passed, I’m sure Brenda was aching for her baby until it was unbearable, and she had to go check on the infant herself, bringing the sweater as a gift.

All of Brenda’s life, it seems she was told she wasn’t good enough - that something was wrong with her, and that she was mentally ill. She had been conditioned to think she wouldn’t be capable of being a mother. The way that Trixie and Mother Mildred offered kind, compassionate care to Brenda, as well as fiercely advocating for her (especially while being bullied and gaslighted by the priest, Father Duncombe) really highlighted the kind of care that is the hallmark of midwifery. Trixie provided Brenda with a nonjudgmental listening ear, as well as the physical resources for these early days with her baby when Brenda had nowhere else to go. Trixie helped Brenda gain confidence in herself, that she could be a good mother.

The quote we heard at the closing of the episode struck a chord with me: “The gift is knowing that the present will soon pass, and that the way we embrace it has the power to change everything.” This can apply to so much, from our precautions and preparedness in dealing with a pandemic new virus, to meeting the daily challenges within our family or work life. The way we react and respond today shapes our future, and the futures of those around us. This reminder was quite timely, and I can’t wait to see what other life lessons this season of "Call the Midwife" has in store for us.

Get Another Take: Recommended Call the Midwife Recaps 
From | The British Tele Dish
From WTTW Chicago | The Playlist Blog
From NPT Nashville | The Vanderbilt University School of Nursing Recap
From WETA Washington | The Tele Visions Blog
From WGBH Boston | Watch Drama After Darkor Read the weekly recap

About the Author

Andrea Altomaro MS, CNM, IBCLC has been nurse-midwife since 2012 and is currently working for the Henry Ford Health System. Andrea knew from a young age that she was interested in pregnancy and birth, and decided to become a nurse. When she learned about the role of certified nurse midwives when she was in nursing school, she knew she had found her path.