- It's been four years since the pandemic swept the planet.

The cost was staggering and met head on by healthcare workers who faced sick and dying patients every day.

Today's guest was among them, and her pleas for the public to help in 2020 were unflinching, emotionally powerful and impactful.

She's Dr. Cornelia Griggs, this week on "Story in the Public Square."

(upbeat music) (upbeat music continues) Hello and welcome to "Story in the Public Square" where storytelling meets public affairs.

I'm Jim Ludes from the Pell Center at Salve Regina University.

- And I'm G. Wayne Miller, also with Salve's Pell Center.

- And our guest this week is Dr. Cornelia Griggs, a pediatric surgeon and author whose memoir of the pandemic, "The Sky Was Falling: A Young Surgeon's Story of Bravery, Survival, and Hope," is out now.

She joins us today from Boston.

Cornelia, thank you so much for being with us.

- Thanks for having me, it's great to be here.

- And congratulations too, "The Sky was Falling" was I thought powerful, emotional, triggered some memories that I think probably suppressed, and we wanna talk about all of that.

But let's start a little bit talking about you and what you were doing in New York City on the eve of the pandemic.

You were working there.

- Yeah, so I was a pediatric surgery fellow in New York City working at one of the busiest hospitals in the city.

And what that meant was I was at the tail end of almost a decade of training in surgery after medical school.

I'd already signed on with my dream job in Boston here at MGH, as a full fledged pediatric surgeon.

And I had about four months left to go, trying to balance the busy life of a pediatric surgery fellow with two little kids at home.

- What attracted you to surgery in the first place?

You call the operating room your happy place, but what was it that drew you to surgery in the first place?

- Surgery was the hardest thing I could imagine doing, and in some ways the scariest, and I felt like the humanity and the rush of adrenaline every time I felt when I stepped into the operating room meant that I would have a really rewarding and fulfilling life.

The truth is that when I went to medical school, I thought I wanted to be a primary care doctor, deliver babies, treat elderly people, do home visits, and temperamentally, I was just better suited for the operating room.

I love the rush of taking a problem and fixing it and being able to send a child home the next day with a totally different outlook on their life.

- That's remarkable.

So we're taping now four years after the events you describe, let's go back to that January-February period, before the pandemic really reached the United States.

How worried were you?

- I would say in January and February, mildly interested, but still of the belief that there was no way a global pandemic would unfold in the way that it did.

I'm kind of embarrassed to admit this, but as a former history and science major, my understanding and knowledge of the Spanish flu of 1918 was really minimal.

And I'd watch sci-fi movies like "Outbreak" about the idea of a global pandemic, but the reality of it still felt remote.

- Yeah, I think all of us, I think we all sort of got a graduate level training now in what a pandemic's gonna look like.

You decided, though, in the middle of that, to start keeping a diary.

- Yes, yeah.

- What inspired you?

- So I think something that was unique about my experience at the time was I was online a lot already and following international doctors on social media and keeping really close tabs on what was happening out of China.

And that is what first started to raise alarm bells internally.

And when I really started keeping a diary, I think the benefit of having that perspective of a history major is I could kind of feel that this was gonna be the black swan of my medical generation, maybe our entire generation.

- So Cornelia, as a staff writer for the Providence Journal, I covered the pandemic starting in January four years ago.

As the early days unfolded, and that's really the crux of your book here.

Obviously I was covering what was happening inside hospitals, but I was not allowed in, no members of the media, you point this out in your book as well, were allowed in.

So we were talking to people after they came home or we were Zooming or whatever, we were not physically there.

You were physically there and you decided to do a couple of things.

One was you wrote an op-ed piece for "The New York Times," from which the title of your book came.

Talk about that op-ed piece and what motivated you to write it.

- Yeah, I think what motivated me to write the op-ed piece was that I could see and feel that people around me and in New York City for the most part, were still not really taking COVID seriously or had the illusion that this was gonna be kind of a cozy little one week, two week stay at home situation where they would make sourdough and do crafts with their kids.

But I had the benefit of some background in media going into my medical training, and I decided to take on the lens of a reporter as I saw what was unfolding in our emergency room.

To get to my office every day, first thing five in the morning, I had to walk right past the emergency room, and each day I could see throngs of people growing and growing and coughing and sneezing and the look of terror and misery in their eyes.

And I knew that this was gonna be devastating, especially in a city like New York where we were crowded onto subways and a lot of living conditions in different parts of the city, were gonna promote really rapid spread of this virus.

And I was frankly terrified, but we were not wearing masks inside the hospital at that point, we didn't have reliable testing at the time that I wrote the op-ed.

And it was essentially a cry for people to take this seriously and to know that even if they weren't a doctor, even if they weren't working in the hospital, that they had a role to play in decreasing the spread of disease.

- Cornelia, I actually remember the op-ed when it appeared at The Times.

And I remember being partly terrified and frustrated that more people weren't taking it as seriously as you and others were telling us to take it.

What kind of response did that generate from the public?

- I think there was overwhelmingly a really positive response.

I mean, my faith in humanity was restored in writing that article, because I can't tell you how many people wrote to me from all over the globe, people started sending N95 masks from old construction projects in their homes, from all over the globe.

I even got one from a little boy in Russia who wrote me the sweetest note.

So I would say I wrote it from a place of real fear and alarm.

But I think kind of immediately after I wrote the op-ed, and as things started to rapidly shut down, the gravity of what we were facing started to hit people like a brick wall.

And on the other end of it, I truly was moved and inspired by the people who came together in support of our hospitals in New York.

- So your book, Cornelia, is organized obviously in chapters, and the chapters have dates.

And by March 20th, one of the titles of one of your chapters, by March 20th, your hospital, all hospitals across the country, indeed the world, are in crisis.

And at American hospitals, including where you were, PPE was in scarce supply or wasn't in supply.

You mentioned masks, masks were disappearing, or there weren't masks, or respirators didn't exist or there weren't enough of them.

How could that possibly have happened?

- Yeah, I was asking myself the same question.

How are we in the year 2020 and something as simple as a surgical mask has become hard to find in the walls of one of the greatest hospitals in the country?

And I think it was a real life-changing moment for me to realize how fragile our public health infrastructure was at that time, and how Ill-prepared we were even at a well-resourced hospital in New York City.

And it was an event that none of us were prepared or trained to handle.

I like to think of myself as a really competent, really well-trained surgeon.

Like I said, I did nine years of training in surgery, and that's after medical school, after college.

But I had had no real training in how to manage something that was the scale of a COVID pandemic.

And we were building the plane as we were flying it in New York.

And I think my lens as someone who had worked in media and had a background in media, my lens as a reporter, taking an interest in all areas of the hospital and my position as a pediatric surgery fellow also meant that I was working in the, you know, I'd float back and forth from the emergency department to the pediatric ICU.

I had friends in the adult ICU, I was all over the hospital all the time.

And so I got to see how quickly our ICUs were filling up, how devastating the situation was in our emergency department and had a front row view to all of it.

- So the impact on everyone from patient to visitors, there weren't visitors of course, in the early days, to staff was extraordinary and devastating.

You write at great length about numbers of healthcare professionals who left the field, either because they couldn't take the stress of what was going on with all of these failures to provide the correct equipment, or they were afraid of infecting family members and so forth.

You write specifically and repeatedly also about nurses as being frontline people.

Talk about that, talk about how nurses were and are the frontline people, obviously supported in working with many other professionals, including MDs.

- Yeah, it's my opinion, there was a lot of jockeying during the pandemic and after the pandemic about who was more or most front lines.

And it's my opinion that nurses were potentially most devastatingly impacted by the COVID pandemic.

They were the ones really in the room the most with patients, holding people's hands as they were dying when their loved ones couldn't be there, brushing their hair, being there for those final moments of terror when no one else was allowed in the hospital.

And the effects were profound.

These were nurses who were balancing children at home, who were doing remote school, who were trying to make sure that there was dinner on the table at night.

The amount that they were juggling and balancing while taking the brunt of the trauma at the front lines was extremely severe.

And I was really worried about my friends who were in nursing and especially in the emergency room and in the ICUs.

I think it's still for a lot of us who work in healthcare, even if you don't work in healthcare, it's hard to think about, talk about, and go back to those days.

But I don't think enough has been said about the lasting effects of the collective trauma that was experienced by healthcare workers and especially nurses, especially during those early days of the spring of 2020.

- You write also about disparities in terms of people of color, people living in poverty, essential workers who had to go to work and were earning $15 an hour, obviously all at great risk.

Talk some more about that.

I mean this to me really exposed a theme that we've hit before on this show, which is it's a two class society we live in, that's not the right description, but you know what I'm saying, many, many people just did not have the same opportunities and chances that some of the wealthier people who could leave New York City and go somewhere else and wherever.

Talk about that, that to me was such an important part of the book and your message and still is your message.

- Yeah, I'm so glad you took that away from the book.

It's a major focus and a major theme and one of the primary drivers that inspired me to write the book because I thought nowhere were the health disparities experienced by people of color more obvious than during the spring of 2020 in New York City.

We knew that there were health disparities before the COVID Pandemic, but the pandemic really pulled back the curtains for the American public at large in a very obvious way.

We lost so many people whose lives could have potentially been saved by a more robust public health infrastructure, better resourced hospitals.

And in New York, there were just deserts, neighborhoods where hospitals had been closing for decades.

And the difficulty of getting access to basic care during those early days resulted in a profound loss of life.

And I think we are still reckoning with that in the wake of the COVID pandemic at hospitals all across America, because a lot of hospitals took and continue to take a huge financial hit.

And we are still figuring out as a country how we're gonna right the ship.

And I think that is an urgent message that we can't talk about enough.

How do we correct health disparities that result in unfair rates of infant and maternal mortality, infectious disease, cancer screening, it affects all aspects of our health.

- Why can't we do better both now and historically?

This is the wealthiest nation in history, ever if you look at just wealth.

Other countries have figured this out so that they don't have these disparities.

So everyone has access to quality care and gets that care.

Look north to Canada, look across the ocean, the Atlantic Ocean, to England, or to Scandinavian countries, why?

Why?

- It's a loaded question.

- It is a loaded question, but it angers me, it angers me, it angers me.

- It angers me too.

I desperately wish that I had a simple and perfect answer for you, but the American healthcare system is so messed up and so complex, and I see that even working in it, and I say that with tremendous love for my job and what I do, but that anger at why aren't we doing this better?

How can we be the wealthiest nation in history but our infant and maternal mortality rates are mediocre at best compared to other industrialized countries.

And that's what inspired me to apply to the School of Public Health, and I'm actually working part-time to get my master's in public health, because it's my strong belief that if we have another health crisis in this country, on the scale of the COVID pandemic, hopefully not, but if we do, I wanna be better prepared from a leadership position to be able to influence the conversation about how we build systems and structures to protect people who are most vulnerable.

- One of the things that I think we all remember and you write about in the book is the way our institutions performed.

Whether or not we're talking about individual hospitals or we're talking about state and certainly the federal government.

Looking back on that period, how would you grade those institutions?

How did we do?

- I think that institutional leaders were trying their best, but we got a lot of the messaging wrong.

One of the most frustrating things in the beginning was how little we knew about how COVID was transmitted.

There were these kind of arbitrary guidelines about situations in the hospital, I write about this in the book.

Like you could be in the room with somebody who was COVID positive and you didn't need to wear an N95, just a regular surgical mask.

But if you were intubating them, then you needed an N95, or if you were doing some kind of suctioning.

And a lot of us were left wondering, are these the guidelines they're putting out because it's actually backed by science and we're starting to develop an understanding of how COVID is transmitted?

Or are they telling us we don't need an N95 because they quite literally don't have them?

And there was a lot of skepticism, and I think it not having proper PPE was a huge moment that eroded the trust of the medical staff who was working for those hospitals.

So the first time I felt as a hospital employee that my safety and my life was not being appropriately accounted for by my employer.

And that was a huge kind of crisis of consciousness for me as a trainee at the time.

- Well, and you linger in that thought very, very powerfully by comparing your experience and your preparation for this with a colleague of yours who had served in the US Air Force, I believe, and had been deployed into combat situations overseas.

Had you ever considered yourself going into harm's way by being a surgeon, by being a physician?

- Yeah, I'll be honest with you, I had never thought of myself as being prepared for battle by going into medicine.

And that was a question I grappled with a lot in the book and during the pandemic, because I think there were some people who had the belief that as doctors and nurses, we were prepared for battle.

We were prepared to see the speed and quantity of death that we were experiencing.

But the reality is that that wasn't part of our training, at least pre pandemic, it wasn't.

And I'm so inspired by all of those students who have now in the wake of the pandemic, decided that they want careers in healthcare, that, again, restores my faith in humanity.

And one of the themes I grapple with in the book, and it's on the cover, is bravery.

What does it mean to be brave?

Because I had always thought I wouldn't necessarily be the type of person who had the level of bravery to run out onto a battlefield or into war.

And after COVID, my idea of what bravery really means has completely shifted.

Bravery was the nurses who showed up every day, despite the fact that they felt like they should be at home homeschooling their kids.

Bravery was staying away from your 85-year-old grandmother or grandparent for three months, five months, six months, a year, because even though you love them and wanted to see them, you knew that you were doing what you had to do to keep them safe.

Bravery happens in the little acts and choices that we make every day to respect the humanity in others.

It's not rushing out onto battlefield, although that is one form of bravery.

What I try to talk about in the book is how you can feel terrified in the moment, but what you're actually doing is very brave.

- That's powerful.

- That is really powerful.

- You write also, and you touched on this a bit before about the mental health aspect of the pandemic and now post-pandemic, if we can call this period that, I guess we can, talk about the mental health effects on children.

I mean, you're a pediatric surgeon, obviously, healthcare professionals and older people face challenges, and were affected by the trauma of this.

But talk about children and what children might be able to do or parents might be able to do for their children who were so traumatized and remain traumatized by what happened during the pandemic.

- Yeah, I think about this all the time, and I think about it as an effect on my own children who were separated from me and my husband, who is also a surgeon.

They lived apart from us for three and a half to four months while I was in New York.

My husband was already working in Boston.

We made the very difficult choice to move my children to be with my parents in Connecticut because it felt like the safest choice to make for them at the time.

But I still wonder, does my son have lingering attachment issues from having been pulled away from his parents during that time?

In so many ways, we were lucky to have that option even.

But there's no question that what we're experiencing in the United States now is a total mental health crisis among our nation's youth.

I really worry about adolescents and pre-teens.

They were of an age during the pandemic where they watched our systems and structures and our leadership fail spectacularly, and they watched adults be confused about basic questions about what to do.

Should we send kids back to school?

Should we have them wear masks?

Should we vaccinate them or not?

And that effect on young people and questioning our basic structures and safety has profound and lasting impact on their sense of safety and security in an uncertain world.

And we don't have nearly enough resources right now.

Pediatricians across the country are serving as many of their patients' primary psychiatrist or psychologist, while they're also trying to figure out how to combat childhood obesity and basic vaccination of children and wearing car seats, bicycle helmets, drowning prevention, there's too much on their plates.

And we're also expecting them to be the primary source of mental health care for our nation's youth.

I mean, it is a big problem out there.

And there are still tons of kids that are grappling with developmental difficulties coming out of COVID, whether that was missing critical years of phonics and reading instruction during a developmental window when that's what they really needed in school.

And also socialization even for some of our youngest kids.

I mean, people make jokes about it.

Oh, he or she's a COVID baby, a little scared of strangers.

But there are so many effects that won't be totally clear for another five to 10 years from now as we begin to grapple with what it meant to live in that degree of fear and isolation.

- You know, Cornelia, we've literally got about a minute left and I want to ask you a big question about two sides of the same coin.

Four years after the onset of the pandemic in the United States, what did we learn and what have we already forgotten?

- I felt even going back and reading my book to record it for the audio book, there were so much that I forgot that we didn't know at the time.

So the hopeful message is that we've come a long way in terms of loss of life and vaccination.

I mean, the miracle that was the COVID vaccine that we had in less than a year has saved hundreds of millions of lives globally.

And that is a marvel, a more miraculous feat of science that still boggles my mind.

The flip side of that is that I don't know as a country, in terms of our public health infrastructure, if we are truly any better prepared for another pandemic.

And from some of the infectious disease experts that I've talked to, the likelihood is that there may be another pandemic in our lifetime.

There are a lot of issues around globalization and infectious disease and antibiotic resistance that are making us even more vulnerable to infectious disease than we previously thought before 2020.

So the short answer to your question is, I am simultaneously hopeful in the power of science and medicine and also worried about our public health infrastructure overall if we don't dramatically invest more resources into that to be better prepared, - That's a powerful place for us to leave it.

Dr. Cornelia Griggs, thank you so much for being with us.

The book is, "The Sky Was Falling," it's a remarkable read.

That's all the time we have this week.

But if you wanna know more about "Story in the Public Square," you can find us on social media or visit pellcenter.org where you can always catch up on previous episodes.

For G. Wayne Miller, I'm Jim Ludes, asking you to join us again next time for more "Story in the Public Square."

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