By Katie Keith
“Mark it Covid” has become a phrase around our house. I’m not sure exactly what it’s a placeholder for. “Put a Fork in It”, maybe. “So It Goes,” is a possibility (Vonnegut). Or it could be just a thing to yell across the room after weeks on end of spending too much time together and running out of things to say. “Hey, we need more milk.”
“Mark it Covid!”
I don’t exactly know what it means when I say it but I do know why I say it. Of course, it was when my mother told me that we didn’t have an accurate count of COVID deaths because they were just calling all deaths COVID. And this got me thinking about cause of death, which, as it turns out, is a subject I am very interested in.
When my brother died in 2007, I found out very early in the morning. My sister called and said “There was an accident: and then she said he “jumped off a balcony.” So was it an accident or did he jump? We still don’t totally understand but around sunset of that same day, I realized people were going to say he killed himself. Oh no. That would never be the cause of death to me. I know too much context.
When my grandmother died in 1997, prior to her death, she had a very prolonged illness, wherein she was, well, I don’t know what you call it—catatonic? They called it dementia. I remember the dementia part; that was shorter. During that portion, she was salty and confused which was the exact opposite of how she’d been prior to dementia. My grandfather, who visited her everyday and brought her a red rose every Friday, agreed with his children (one of them my mother) that they would get an autopsy when she died so they could determine her real cause of death. Then she died. My Aunt Susan, my mom’s sister, who needed to fly from California to Maryland to attend the funeral tells it like this: I talked to Dad about the autopsy before I boarded the plane, and by the time I got home, she was cremated. Mark it Covid.
In Russia, if you have late stage cancer and then you get COVID they will not mark it COVID even if it was in fact the COVID that pushed you over the edge. Speaking of over the edge, they are also pushing doctors out windows. Now, are those COVID deaths?
My Aunt Susan died recently. She was a lonely person and she drank a lot. Her cause of death was ruled heart attack but wasn’t it really loneliness? Although, in the end, she wasn’t that lonely. She’d recently found a new drinking pal in her interior decorator. So it was the companionship that may have actually done her in. Likely, this was not summarized on her death certificate, although there may have been room. According to an article recently published in Scientific American called “How COVID-19 Deaths are Counted,” death certificates have space to list an immediate cause of death, as well as the chain of events that led to that final disease or incident. The example they give for a COVID patient is the immediate cause of death would be respiratory failure and the secondary would be “due to COVID-19.”
Then there was my other Aunt Susan, Uncle Dan’s wife. She died alone in the house while Uncle Dan was mowing the lawn. They did not do an autopsy because she was recovering from knee surgery and the presumption was she got a blood clot and died instantly. Since everyone in the family seemed satisfied with this explanation, that became her cause of death, and the medical examiner got the weekend off.
I never really considered the power of medical examiners. If there is room for “chain of events,” then there is room for a tale. If my mom could imagine all the medical examiners as DNC operatives, could I imagine them as Nick Carroway? Isn’t Gatsby just a terrific chain of events? Immediate cause of death: Gun shot. Secondary: Hopeless romantic. Or better yet: “No amount of fire or freshness can challenge what a man will store up in his ghostly heart.”
What we do know about COVID is that when people with contributing factors like heart disease or high blood pressure get it, it can be a last straw. This is actually the phrase that Dr. Sally Aiken, president of the National Association of Medical Examiners used, which I think is a great phrase. It also strikes me as a phrase that can be highly speculative or highly straightforward depending on the circumstances. What isn’t either of those, is whether or not someone is dead when they are dead. As of yet, this point has not been politicized and therefore muddied.
When my grandmother died, my grandfather likely felt he was next, or hoped it and in thinking ahead to the weight of that inevitability, didn’t really care anymore why my grandmother was dead. Or maybe he was just really sad. He’d seen a lot to be sad about in his life. My grandmother died right after Christmas and I went to help my grandfather straighten up before out of town guests started to arrive. He asked me to store some left over wrapping paper in a back bedroom because, “Christmas will come again, I suppose.” He didn’t seem sure.
He was diagnosed with cancer nine years later and everyone gathered at the house to be with him. We thought it was near the end but it was hard to tell. When it was over, we agreed as a family, immediate cause of death: cancer. But his last straw seemed to be when my father, his son-in-law had to help him to the bathroom the morning before. This 86 year old had seen enough, he was not going to have someone hold him up while he peed. So, secondary cause: stubborn and willful. The man that had buried his love nine years earlier, saw his mother drown in a boating accident when he was 10 in 1929, whose father abandoned him and headed West afterwards, who entered France the day after D day, well, he was done. Mark him Covid.
Katie Keith is a former resident of the West Village that currently resides in Maplewood, NJ. She can be reached at firstname.lastname@example.org