Senator Susan Collins has caused financial harm to Maine because her vote to support the Big Ugly bill cut health care for thousands)

COLLINS’S PORK BARREL BALANCE SHEET DOESN’T ADD UP - ….and besides, it’s just more deficit spending

(Op-ed in the Press Herald) Maine can’t afford Senator Susan Collins’ earmarks: The numbers and the reality on the ground don’t lie. 

Maine Republican Senator Susan Collins

Wayne Clark, of Durham, is an eighth-generation Mainer, a retired public relations and marketing executive and author of The Blue Yankee on Substack.

Sen. Susan Collins keeps reminding us how much money she brings into Maine. That money comes from congressional “earmarks” (sometimes known as “pork”). She says she has brought in $1.5 billion over the past five years.

There’s another side to the ledger, though: how much has Sen. Collins’ subservience to Donald Trump and the GOP cost Maine?
Collins (and to be fair most of her colleagues) did not lift a finger to stop DOGE, 😡illegal tariffs, illegal wars, deteriorating foreign relations and the One Big Beautiful (Ugly❗) Bill Act. Nor has she tried to rein in Trump. Can we afford the cost of her votes and inaction❓ First, let’s do a numbers check.

Collins brought in 💲200 million worth of pork in 2022, $308 million in 2023, 💲576 million in 2024, 💲0 in 2025 (no earmarks for anyone that year due to the continuing resolution) and 💲428.6 million in 2026. So, the average per year over the past five years is roughly 💲302 million. Against that 💲302 million number, let’s look at how much Collins’ and Congress’ inaction and obedience to Trump has cost Mainers.

The Maine Center for Economic Policy reports that the total tariffs collected by Trump in the first year equal about 💲1,100 per household. In Maine, that translates to a total of 💲677 million. And that’s just one year. Most of that has been paid by Mainers in the form of higher prices.

The budget bill imposed new work requirements on Medicaid recipients (even though most already work). Maine DHHS estimates that 30,000 Mainers are expected to lose coverage in the first year alone because they can’t navigate the reporting requirements. Just administering the work requirement paperwork will cost Maine $8 million in year one, and 💲5.5 million per year thereafter.
Trump and the GOP declined to extend the tax subsidies that made coverage under the Affordable Care Act actually affordable for many people. A report from Defend America Action says that Mainers who buy health insurance through the ACA exchange will see their coverage costs for next year increase as much as 💲900 per month.
The budget bill adds a work requirement to the Supplemental Nutrition Assistance Program (SNAP) and reduces the federal contribution to the costs of running the program. Total loss of money to Maine❓= 💲145 million per year.
Those people who are losing Medicaid covera(ge and many of the ones losing their ACA subsidies will be uninsured. That hits our hospitals: the loss of coverage will cost Maine hospitals 💲66 million per year, and free care is expected to go up by 💲86 million per year by 2034.

Canadian tourism is down (-) 40％, as a result of tariffs and Trump’s insulting behavior toward Canada. In 2024, Canadians spent about $500 million in Maine. So that means Trump and the Congress that let him get away with tariffs and bad behavior cost our tourism sector about $200 million in just one year.

The combination of tariffs and the Iran war have skyrocketed our costs. Coffee is up, beef is up. Gas is up by nearly a dollar in Maine, and it has been up as much as 💲1.40 a gallon. The war Collins didn’t vote against nine times has cost everyone at the pumps.
Now, I wouldn’t add up the numbers above and pretend to have an accurate, defensible total. But it doesn’t take long to overtop Collins’ 💲302.5 million of pork. In fact, the Maine Center for Economic Policy totals the cost to Maine just from the budget bill at 💲400 million per year.

That’s a lot of money talk. The human costs are harder to quantify, but they’re very real. It seems to me we simply can’t afford six more years of this. Pork or not, we can’t afford Susan Collins.

Donald Trump and dangerous maga Republicans must resign because they are creating a Nazi "Mein Kampf" government

Echo opinion: FIRST HAND ACCOUNT: WORSE THAN HITLER AND THE NAZIS (Letter to the editor, Portland Press Herald)

Comparison between Trump administration, Nazi regime is chilling❗

I am a 94-year-old Jewish American ✡️who still has fire left in the belly. I enlisted and served for three and a half years in the United States Marine Corps. My father was born in Odessa, Ukraine, and my mother was born in a small village near Moscow. 

She was persecuted by pogroms, they emigrated to Canada and then the United States. Many of my father’s family perished under the Nazi regime.

When I see, hear and read about the immigrant policy under the current presidential administration, it is — without a doubt — a carbon copy of Hitler’s “Mein Kampf” from the 1930s, and ’40s in Nazi Germany. However, the present seizing of immigrants and racially profiled citizens has become worse than the Gestapo “rounding up” the Jews. 

The systematic, dehumanizing process employed by this cruel Donald Trump administration far surpasses Hitler’s Nazi Germany.

My hope and wish is that the American people will wake up, see through this sham, and take appropriate action before we soon become a fascist state and lose our precious democracy. 

God bless America. - From Ed Fraktman, in Scarborough, Maine

Calling on Maine Senator Susan Collins to provide leadership like Margaret Chase Smith her heroic predecessor

Echo guest opinion published in The Portland Press Herald in Portland, Maine: Party Invite for Senator Susan Collins

https://www.pressherald.com/2025/04/08/opinion-party-invite-for-sen-susan-collins/

This is a moment in time where the country needs a Margaret Chase Smith... not a coward. A person in Sen. Collins' position holds a great deal of power. 

She should use it. Get a spine, Susan. 

Be more like Margaret Chase Smith, for once❗
Party invite for Sen. Susan Collins

Now might be the time to consider a move away from MAGA world. Please RSVP❗

I know I'm just a rural Mainer, a Democrat from a small Maine town, but I have a suggestion for our Sen. Susan Collins. 

No, not just a suggestion, an invitation too.
Let me start with the suggestion.

Now is the time to change horses 🐎, even though it is in the middle of a stream, because the MAGA trail boss you are following is going the wrong way — getting deeper and deeper. 

And,you have known that for a long, long time.
Let me refresh your memory.

Here's what you said the first time Donald Trump ran for president: "I kept hoping that Donald Trump, once he won the primary, would change. I hoped that we would see a new Donald Trump, one who put forth thoughtful policy positions, stopped denigrating people and had a more positive vision for America. Regrettably, I have concluded that there is not going to be a new Donald Trump, that he's incapable of saying he's sorry, of changing, of learning, of growing." — Aug. 9, 2016

Three times since then you have — by your own proclamations — voted against Donald Trump, against electing him president every time he ran. Although you made the mistake of voting to acquit Trump in his first impeachment trial, you did join seven Republican senators who voted to convict him in his second impeachment trial.

And, in May 2021, you were one of five Republicans who voted with Democratic senators to establish a bipartisan committee to investigate the January 6th insurrectionist attack on the Capitol, calling it "a dangerous, shameful and outrageous attack on our democracy" and blaming Trump for "working up the crowd and inciting this mob."

Even before he took office this time, you said in December that you were "surprised" by his demand to increase the debt ceiling. 

In early February, you called the Trump administration's mass firings "indiscriminate."  You have yet to comment about the firings in the Social Security Administration, even while tens of thousands of your constituents are living on their retirement incomes. 

In late February, you called the decision to cut $4 billion in health research grants "devastating" and a violation of appropriations law. And now you have joined with the Democratic vice chairof the Senate Appropriations Committee, Sen. Patty Murray of Washington, in writing a letter to Trump opposing cuts of $3 billion in recently passed emergency funding, again suggesting he is breaking the law: "He does not have the ability to pick and choose which emergency spending to designate."

Meanwhile, your popularity with voters has taken a nosedive.
Public Policy Polling recently reported only 24% of Maine voters now approve of you while 61% disapprove — worse approval numbers than Trump himself gets from Maine voters.

Republicans aren't happy because you are, famously. the most centrist Republican senator in the Senate. You are one of only two pro-choice Republican senators.

You began expressing concern about climate change more than two decades ago ("Like the canary in the coal mine, the climate changes already evident in the Arctic are a call to action."— Sept. 7, 2004).

You voted with President Barack Obama much of the time in 2013 as he began his second term, more than any other Republican, and in 2017, you voted against repealing Obamacare, helping kill Trump's pledge to get rid of it his first year in office.

Democrats aren't happy because too often you use words like "surprised" or "concerned" or "troubled" in response to Republican overreach instead of taking action. 

Republicans hold only a slim majority in the U.S.
Senate. If only three Republican senators switched parties and joined the Democrats, or even became independents and caucused with the Democrats, there would be no Senate majority. 

Every vote would become a toss-up.

So, here's the invitation: come join the Democratic Party. We need and will welcome Republicans who realize they have made a mistake. Or at least get off that MAGA horse and become an independent.

Stop following Trump as he leads us into deeper and deeper water. Be a leader — not in words but in deeds.

It is hard to imagine an action that could communicate better to the Republican Party that it needs to wake up and stop acting like it has a mandate to do whatever it wants.

ABOUT THE AUTHOR
Gordon Street, Ph.D., is a clinical psychologist. He lives in Lincoln, Maine.

Health care expenses must end surprise medical bills - a patient must only pay for treatment not facility fees

Published in the Portland Press Herald and Consumers for Affordable Health Care, in Augusta Maine:

WATERVILLE, Me- Kelly Brignac, photographed at her home in Waterville on Tuesday, was charged a $1,500 facility fee at Maine General after getting an ultrasound in the emergency department because of pregnancy complications that later led to a miscarriage. 

Kelly Brignac obstetrician’s office was closed on a Friday afternoon in early May when she started bleeding from complications early in her pregnancy.

Feeling like she had no other option, the 34-year-old from Waterville went to MaineGeneral Medical Center in Augusta’s emergency department. Hospital staff gave her an ultrasound and a blood test, and sent her home with instructions to follow up with her doctor.

She miscarried at home that evening.

When she received the hospital bill, Brignac said she was shocked to see a charge for more than $2,000. She would have to pay out-of-pocket because she hadn’t yet met her deductible.

When she looked closer, Brignac said she saw a $1,544 charge that wasn’t linked to a specific procedure or test. The hospital later confirmed it that the charge was a so-called facility fee, Brignac said, who also showed a copy of her bill to the Portland Press Herald.

Hospitals add such fees to help pay for their general operating costs, but insurance plans often don’t cover them and patients are often surprised by them.

“I did feel like I was being taken advantage of,” said Brignac, a Colby College professor. “I had no idea I would be charged this much. I got a $2,000 bill that essentially was all for the doctors telling me, ‘Well, you have to wait and see.’ ”

Brignac said she is not criticizing the care she received at the hospital, only that the bill was so high compared to the limited services she received in the emergency department. The ultrasound, blood test and other miscellaneous charges cost about $600, and she didn’t contest those charges.

Brignac said she reluctantly paid the bill.

Hidden charges, denies claims: Medical bills leave patients confused, frustrated, helpless

A Portland Press Herald investigation revealed that Brignac’s experience is common for patients who seek care in Maine's hospitals (and in other states as well), which sometimes hide facility fees in medical bills with no explanation.

Even worse, the insurance companies sometimes refuse to cover these fees, leaving patients on the hook for hundreds of dollars in unexpected charges simply because they went to a hospital instead of seeking treatment from another provider.

McKenna said the facility fee “covers the additional costs of providing care in the hospital or hospital outpatient department and is separate from medical staff care provided to the patient.”

A FOCUS OF SCRUTINY:  Facility fees have been the focus of scrutiny and debate in the Maine Legislature since 2022, when the Press Herald highlighted patients’ complaints about the fees in an article about the nation’s byzantine system of medical billing.

Maine Senate President Troy Jackson, D-Allagash, proposed strong limits on the fees, arguing that there should be limits on the fees and that hospitals need to be more transparent so patients aren’t surprised by the extra charges.

Hospital officials, however, have long argued that facility fees are an important part of the revenue stream.

Jeff Austin, vice president of government affairs for the Maine Hospital Association, argued during the legislative debate this year that banning facility fees would “have a devastating financial impact on hospitals, including the potential closure of some facilities and the loss of patient access to health care services.”

Joy McKenna, spokeswoman for Maine General Medical Center, said she would not comment on a specific case to protect patient privacy. But, she said, a facility fee is a standard charge for all patients cared for at the hospital.

“Hospitals are generally bound by the federal Anti-Kickback Statute and the Civil Monetary Penalties Law, which prohibit waiving or reducing fees, including facility fees, for individual patients as a routine practice,” McKenna said.

After years of debate, studies and intense lobbying by the hospitals, Maine earlier this year passed a watered-down version of facility fee regulations that only requires hospitals to state that they charge such fees, without requiring that the amount of the fees be disclosed. Even the slimmed-down version of the law hadn’t yet gone into effect when Brignac went to Maine General in May.

Stricter regulations, such as barring the fees from being charged during telehealth appointments or at outpatient facilities, were discarded.

Fifteen states, including Maine, have some laws regulating facility fees, while the majority of states either have no laws on the books or do not implement bans or restrictions on the fees, according to an analysis this year by the PIRG Education Fund (Public Interest Research Groups).

Only seven states impose significant restrictions or bans, with Connecticut passing the strongest measures. Connecticut bans facility fees from being charged for outpatient services or telehealth appointments, among other regulations.

The PIRG analysis said there is “no rhyme or reason” for the amount charged in facility fees. “Facility fees vary tremendously, adding as little as a few dollars or more than $1000 to the bill,” the report said.

Ann Woloson, executive director of Consumers for Affordable Health Care, a Maine-based patient advocacy group, said she would like to see the Maine Legislature take more steps to have stronger regulations of facility fees. Brignac’s case is an example of why more needs to be done, Woloson said.

“There needs to be more transparency on how facility fees are developed by the hospitals,” Woloson said. “And the fees should be appropriate for the service provided.”

Lewiston Maine mass killer differs from past shooters because his mental illness was known

Maine Writer- Thinking about reports from past mass killings by those who were guilty of slaughters, one of the common responses from people who knew the murderers has been, "He was quiet." ((About 99 percent of the killers have been men.)  Well, that response is certainly not the experience expressed about the Lewiston Maine mass killer who was obviously exhibiting dangerous behaviors that were repeatedly documented. Moreover, all reports about the killer pointed directly to his expertise with fire arms and expressed concern about his easy access to many guns. So, Everyone feared the worst about Robert Card. No one stopped him.

Echo investigative report published in The Portland Press Herald: There are still many unknowns, but a harrowing question weighs heavy: Could one of the deadliest mass shootings in U.S. history also have been the most preventable?

Everyone who knew the killer Robert Card was concerned about his behavior. His ex-wife and teenage son. His siblings, parents, and friends. Fellow members of an Army Reserve unit in Saco.

1. They knew he was having psychotic episodes 
2. And hearing voices
3. They knew he was making threats
4. And, those threats were getting more specific
5. They knew he had several guns 
6. And knew how to use them

Many spoke up.

Local police were alerted in May and again in September about his increasingly erratic behavior. 

In between those contacts, the killer Card spent two weeks at a New York psychiatric facility, at the urging of commanding officers.

The warning signs before Card shot and killed 18 people on October  25th in Lewiston were glaring and abundant, and still, he was not stopped before he carried out the worst massacre in Maine’s history and then took his own life. 

Sadly, the drip, drip, drip of information that has come out since the tragedy suggests Card’s mental health deteriorated rapidly early this year and may have coincided with or been triggered by a bad breakup and his first hearing aids.

But, significant gaps in the timeline remain – the biggest being from September 17, when a Sagadahoc County Sheriff’s deputy tried unsuccessfully to visit Card at his Bowdoin home, to October 25, when the shootings occurred.

Family members told police Card distanced himself from them in the month before the shootings and wasn’t responding to messages or visits to his home. They have so far declined to speak with Portland Press Herald/Maine Sunday Telegram reporters or failed to return messages. If others encountered Card more recently, they haven’t come forward.

In the days since the tragedy, scrutiny has intensified over whether enough people took Card’s behavior and threats seriously and whether enough was done to intervene. 

Maine Governor Janet Mills acknowledged this on Wednesday when she launched an independent commission that will look into the shootings and police response that followed, as well as the months before.

“It is important to recognize that, from what we know thus far, on multiple occasions over the last 10 months, concerns about Mr. Card’s mental health and his behavior were brought to the attention of his Army National Reserve unit, as well as law enforcement agencies here in Maine and in New York,” Mills said. “This raises crucial questions about actions taken and what more could have been done to prevent this tragedy from occurring.”

The commission’s findings will be made public, but that could take many months, or more.

The following account of Card’s troubling descent into mental illness is built from court documents and other public records and interviews with those who knew Card or his family, some of whom spoke on the condition that they not be named publicly.

There are still many unknowns, but a harrowing question weighs heavy: Could one of the deadliest mass shootings in U.S. history also have been the most preventable?

The earliest signs that Card’s mental health was worsening date back to the beginning of 2023.

His ex-wife and 18-year-old son raised concerns in May with the school resource officer at Mt. Ararat High School in Topsham, where Card’s son was a senior. 

At that time, the officer contacted the Sagadahoc County Sheriff’s Office – responsible for Bowdoin, where Card lived his entire life – which sent Deputy Chad Carleton to investigate.

According to Carleton’s report, Card’s son started worrying about his father’s behavior in January. They would be out in public places together, and the older Card insisted that people were talking about him and saying derogatory things, including that he was a pedophile.

The son told Deputy Carleton that he stopped visiting his father sometime in April and that his father was upset about that. 

Card’s ex-wife said she was worried about their son spending time with him and told the deputy that Card had recently picked up as many as 15 guns from his brother’s house.

Card’s ex-wife and son told the deputy they didn’t want Card to know that they had come forward “for fear that it would aggravate the situation.” Instead, they would keep their distance.

Carleton said he would reach out to Card’s commanding officer in the Army Reserve’s 3rd Battalion, 304th Infantry Regiment, which is headquartered in Saco and includes many Maine law enforcement officers among its 70 members. Card had been a member of the part-time unit for many years.

The ex-wife said she would contact Card’s sister-in-law, who is a nurse.

Carleton spoke with Card’s supervisor, Kelvin Mote, a corporal with the Ellsworth Police Department. Mote told him members of the unit already were concerned and said Card recently had been accusing other soldiers of calling him a sex offender. It’s not clear why Card was fixated on that notion, but Maine’s sex offender registry does list a different Robert Card. Immediately after police released Card’s name, some people assumed it was that Card, who is one year younger and lives in Waterville.

Mote told Carleton he would consult with the unit’s commander, Jeremy Reamer (a police officer in Nashua, New Hampshire), about getting Card help.

The sheriff’s deputy then spoke with Ryan Card, the shooter’s brother, who was not aware that Robert had come to his house to retrieve his guns. He told Carleton that his brother’s behavior seemed to shift shortly after he was fitted for hearing aids in February.

Some other family members knew his mental health was declining but felt their efforts to help him were fruitless, because he was in denial, Carleton wrote in his report.

There are some links between hearing loss and mental illness, but it’s not known if they apply to Card. It is also unusual for a 40-year-old to suddenly exhibit first-time paranoid behavior.

Carleton asked Ryan Card if he wanted a deputy to accompany him when he next spoke to his brother. But Card’s brother, like his ex-wife, feared police involvement would make things worse.

That same night, Ryan and a sister, Nicole, went to visit Robert at his trailer. He answered his door holding a gun but talked with his siblings at length and agreed to go see a doctor about the voices he was hearing.

Finally, Carleton called Mote again, who told him supervisors in the Army unit would “sit down with (Card) in the near future to see if they could get him to open up about what has been going on.”

Neither Mote nor Reamer responded to multiple messages last week asking them to discuss any actions they had taken.

Medical history and racism: More about the Henrietta Lacks family's settlement

Echo commentary by columnist Theresa Vargus, published in The Washington Post and reprinted in Maine's newspaper the Portland Press Herald:

The Henrietta Lacks settlement about the proprietary use of her HeLa cells,  is bigger than one family’s victory.

In the lawsuit that led to the historic agreement, the outcome acknowledged the history of racism in the country’s medical system and the need to right those wrongs.

Like many women, I push a tiny pill out of a rectangular pack each day and pop it in my mouth.

For years, I never gave that act much thought. Birth control pills are one of the most common forms of contraception and have allowed countless women the freedom to decide when they want to start their families. When a doctor first prescribed them to me, that’s how I viewed them – as a way to plan for the future. I saw them only in the context of looking forward.

But that changed several years ago. I grew curious about the history of those pills and decided to look back at how they came to exist on the market.

Henrietta Lacks was born August 1, 1921 in Roanoke, Virginia and died on October 4, 1951, in Baltimore, Maryland.

What I found showed me how little we know about the dark parts of the country’s medical practices. I found myself reading about one medical breakthrough after another that used Black and brown bodies, often without full disclosure to the participants, to achieve advancements that benefited the masses.

The pill became known for its role in women’s liberation, but a lesser-known part of its story are the women who participated in the first large-scale human trial of it.

In the mid-1950s, before the pill was deemed safe enough to market to women throughout the country, it was tested on women in Puerto Rico who lived in a public housing project. Based on reports, some were illiterate and many were desperate for birth control.

At the time, hopes were high for the pill, but little was also known about its side effects. It had reportedly been tested on rats and rabbits, and on a small sampling of women in a medical practice in Massachusetts.

In Puerto Rico, researchers gave the pills – at much higher doses than are prescribed today – to as many as 1,500 women for years. Three women in the trial died, but no autopsies were conducted, so it remains unclear whether their deaths were linked to the drug. 

After the Food and Drug Administration approved the pill as a contraceptive, women across the United States started complaining about the side effects. Later, after concerns arose that the pill could be linked to strokes, heart attacks and blood clotting, congressional hearings were held.

But those health risks weren’t the only reason people later questioned the ethics of what happened in Puerto Rico and compared it to the shameful Tuskegee syphilis study, in which the government conducted research on hundreds of Black men for decades without their informed consent. A 2004, Orlando Sentinel article that featured several of the participants in Puerto Rico described them as “unwitting pioneers.”

“It remains one of the most controversial chapters in the island’s history – notably because participants weren’t informed that they were guinea pigs in an experiment to test the world’s first birth control pill, a tablet with three times as much hormones as today’s version,” the article reads.

I wrote about that human trial years ago, before I became a columnist. But, I found myself thinking about it again after learning that the family of Henrietta Lacks had settled its lawsuit against Thermo Fisher Scientific, a biotech company that had been accused of profiting off her “immortal” cells.

For Lacks’ descendants, the settlement marks a long-overdue victory. It comes more than 70 years after a doctor at Johns Hopkins Hospital took her cervical cells without her consent and the hospital shared them with researchers.

Mrs. Lacks was a Black tobacco farmer who grew up in southern Virginia. She was a mother of five, living in Baltimore (Turner Station) when she was diagnosed with cervical cancer. She was treated in a segregated section of Johns Hopkins, when those cells were taken and discovered to be extraordinary for their ability to grow outside of the human body. Her cells, known as “HeLa” cells, have since been credited with helping researchers achieve numerous scientific and medical discoveries. A few of them: a polio vaccine, an HPV vaccine, coronavirus vaccines, cancer treatments and in vitro fertilization. Her cells were even sent into space to test how human tissue would react under those conditions.

Those achievements are incredible. They are also ones that Lacks didn’t live long enough to see and that, even as companies profited off those bits of her body, her descendants never received compensation for. That is, until now.

The amount of the settlement was not revealed, but a specific number wouldn’t have changed the significance of the moment. It was a win for the family. It was also a win for the public. The lawsuit that led to it told of a history of racism in the country’s medical system and the need to right those wrongs.

“The exploitation of Henrietta Lacks represents the unfortunately common struggle experienced by Black people throughout history,” the lawsuit read. “Too often, the history of medical experimentation in the United States has been the history of medical racism.”

Medical racism, we know, is not only a thing of the past. 

In fact, Black women are still more likely to die from childbirth than their white counterparts. But recognizing and addressing past wrongs is a start to creating a medical system that treats all bodies with the same respect and consideration, no matter a person’s race, ethnicity or financial situation.

In an article my colleagues Dan Morse and Gillian Brockell wrote about the settlement, they told what happened after Lacks’ death: “For decades, the family struggled to carry on without their mother. One of her daughters, Elsie, who had disabilities, was institutionalized and died at 15 in 1955. In the 1970s, two decades after Lacks’ death, members of her family started getting strange phone calls from researchers requesting blood samples. Their medical histories were published in research papers without their knowledge. One night, at a dinner party, a guest asked family members if they were related to the source of the famous HeLa cells. That’s how they found out cells from their mother were still alive all over the world.”

Many of us know about Lacks because her family’s story was captured in a best-selling book titled “The Immortal Life of Henrietta Lacks” and a movie by the same name. But there are many Black and brown people who remain mostly unknown, even though their bodies were used to create the comforts we now take for granted.

Abortion marathon debate in Augusta Maine where two thousand plus people showed up to give testimony

Echo report published in the Portland Press Herald in Maine by Penelope Overton

AUGUSTA, Maine — A public hearing on proposals to expand access to abortion in Maine continued through the night and did not end until after 7 a.m. Tuesday – 19 hours after it started.

Hundreds of Maine people signed up to testify in person as a crowd of more than 2,000 people packed the State House complex Monday to support or oppose a slate of bills that would increase abortion access in Maine, including Gov. Janet Mills’ proposal to legalize abortion later in pregnancy if deemed necessary by a licensed doctor.

The in-person testimony began at noon Monday and continued through the evening and into the night. Then the people who waited to testify online got their turn. The hearing was not only extremely long, it also was intensely emotional.

Zoe Reich of Portland urged lawmakers to endorse Mills’ bill to expand abortion access so nobody else would have to do what she had been forced to do: spend thousands to fly halfway across the country to get an abortion after a later-in-pregnancy scan revealed heartbreaking fetal abnormalities.

“I was denied critical abortion care when I needed it because of a cruel and arbitrary time line set by politicians, not doctors,” Reich said. “It doesn’t have to be this way. Abortion is health care. All Mainers should have the freedom to get the health care they need, when they need it, right here at home.”

Opponents said Mills’ bill is too radical and vague. They urged lawmakers to stick with Maine’s current abortion law, which limits abortion beyond the 24-week window, which is about when a fetus becomes viable outside the womb, to situations when the life or health of the mother is at risk.

“As a historically pro-bodily autonomy voter, the pushing of the window is appalling to me,” said Lauren Knebel of Cape Elizabeth. “If this bill passes, where would the line then be drawn on when this procedure becomes murder? Why is a week to a month before birth not murder, but a week or a month after is?”

More than 700 people signed up to provide face-to-face testimony on Mills’ bill: about 65 in favor and about 650 in opposition. 

More queued to deliver online testimony. Capitol police said 2,200 people passed through the State House metal detector on Monday.

Mills’ bill is the most high-profile of five abortion bills heard Monday. Other bills proposed to eliminate abortion insurance co-payments, ban local preemption of state abortion laws, protect providers who treat patients from states with abortion bans, and require abortion care to continue after hospital mergers.

A hearing on a bill to enshrine the right to bodily autonomy in the Maine Constitution was postponed.

While most bills are allowed just 10 co-sponsors, Mills’ proposal, L.D. 1619, has a whopping 75 House co-sponsors and 20 Senate co-sponsors, all Democrats or independents, which combine to represent a simple majority of both chambers. That is enough to assure passage if all co-sponsors remain steadfast.


Michaela Gladu, of Orrington, was one of hundreds of people who testified at the State House on Monday against Gov. Janet Mills’ proposal to make Maine’s abortion law one of the least restrictive in the nation. Ben McCanna/Staff Photographer

The bill was presented by House Speaker Rachel Talbot Ross, D-Portland, who spoke Monday of Maine lawmakers’ need to meet the challenges posed by the U.S. Supreme Court’s overturning of Roe v. Wade, which is unfairly hurting people of color, the poor, and those living in rural areas.

“Faced with this stark reality, Maine leaders have an obligation to meet this moment and do all we can to protect the rights, freedoms, health and safety of Mainers,” she said. “This legislation is compassionate. It is bound by science and best medical practices, and it recognizes abortion as health care.”

Testy Exchanges:  Speaker Talbot Ross bristled when Republican members of the Judiciary Committee asked her to define exactly when a licensed physician might deem abortion to be necessary, the post-viability threshold laid out in Mills’ bill. They asked if such broad discretion opened the door to last-minute abortion on demand.

Talbot Ross called some questions out of order, refusing to answer, and dubbed others inflammatory.

“It is impossible to legislate for all instances in which someone might need access to abortion later in pregnancy,” Talbot Ross said. “States that have tried have failed and instead caused greater harm. This is why the language in L.D. 1619 is clear. It puts medical decisions in the hands of doctors and patients.”

She repeatedly told lawmakers: “We, as legislators, should not be making these decisions.”

The proceeding, which was expected to last until late in the night, was mostly an orderly affair, however. Some people who testified did so through tears. Others quoted religious verses or shared heartbreaking stories of their own abortions.

Lawmakers tussled over the order of speakers (all in favor of the bill spoke first, followed by opponents), the number of questions committee members got (only one), and the amount of time people could speak (cut from 3 minutes to 2 as a nod to the sheer number of people who signed up).

Then at 10 p.m., the Democratic heads of the committee told the crowd of 500 or so opponents still waiting in the State House to testify that they would now only have a minute to deliver face-to-face testimony. Some had been waiting to speak since 7:30 a.m.

All of the bill’s 65 or so supporters got two minutes each to address the committee.

Committee co-chair Senator Anne Carney, D-Cape Elizabeth, apologized for the change, but she said the committee would be there for another 16 hours if all remaining opponents had two minutes to speak – four hours after the Legislative session reconvenes at 10 a.m. Tuesday.

Outside the hearings, anti-abortion advocates watched the proceedings on televisions spread around the State House, taking breaks to hold rallies and prayer circles and make coffee runs. 

Those advocating for increased abortion access held a news conference with Mills in her cabinet room.

“You will hear today that this bill is ‘abortion on demand’ or ‘abortion up until birth,’ ” Mills said. “These claims are not true. The truth is that no doctor is performing abortions up until the moment of birth and no pregnant women are just waking up suddenly and asking for them.”

Mills cited statistics that show nearly all Maine abortions – 92 percent – occur during the first trimester.

“You will also hear today that this bill is ‘extreme,’ ‘gruesome,’ ‘depraved,’ ‘barbaric,’ or even ‘evil,’ ” Mills said. “What is extreme is forcing a woman to give birth to a child who is going to immediately die. What is extreme is forcing a woman to leave her state to seek care.”

Augusta State House anti-abortion rally in the Hall of Flags

Hundreds of abortion opponents listen to Dr. Thomas Page, an OB/GYN at Central Maine Medical Center, during a rally on the second floor of the State House in Augusta on Monday, when legislators heard testimony on a number of bills that would expand access to abortion. 

The Judiciary Committee will next hold a work session on the merits of the proposal, but unless one of the co-sponsors changes their mind, that will all be a formality. The best shot for Republicans to stop it will be in the House, where Mills will need all co-sponsors and Ross to tip the scale her way.

The seven House Democrats who didn’t co-sponsor: Mana Abdi, of Lewiston; William Bridgeo, of Augusta; Michel LaJoie, of Lewiston; Anne Perry, of Calais; Joseph Perry, of Bangor; Ronald Russell, of Bucksport; and Bruce White, of Waterville.

Mills has said she was inspired to propose her legislation by the story of a Maine woman, Dana Peirce of Falmouth, who had to fly to Colorado to end her 32-week pregnancy after a scan revealed a rare, painful and fatal genetic mutation.

Peirce told lawmakers on Monday that her sad situation was made much worse by Maine’s current law.

“You have an opportunity to make sure no other Maine families have to go through what mine did,” she told committee members through tears. “Abortion for any reason is a deeply personal decision, one that should be left to pregnant people and their medical team.”

The bill does not include any specific conditions or limitations but leaves the decision up to the patient and physician about what circumstances would make abortion necessary. It removes criminal penalties for doctors performing later-in-pregnancy abortions.

Opponents argue that Mills’ bill is too broad and could legalize later-in-pregnancy abortions that do not involve fetal anomalies. Stories such as Peirce’s are heartbreaking, they say, but could be addressed by expanding the post-viability exemption list.

“This abortion bill is so extreme,” said Natalie Salavarria of Kenduskeag, a registered nurse who worked for 30 years in a neonatal intensive care unit. “We have made great advancements in the care of prematurely born babies and I have personally witnessed the birth, growth and development of countless babies, some as young in their development as 25 weeks of gestation. The miracle of life is not something that can be ignored, nor should it be in man’s hand to snuff it out.”

A Question Of Health Care:  But Connie Adler of Bath, a recently retired 30-year veteran of women’s medicine, told lawmakers that they would be smart to stay out of this discussion altogether and leave it to medical doctors to sort out. Best medical practices change fast, she said – it’s hard for doctors to keep up, much less the Legislature.

“Patients and providers often have difficult conversations and make plans based on numerous biological and ethical variables,” Adler said. “Government does not interfere when that discussion is about cancer treatment, hospice care, surgery and it should not interfere in reproductive health care.”

As for abortion of viable fetuses on demand just before birth – a scenario that Republicans raised during questions repeatedly – Adler said doctors would no sooner abort a healthy viable fetus for no reason than they would cut off a patient’s foot for no reason.

Shannon Carr of Bristol, a certified OBGYN who provides later-in-pregnancy abortion care outside of Maine, said some of the small number of women who get post-viability abortions do so for reasons not related to fetal abnormalities, including domestic violence, regulatory barriers or poor mental health.

“In the very uncommon event that someone presents later in pregnancy for an abortion, I’m asking that you please try to understand that something has gone terribly wrong,” Carr said. “Something tragic has happened to the baby, something life-changing has happened in the pregnant person’s life.”

Brittany Lee of Berwick said she would have killed herself if forced to continue an unwanted pregnancy while dealing with trauma from repeated rapes during her military service. 

She was 22 weeks pregnant – too late to get an abortion in South Carolina, where she and her husband were stationed.

“In the end, we found one in Georgia,” Lee told lawmakers. “We had to pack up our van with the children and the dogs, drive hundreds of miles, and find a pet-friendly hotel where we could stay overnight. … My abortion was the best and most compassionate health care I have ever received.”

The Maine Medical Association tried to reassure skeptical Republicans that doctors wouldn’t perform an unnecessary abortion even though Mills’ bill would remove specific criminal penalties for doing so out of fear that they would be sanctioned or stripped of their medical license by the Maine Medical Board.

Opponents accuse Mills of reneging on her campaign pledge to leave the state abortion law alone.

After introducing the bill, Mills pushed back at critics and called it a rational, compassionate proposal that would help people like Peirce and not open any abortion floodgates. She said she didn’t break any promises – that voters knew they were electing an ardent abortion defender.

The number of people seeking abortions after the first trimester is small. In 2021, the most recent year data is available, 94% of the 1,905 abortions conducted in Maine were done within the first trimester of pregnancy, or up to 14 weeks. The remaining 107 occurred before 20 weeks.

Abortion-rights advocates note the chilling effect of Maine’s existing viability restrictions. The state law allows abortions for any reason through about 24 weeks, but doctors won’t do them after 20 weeks out of fear that imprecise gestational dating could lead to prosecution.

When the U.S. Supreme Court struck down Roe v. Wade last year, which essentially made abortion a state-controlled issue, about half of the U.S. states enacted or began discussing abortion bans. 

In Maine, which has a strong abortion law, the issue helped Mills win a second term in November.

Donald Trump lacks dignity - He's a Republican disgrace

Echo opinion by Leonard Pitts published in The Portland Press Herald:

We turn, one last time, to Hans Christian Andersen. Trump is a fake.

Over the past four years, many observers, this one included, have found one of the Danish writer’s most famous tales irresistible for explaining both Donald Trump and the Republican Party’s slavish sycophancy toward him. In “The Emperor’s New Clothes,” a monarch parades through town naked, having been convinced by swindlers that he’s actually draped in an exquisite outfit made of a fabric visible only to those who are not “unusually stupid.”

Not wanting to be thought dense, everyone pretends they can see the magnificent outfit. Then a child blurts out the obvious. “But he hasn’t got anything on!” And the crowd begins to whisper to itself, until the truth finally breaks like a shaft of sunlight through the clouds, and the whole town cries out that the emperor is unclothed.

Well, in the wake of Donald Trump's definitive election loss and his refusal to concede the same, it’s Trump who stands naked before us, revealed for anyone who inexplicably still harbored doubt, as the liar and loser he always was (and always will be). He rages against math, excoriates voting, raves about imaginary schemes to steal a victory he never won. His psychopathy is nude, his disconnect from reality is disrobed, his toxic narcissism stands bare-cheeked before us all.

And you wait for the whispers to begin, wait for the toadies and lickspittles who have long enabled him to at last blurt the obvious. And you wait. And you wait.

And there is silence.

In a political season that has produced more than its share of embarrassments, this may be the greatest humiliation yet for a nation that styles itself a beacon of democracy. At this writing, almost no one – not party elders, not young guns, not cabinet members, not the first lady, not the children – has found the courage to publicly say the truth. Indeed, some – like the invertebrate Sen. Lindsey Graham – have even encouraged Trump’s delusions, a display of political gutlessness with few, if any, equals in recent memory.

Its insistence on denying reality has reduced the GOP to a state beyond parody. Think a Washington Post report of party loyalists marching seven times around the U.S. Capitol like Israelites in the Bible around Jericho. Think the once-respected Rudy Giuliani holding a press conference in a Philadelphia landscaping supply company parking lot near a sex shop to decry fictitious election irregularities. “Do you think we’re stupid?” he cried. “Do you think we’re fools?”

It’s enough to make comedy writers obsolete.

But it’s not a joke. Attorney General William Barr, Trump’s consigliere, has authorized prosecutors to “pursue substantial allegations” of voter fraud. Even though there are none. The General Services Administration has refused to process paperwork needed to release funds for President-elect Joe Biden to begin the transition process. In other words, the machinery of government has been brought to bear to protect a boy man’s fragile ego from the truth.

Acknowledging a bitter defeat is never easy. But, so many others have risen to the task with grace. Hillary Clinton did it. Mitt Romney did it. John McCain, John Kerry and Al Gore did it. The weakling Trump is uniquely unable to do it, a failure that makes you long for Jan. 20. On that day, he’ll be escorted into disgrace, still insisting that he won what he didn’t. One imagines the emperor would empathize. Even after the child cried out, he still couldn’t admit his nakedness.

“So he walked more proudly than ever, as his noblemen held high the train that wasn’t there at all.”

Leonard Pitts Jr. is a columnist for The Miami Herald. 

My personal letter to the editor: no need to be rude about public health

https://www.pressherald.com/2020/05/16/letter-to-the-editor-maskless-man-makes-point-of-rude-behavior/

My letter to the editor published in the Portland Press Herald, in Maine and the responses I have received:

During a visit to a midcoast grocery store, I was wearing a mask and rubber gloves.

Suddenly, a brute of a man, without a mask, deliberately came toward me from the opposite direction from the one that was marked with a large directional arrow, taped on the store’s floor. He pushed me and made a highly visible reach in front of my face, to grab a bottle of ketchup.

“You are going the wrong way!” I said. His response was: “Yes, I suppose I am.”

People who object to wearing protective masks in public are ostentatiously making wrong-minded political statements in the face of public health advice.

Nevertheless, the refusal to wear masks for the purpose of protecting others from contagious air-borne droplets should not allow them to deliberately harass others who want to comply with public health advice.

After I paid for my groceries in a safe transaction, where the polite grocery clerk was behind a Plexiglas shield and a courteous gentleman put my purchases into clean plastic bags, I went to my car, sat inside and cried about the rudeness of a man who obviously singled me out, just because he could.  Unfortunately, he was symptomatic of political polarization that has put the fundamentals of proven public health aside and will inevitably cause an exacerbation of the coronavirus pandemic. “We are all in this together” is lost on rude people who have no reason to harass those who want to diligently follow public health advice.

Juliana L’Heureux, Topsham Maine

#wearamask
Responses to my letter hortly after it arrived in my email shortly after it was published and with the permission of the author, here is what I received (the authors requested anonimity):

Responses received:
Hello Juliana,  I just want to say I read your letter this morning and want to encourage you not to let miscreants like the oaf who was rude to you get you down. You are so right about the political polarization in our country. I suspect the bum watches Fox News and somehow thinks not wearing a mask is a badge of courage. We know it is actually one of stupidity. You can counteract ignorance, but there is no cure for stupidity! I recently had a similar experience at a market in Brunswick. A woman was going the wrong way, forcing people coming towards her to yield to
her. I passed by her and simply said, "wrong way," in a friendly tone. She stopped, turned around and shouted at me, "Are you serious?" To have felt so entitled as to protest the rules the merchant and the state want customers to follow is another symptom of what's wrong in America. The experience left me more sad than angry, because I can think of no solution. Surveys seem to indicate that 85% of Americans are observing recommended or mandatory guidelines. Yet in a country of 330 million,
that means 50 million are not, so it's impossible not to run into them. I'm sorry you had this unnerving encounter in the grocery store, but please know that others are also appalled by the actions of this Neanderthal.  All the best....,

And this: My wife's friend was in a store and all the employees were wearing masks. One of the employees, pulled down her mask, coughed, then pulled her mask back up. WTF?

And this:  Great letter Julie, sorry you had to experience that rude shopper. Wrong way happens here all the time. I do remind them that they are going the wrong way. So far they do apologize and say “just getting used to this new way of shopping.” It’s a new way of life for all of us that follow the rules. Those who don’t, I get as far away from them as possible. 😊

Captain Brett Crozier put the well being of his crew ahead of his career

US Navy Admiral admist morale is negatively impacted by the incompetent decision to remove Capt. Brett Crozier from his command of the USS Theodore Roosevelt.  

Commentary: By sounding alarm about COVID, Navy captain put crew ahead of career:  Brett Crozier followed the evidence and acted rationally out of concern for the lives of his sailors, a fellow Naval Academy graduate says.

USS Theodore Roosevelt CVN-71

Author:  Sam Zager, M.D., of Portland is a family physician, a Navy veteran and a Naval Academy graduate. He is a candidate for the Democratic nomination in Maine House District 41.

Leadership, health and national security all collided these past two weeks, as COVID-19 rapidly spread aboard the aircraft carrier USS Theodore Roosevelt (CVN-71). 

Opinion echo published in the Maine Portland Press Herald

In late March, Capt. Brett Crozier sounded the alarm about the virus rapidly spreading among the nearly 5,000 service members aboard his ship. Acting Secretary of the Navy Thomas Modly relieved Crozier of command April 2. Modly then flew to the ship in Guam and grossly disparaged the officer Sunday in a highly unusual address to Crozier’s former crew, abruptly resigning Tuesday amid the subsequent uproar.

All the while, the virus has been proliferating rapidly, now infecting hundreds of crew members, including Crozier himself. As a Maine-trained family physician actively fighting COVID-19 here in Portland, as a fellow graduate of the U.S. Naval Academy and as a veteran who served in both peace and war aboard two sister-ships of the USS Theodore Roosevelt, I believe that Crozier demonstrated self-sacrificing leadership of the highest order when he sounded the alarm about COVID-19 aboard his ship.

Because lives are on the line in the military – just like in medicine – one learns quickly to follow the evidence and act rationally. Crozier rightly recognized last month that things were moving very fast soon after the first COVID-19 case aboard the ship. His four-page letter to other senior Navy officers, subsequently leaked to the San Francisco Chronicle, was a dramatic but reasoned plea.

He explained the urgency of the situation and cited the most current peer-reviewed medical research about the deadliness of COVID-19 aboard a large ship. He then urged a rapid offloading of most of the crew to quarters on shore, consistent with pandemic guidance from both the Navy and the federal Centers for Disease Control and Prevention. (He recommended retaining a skeleton crew aboard Theodore Roosevelt to safely operate the nuclear reactors and be available for firefighting or other damage control.)

A deployed Navy aircraft carrier is a national asset, with a heavy burden of responsibility. Everyone aboard knows that if needed, they must lay down their lives to advance the interests and values of our nation. “In combat we are willing to take certain risks that are not acceptable in peacetime,” Crozier emphasized in his letter, “However, we are not at war, and therefore cannot allow a single sailor to perish as a result of this pandemic unnecessarily.” Crozier demonstrated a sober consideration of the risks and benefits of available courses of action.

Sailors cheer Captain Brett Crozier aboard the USS Theodore Roosevelt (Reuters)

Some critics say that Crozier failed to respect the chain-of-command and security procedures when he emailed the letter. 

The usual channels may not have been working, though, and he was justifiably very concerned for the lives of his crew and the readiness of his ship. The Navy would not have selected him to command an aircraft carrier if he had anything but a sterling record of getting results under pressure, and operating within the usual chain of command.

Why would a top-notch officer adopt unconventional means for an urgent message? The answer may emerge from a formal investigation. Presently, the public does not have access to the classified messages regarding COVID-19 that must have passed between Theodore Roosevelt, the embarked admiral’s staff, Pacific Fleet Headquarters and Washington, D.C. We do know, though, that front-line warfighters sometimes must act unconventionally in order to get things done. The ship’s namesake himself was one example from the Spanish-American War in 1898. Theodore Roosevelt’s great-grandson recently described how then-Lt. Col. Roosevelt authored a similar letter during a yellow fever and malaria outbreak among deployed U.S. troops in the face of sluggish “usual channels.”

At the Naval Academy, there’s a saying: “Ship, shipmate, self.” In sounding his urgent alarm, Capt. Crozier knew he was likely sacrificing a career he’d spent more than 32 years building. And still he proceeded. He exemplified selfless leadership in recognizing that the lives of his sailors were more precious than his own career.

Maine Corrections during pandemic - Release youth from prison and put resources into transition

Maine Department of Corrections during the coronavirus pandemic. An echo opinion letter from Portland Maine:

We applaud the recent plan by Maine’s Department of Corrections to release a few incarcerated young people at Long Creek Youth Development Center, the state’s last youth prison, by April 1 to curb the spread of COVID-19. 

However, we cannot forget the remaining 37 young people locked up there, who remain at extreme risk during this outbreak. Youth prisons, harmful under normal circumstances, are not equipped to protect young people during this public health crisis, as they commonly cage children in unsanitary, close quarters.

The MDOC must publicly provide a transition plan for the remaining youth and a plan that gives the young people immediate access to free housing, health care and basic resources once they are released.

The Department Of Corrections is spending approximately $18 million to lock young people in cages and to traumatize them for the rest of their lives. We are calling for the immediate reinvestment of those funds into the community. Maine needs housing more than ever to halt the spread of COVID-19; closing Long Creek for good and turning the property into housing for those without is no longer a utopian idea.

It’s time for our Maine leaders to do the right thing and ensure the safety and health of our young people in this moment of crisis. History will remember us by how we treat our most vulnerable during this national emergency. We cannot let our young people down.

Al Cleveland
Campaign manager, Maine Youth Justice,
Portland, Maine

No medical plan response- physicians sadly doing work arounds - echo opinion

https://www.pressherald.com/2020/03/21/commentary-our-health-care-system-is-about-to-become-completely-overwhelmed/

"...We are out of sanitizing wipes in the hospital, largely because many of them were stolen," Dr. Caitlin Bonney 

Echo Commentary published in the Portland Press Herald in maine: ‘Our health care system is about to become completely overwhelmed’
An emergency physician with roots in Maine describes 'a turning point' on the COVID-19 unit of the out-of-state ER where she works.

By Dr. Caitlin Bonney

Worried well tie up emergency rooms

Just finished my fifth shift in a row in our Emergency Department COVID-19 unit, and I have to say, I’m spooked. I’m pretty worried about what’s coming. Our health care system is about to become completely overwhelmed. And I know that in some parts of the country it already is.

In the ED we think a lot about “volume,” or how many people are coming through who need to be seen. We’re getting a big surge in what is called the “worried well,” who take up a lot of time and a moderate amount of resources. We’re doing everything we can to keep these people from tying up the Emergency Department, but there is no place else for them to turn. They are terrified. They want to get tested. We don’t have any tests. It makes my job easy. In my mind, anyone who felt sick enough to come to the Emergency Department during a pandemic is sick enough to quarantine at home for 10 days. It will help with social distancing and keep people from coughing on each other while they fight over toilet paper at Costco. But they have no place else to get information. Every urgent care and primary care office is terrified and sends them directly to the Emergency Department to “get tested,” but we don’t have any tests. It overwhelms the system.

Another issue we have had is people in group living situations: patients sent in from homeless shelters and detox or sober living programs. They can’t quarantine where they live. But if we tell the program we can’t rule out COVID-19, they could lose their bed and be on the street during a time when all businesses and restaurants are closed. We don’t have a plan. We have been secretly testing some of these people – sending tests to California, telling them to wear a mask when they go back and calling them with their results. I hope. I can’t get the results because they’re run in a lab in California, so a nurse in Infection Control is supposed to get their results and call them. I can’t see the results myself.

Also, seeing a fair number of people with mental health issues who are having trouble with quarantine. Their therapists offices are closed, or if they try to get treatment, their insurance company is closed. They are stressed and anxious about being quarantined and losing their social support.
Influx of young COVID-19  patients

Today was a turning point. Much higher volumes; the staffing plan we put in place five days ago has started to fail. We’re going to need to shift more doctors and nurses over from the main ED into the isolation unit as volume picks up. At the beginning of my shift it was a lot of the worried well, but as the night went on, we started to see some sick patients. What’s spooky is that a lot of them are young, and they go downhill really fast. My worry is that because we are seeing a skew toward younger patients in the beginning, there will be no beds or ventilators left when the surge of older patients comes.

Intubation is another issue. Normally, intubation (inserting a breathing tube) is a fast process. Maybe five minutes for setup, 30 seconds for procedure, 10 minutes for post-procedure care. Can be even faster if needed. But intubating a COVID-19 patient is very dangerous for staff because it creates aerosols and makes it much more likely that the virus will spread. It takes much longer to set up and perform. Everyone needs to be in real full protective gear.

One of the big changes in emergency medicine and critical care over the past few decades was the introduction of BiPap (Bilevel Positive Airway Pressure), a kind of breathing machine that helps patients breathe without them needing a breathing tube inserted or needing to be sedated. It helps patients who are too tired to breathe, it helps push fluid out of the lungs, it helps patients with asthma and chronic obstructive pulmonary disorder. We can’t use BiPap on COVID-19 patients because it creates aerosols that spread the virus. And since we don’t know who has COVID-19, we can’t use BiPap on anyone. We also can’t give nebulized breathing treatments, the mainstay of therapy for asthma and COPD exacerbations, because those create aerosols. I’ve had to learn how to use alternate medications that have been out of practice for decades to treat these conditions.

Hospital workers are unprotected

On top of all this, none of us knows how to protect ourselves. There is a lot of confusion about what personal protective equipment we should be wearing, but that debate is kind of settled because we don’t have high-level PPE available anyway. We still have N95 masks and I get one of those per night (recommended wear time is five hours, I wear mine for 10). I save all my used masks for the day when we run out of clean ones. I wear safety glasses, which may or may not be the right level of protection. I wear one gown through my whole shift and take it off if I leave the unit and put it back on when I get back; that is not the way you are supposed to handle PPE, even of this level. We are out of sanitizing wipes in the hospital, largely because many of them were stolen. These are what we use to sterilize beds and equipment between patients. I have a Ziploc bag with a few wipes in it that I have been bringing with me to each shift to reuse on my stethoscope between each patient. I fully expect to get infected and just hope that my relatively young age is protective against severe disease.

I see videos online of people who have no daily contact with the virus getting packages from Amazon: going outside, wiping down the outside of the box with a wipe, opening the box, wiping down the contents with a wipe, then taking off their shoes and going inside. I work every day with patients I’m 100 percent sure have the virus, and I don’t have the time or resources to live like that. I’ve started stripping my scrubs off into the wash when I get home, but there’s really no way for me to avoid contamination. I don’t wash my hair every day (once a week is good at this point), but I wear a bouffant. I drive to and from work in my car and touch the inside. My phone is marginally cleaned by one of the few wipes I have. I carry my bag to and from work and leave it outside the unit, but there are things I put in and take out of there that I can’t wipe down. I definitely can’t spend my energy focusing on whether I touch my face. The message here is not that you shouldn’t be cleaning things, but it seems skewed that people with no exposure to the virus are able to clean everything and those of us actually caring for COVID-19 patients are not.

My daily schedule is like this: Wake up, attend a Zoom meeting about COVID-19 for several hours, read about COVID-19, drive to work, work in the COVID-19 unit for 10 hours, drive home in silence thinking about the day or decompressing with a friend on the phone, shower, sleep three to five hours, repeat. Having friends going through the same thing around the country is my only sanity saver. We’re all scared.

U.S. NOT TAKING THE RIGHT STEPS
When I do get some time to run errands, the grocery stores are empty. I can’t get basics I would like to have to continue taking care of myself while I work tons of extra hours. The grocery stores are sold out. Scarcity is a powerful human motivator and the hoarding and stealing are making my life difficult. 

I’ve decided that I’m going to try to switch to ordering takeout and delivery during the business shutdown to support local businesses, in the hopes that they will be able to open normally again when this is all over.

In the U.S., we’re making changes that are destroying our economy, but we haven’t taken the steps that will actually slow transmission. We’re not checking people’s temperatures. In the rest of the world, your temperature gets measured at every exit and entry point including pizza shops and your own apartment building. In the U.S., we’re not monitoring for symptoms and we’re doing any surveillance testing. We don’t have tests.

My boyfriend lives in another state. I don’t know when I’ll be able to see him again. I don’t know when I’ll be able to see my parents again, because of their age. All my life plans are on hold. I was planning on visiting my boyfriend next month. Now I’m not sure if I should go because every day we have more shifts to fill as doctors get stuck out of state due to flights being canceled, or are self-quarantining because they have symptoms, or are removed from the schedule because their risk of severe disease is high if they are infected due to their age or underlying medical conditions, or we simply need more doctors to work in the department. I feel like it would be irresponsible to leave and risk getting stuck out of state. Everything I do now feels irresponsible because I could be carrying the virus at any time.