Content Warning: This poem may not be suitable for all audiences and may contain information that some could find upsetting. Reader discretion is advised.
The Corpus Of Jane Doe
A mountain of paperwork Encumbers my day In the mortuary she waits- Chalk-white and purple Coagulated blood at the points We knew to be the lowest Where she laid waiting to be found
She is your typical body- No tattoos or piercings Barely more information than: Hair, Eyes, Skin, Size
What is the immutable?
She had an identity with a past: Information trapped behind Unmoving lips and rigor mortis Lost to the depths of an unseen mind
Someone loved this woman: Her vibrant smile I never see How her cheeks flushed At compliments or with tears
We gather information -what we objectively know- To approximate backward Into a time before death When parents held a baby And gave her a name
Thank you so much for reading my poem today! If you found its words meaningful, please consider liking, commenting, and/or sharing it with others. Truly, I am grateful for the time you spent reading my work.
This year I had planned to be in Savannah, Georgia at Bonaventure Cemetery spending today with you and Grandpa, preferably with my parents or one of my siblings.
You convinced me to keep writing when I wanted to give up.
You told me I could succeed.
You would have been 95 today. We celebrated our birthdays together: yours today and mine tomorrow.
At the time I thought it was weird that I didn’t have normal birthday parties. Instead, we had a big family dinner together on July 9th and then we’d do something together on July 10th. Sometimes whatever we did involved whatever children my family could scrounge together.
It wasn’t until adulthood that I realized this was a birthday party, just not the kind of birthday party most American kids have.
What I hadn’t realized was that every year you celebrated me being your birthday gift.
I was your surprise baby. Your impossible baby.
Impossible Baby
The story goes Mama was sick Mama didn’t know I wasn’t the flu A five month flu Impossible flu
Two kids to chase Two kids to follow
Too Sick, Too Tired Mama didn’t know I wasn’t the flu
Doctor came in the room Test Results Read “Impossible” She said
Ultrasound Boy’s Name Father and Grandfather Dreams Come True Finally The fourth with their name
Grandmother’s Birthday Too Early Don’t Be Born Baby — But Mama can’t stop me Born Just After Midnight July Tenth Belated Birthday Gift
But That’s Not A Boy
No One Agrees: Laraleigh – Laura No, Lo
Being born premature in 1989, my mother did not want to take baby pictures of me in an incubator where she could not hold me. She did not want to have pictures reminding her of what I looked like hooked up to a heart monitor and a ventilator with various IV bags flowing into me. She did not want to remember the hours and hours where she wandered around a hospital screaming because the nurses lost track of where they put me and forgot to tell her anything about my condition.
Seriously, you kids born premature after 1990 had way higher survival rates. One of the reasons my mom didn’t take baby pictures was because she was advised not to in case I didn’t live. That’s the sort of stuff women were told would be psychologically better for them in the 1980s. I swear my mother is one of the strongest women on this planet.
Because of this, I didn’t see a baby picture of me until I was 30 years old – this past February/March while visiting my parents. In the picture, I am almost 6 months old and my grandparents are holding me after my christening service at St. Matthews Church.
Christening
I didn’t see the photograph Until age 30 Grandmother and Grandfather hold me [The red brick of St. Matthew’s Church] Smiling- Laughing so hard Their faces blur
The only baby picture
Mama didn’t want to remember: Wires, tubes, monitors, screens
I don’t remember them either.
In my early twenties, I asked my grandmother for a picture of her and my grandfather for my birthday. I’m terrible at asking for anything, especially if it is something the logical part of my brain has deemed superfluous. What I didn’t expect was this.
It’s a picture of my grandmother and grandfather at Armstrong College in Savannah, Georgia. At the time, my grandfather, having just returned from World War II, was finishing up a Bachelors of Science in Meteorology. My grandmother taught chemistry. They fell in love with teaching, scientific progress, and each other.
They were the types of people that had trouble sitting still.
My grandmother was academically fascinated by her heritage. She honored her connection to the Douglas clan, but I would not call her proud. Often, she focused more on the deep connection it provided her to faith. Her expressions of spirituality changed so much even over the 27 and half years I knew her that it’s hard to say what she believed. What I can say is that she believed in showing endless love, patience, and understanding. We selected her favorite prayers and passages to include on the prayer cards.
Prayer cards from the memorial service for Lillian
What I want every person reading this to know is that though I have only spoken of a few moments, 91.5 years is a long time on this planet. Lillian danced through those years with a love of music, chemistry, objectivity, compassion, education, and love.
The last two gifts she gave me were her engagement ring and her last words.
My grandmother wanted to experience everything there was to experience on this planet. She liked to say, “Heaven Is Here On Earth.” She did not live an easy life – in fact, quite the opposite. Her life was by far full of emotional hardship.
The Last Memory
Restless loblolly pines We sit Dry docked green aluminum jon boat He laughs with goofy faces Old spice arms envelope me Binocular eyes
“That’s the Hale Bopp Comet” His voice is shimmering moonlight on bay water His presence is my father’s smile
He still wears that 1970s brown and tan puffer jacket A flare orange dog whistle on a braided leather cord I taste fried fish tails Bay water drains off the hull
My fathers hold me together The child meant to be the fourth with their names For that moment I belong
Together they point to stardust Teach me constellations How to find my way home If I am ever lost at sea
My grandfather died in 1997 in the doctor’s office while getting dressed after a physical. He wasn’t feeling well and in between classes he managed to get seen. He didn’t make it to his afternoon lecture. In October, he would have been 100 years old.
She never remarried, but she was not broken. She mourned the loss of her best friend and celebrated his memory every chance she got. My grandfather loved fill-in-the-blank style Hallmark cards and writing her love poems. What I didn’t realize until I was a teenager was that she kept all of them and read his words every time she missed him.
Now, I find myself doing the same thing, even with her final words. My birthday buddy can never be replaced. I will celebrate her 150th birthday in 2075 just as I celebrate her 95th.
Terminal Lucidity
They said she’d never play piano again Hematoma Right side CAT scan looks bad
We came to visit at the wrong moment Right moment The nurses couldn’t find the cell phone number They wouldn’t let us in the room
We’d spoken to her that morning We said we’d see her soon
You were out on the boat Knee high in male bonding Falling in love the only way Our family knows how
We finally got you on the phone But you never hung up
At 91 and a half You and I argued You insisted she was clear
We moved her to hospice We prayed she’d tell us that we were wrong
Later that night I sat alone with my other mother She squeezed my hand “I’m not ready”
She never spoke again.
As I conclude this memorial, I thank you for taking the time to be here with me. I recognize that it is not easy to be with someone in mourning. I recognize that it is increasingly unusual in America for people to grow up in a multi-generational child rearing situations where they and their siblings form these close bonds. Because of this, real family, the family that sticks by you and unconditionally loves you, will be my first priority in life for as long as I live. That’s what we were taught by our grandparents and our parents. I hope that this is a legacy my siblings and I can carry on.
With that, I close this with love to all members of my family.
“A good name is to be chosen than great riches, and loving favor rather than silver and gold” – Family Motto / Proverbs 22:1
I have a tendency to wander off – in grocery stores, in parking lots, in Costco. I get this trait from my father. At one point this led to an interesting scenario where I was 17 and in the back of a police car, but that’s a story for after I’m dead.
This is why I wear a GPS enabled watch with Find My Friends and cell service. It’s because my husband loves me and genuinely cares for my safety and is the only person on this planet that has access to that information in case he can’t find me one of these times I’ve wandered off somewhere. Flowers and books can be distracting when you’re in the woods.
There are a lot of people like me in this world. And there are a lot of people mixed up in bad 💩 one way or another. I look at these cases and I see missing people that could have been me, but I’ve always found my way back. I’ve never been lost – for some reason I have a confident sense of direction even when in wilderness areas. I can’t explain that part, but I bet many of these people felt the same way – they tripped and fell without a way for someone to find them.
I think about their families and that’s where I get stuck. I struggle with understanding extremes of emotions – I tend to shut down instead. I think about how many of those families also shut down and the generations down the line that shutting down impacts. It’s like a death with no closure – it’s so much worse because it’s unknown.
With these newer methods we are finally putting faces to the skeletons of unidentified remains. These faces have helped family members identify lost loved ones years after their disappearance and finally put what happened to them to rest.
Last autumn I listened to The Disappearance of Des on my commute. It’s a podcast about Desmond Francis Carr – an Australian man who died in 1979. It was when I started listening to missing persons podcasts that I realized just how many unsolved disappearances. In fact, every few years a news network like NPR in 2013, or even Local News Stations in 2019 notes just how many cases go unsolved and that some states seem to have more than others – in that report Alaska, Arizona, and Oregon has the top 3 lead, with Georgia, Rhode Island, and Massachusetts having the fewest missing people per 100,000 residents.
According to NAMUS the United States has 4,400 unidentified bodies found every year and 600,000 people go missing. I think of the number of lives impacted by those 600,000 missing stories and then I realize that’s why all of those podcasts exist. That’s why people need to keep talking about these missing people.
Recent Cases In Montana
As of Friday, 56 children are missing in the state of Montana. The demographics break down as follows:
Here’s a nifty chart I made for everyone to show the comparison.
Without equal representation in both sex categories, I can’t run a full analysis, so I had to throw one of the categories out. If we focus on just the white and native children and look to see if there’s any statistically significant difference between the numbers of children missing in these groups, there isn’t (this is assuming boys and girls all have equal representation within the population).
There are going to be those that argue with me about the inaccuracies of this analysis because of the identities of these children. If the identity is impacting the way the child is now presenting to the world that’s important information that people should come forward about, but that is not information available on the sheet provided by Montana DOJ. I am working only with that information.
I ran it with a generous 95% confidence interval:
The chi-square statistic is 0.1922. The p-value is .661126. Not significant at p < .05
The chi-square statistic with Yates correction is 0.0195. The p-value is .889073. Not significant at p < .05.
There is one thing that is significant though – these populations are supposed to be statistically different. Only 6% of Montana’s population is Native American, so why are 37.5% of missing children from that demographic?If children were being selected randomly from the population, then the distribution should be proportionate to our population, not insignificantly different between the two groups.
That would mean that if missing children were proportionate we would expect only 3.36/56 missing children to be Native American versus the reality of 21/56 missing children (following the percentages mentioned above). Comparing these proportions with a one-tailed Z-test and a generous significance level of 0.05:
The value of z is -4.0403. The value of p is < .00001. The result is significant at p < .05.
NAMUS has a special program in place because of this issue. You can check out the United States Department of Justice’s data sheet here. Montana is one of the states that has not yet passed legislation mandating case entry into this database. I understand that a lot of decisions will need to be worked out.
Anyways, that’s a lot of rambling. This is a heavy subject to write about. If you have any interest in this topic consider volunteering your time to write about a missing person cold case for some form of media. There are a lot out there – more than have been written about.
Thank you for reading. Without you these little bits of data aren’t anything – communication requires a recipient and for you I am grateful.
How do you describe that feeling of watching numbers climb and realizing that you’re watching in real time the most global example of what you’ve studied and taught your entire adult life?
Dread? Excitement? Existence?
When teaching about pandemics we teach students to look retrospectively at the numbers of those that have recovered versus those that have died. We make estimates on the numbers of those that were actually infected based on documentation available (or more recently – on documented confirmation). At about 6:00PM on 27 March 2020 twice as many people had died of covid-19 in the United States as have recovered. Seeing those numbers broke my heart for a moment, so I had to talk it out to myself somewhere.
It’s too early to call what it will look like in the United States in terms of our final numbers with covid-19. At this time these numbers are skewed by post-mortem testing and testing criteria that limits test accessibility to those already in need of medical intervention over home care.
Things might look scary, but don’t give up hope. Update 30 March 2020: and reporting started coming in of recoveries! Part of why this reporting may have been delayed is due to stringent testing criteria.
https://coronavirus.1point3acres.com/en as of 12:47 AM MST 30 March 2020. The criteria most are going by: 2 negative covid-19 swabs with a minimum of 24 hours separation.
The reason for this standard is that there is a very high false negative rate with the rt-PCR based test. If anything goes wrong along the way – say there’s a bad reagent, too low of a sample of viral particles, or something goes wrong that invalidates the test it will come back negative. This is the bane of every graduate student that has ever done rt-PCR. They will tell you their horror stories, especially if they were from poorly funded labs.
For some additional hope.
There’s this amazing power of graphs. We can look at growth of reported cases overtime to project the number of cumulative reported cases in the United States in the future.
I started keeping these to track the projection if we stayed on an exponential number of cases reported (aware of typo – did not plan on using this graph for anything originally)
Even as we have expanded albeit limited testing across the United States the overall rate of growth of total cumulative cases is slowing. While this hope is based on very limited data, could it be that we may actually be flattening the curve?
Equation is changing – are we flattening? I’m not sure. We added a zero. [Does some math]. I don’t know if that’s significant yet.
We’re able to see the slope change as the day to day numbers change. Thus, we can see when our efforts are working. (See below)
Source: https://coronavirus.1point3acres.com/en has the ability to build graphs showing how the US has slowed growth from 28% to 25%. That 3% isn’t much, but it’s something.Source https://coronavirus.1point3acres.com/en But remember that our reporting is primarily coming from one place right now. Go to the website and visit this graph – it’s actually a movie!
This is part of why we need accurate reporting above anything else. The numbers that only require home care matter. In order to accurately understanding the danger of a disease we have to know how many people have it and are acting as asymptomatic or low symptomatic carriers. This influences anticipatory healthcare planning decisions for patients and facilities. I will address this a bit more later in regards to the limitations of cultural understanding around death, dying, and disease.
Update 30 March 2020: Exciting New Graph! If we start looking at the growth in the number of reported cases since improved surveillance across the United States started around March 19th – Yes, the US is kind of flattening the curve. But not enough. We’re also not far enough in to predict the peak.
We can be hopeful. As of 30 March 2020 we were set to diagnose our 500,000th case on 4 April, 2020. Flattening the curve is succeeding in different parts of the country. I will be addressing this in a new post. As a brief update as of 12:01AM 1 April, 2020, we have moved that projection out to 5 April, 2020. My model is limited by not knowing what the current daily max testing capacity of the United States is yet.
Update 5 April 2020:
Hey, look! We didn’t hit 500,000 cases. That’s incredibly comforting and is a fantastic sign. That said, we still have a backlog of COVID-19 tests, an untested positive population acting as a reservoir to continue infecting our healthy population, and we have no control over this. At this point, it is believed that SARS-CoV-2 will become a seasonal illness in the United States.
Source: Same as before
Remember how I said before that the 500,000th case had been pushed out to 5th April? Now, that’s 6th April, 2020 if only looking at the cumulative cases since the 15,000th case in the United States. What if we look at since 23 March? On this day we had approximately 46,000 confirmed cases, with the next day climbing to 55,000 confirmed cases. This is the date we should look at to consider since 50,000 cases reported.
Source: same as before
It’s not changing. There’s enough growth in of confirmed cases in parts of the country that any flattening is being overwhelmed right now. America’s current check up isn’t doing so hot.
It’s not the fault of our healthcare workers and everyone needs to show gratitude. The United States is facing extreme PPE shortages, resulting in healthcare workers being put at risk for infection and at risk for being vectors of covid-19. Hospital acquired infections have long been a problem in the US due to poor hygiene practices among staff and invasive devices used in hospital settings such as catheters, PICC lines, and IVs. While this has been combatted over recent years by the installation of improved educational programs and the implementation of disease control specialist positions in hospitals and clinics, these measures are useless without sufficient PPE. Washing hands and hand sanitization does only so much. We dedicate a lot of research time and money to this topic.
Diagnostic Testing Has Barriers
Point of Care rapid testing is a luxury afforded us over the past ten years (and toward the end of the 20th century) for strep throat, influenza, drug screenings, and other common “ailments” that bring you in to say hello to someone like me (only using quotes because I included drug screenings). The fact that we have this soon to be available for the coronavirus at all is incredible. Not only will this help with disease surveillance, but we have the ability to accurately study a pandemic in real time on a scale like never before. We could have the ability to intervene and institute true quarantine measures assuming we roll out extensive Point of Care screening for everyone.
But until then, can I even trust this data?
Rituals Around Disease, Death & Dying Complicate Things
How many people are dying at home untested? Remember that across America we have incredibly diverse customs about death and dying.
I recently spoke with friends in New York City and she mentioned that she knew members of certain cultural communities that though they were symptomatic were not getting tested. Part of why this happens is because of cultural beliefs around illness and dying. It’s going to be scary and everyone is reacting in ways that may deter them from getting tested. This will limit our surveillance and will also result in transmission within communities.
In the American South (where I’m from) families conduct home hospice even during severe illness out of pride and the cost of healthcare. Once the family member has died they will contact the local mortician. While it might no longer be legal to do home embalming and many states have prevented home burials, this has never stopped families from caring for the dead. Caring for the ones we love as a final act is one of the most essential acts as a family member that is often robbed of Americans elsewhere across the United States. In twenty to fifty years will we need to do go all paleovirology/anthrovirology (actual fields!) on disinterred bodies to get the actual numbers? Or will we go the route of China with incinerating covid-19 presumed bodies without testing? Will we go the route of the US during 1918? Will we burn it all?
Another thing to consider with any pandemic is how the rituals around death in the home contribute to the spread of a disease. This paper regarding the Ebola pandemic addresses why it is important to understand how we culturally handle death in times of pandemic in order to appropriately control spread.
Future Questions We Will Hopefully Answer:
As we look into ways to protect our healthcare workers with limited PPE we should be reminded that there are other ways we control the spread of disease.
Are healthcare workers on PReP faring better?
Many of the antivirals in PReP and PeP are being tested in the treatment of covid-19. Healthcare workers in Emergency Medicine have recently started turning to PReP and PeP to prevent the spread of HIV as a result of blood born pathogen exposure. Are these healthcare workers faring better than those not on PReP? Only time will tell since the number of workers on PReP reporting is still rather low.
What percent of the population needs to participate in social distancing in order to flatten the curve?
There’s isn’t actually an exact percent. What’s critical is that those at highest risk of being effective vectors for covid-19 during the transmission period of infection while shedding virus are able to infect as few other people as possible. This is a complicated question I’ve broken down into a couple parts.
Who actually needs to be on a stay-at-home order / essential workers only order for us to flatten the curve?
Go Fill Out Your Damn Census So I Have A Better Map
On the U.S. Census map above population density is shown in dark areas.Are you in that darker half? Stay. The 🦆 Home unless you are an essential worker.
Are you NOT in the darker half?Then you should be worried if you hear that there’s community transmission in your county. At that point practice social-distancing.
But you’re not out of the woods yet my friends. I have some more criteria for you:
How far away does your closest neighbor live? If you live in an apartment building – you should stay home. Live out in the country? Congratulations you lucky son of a gun! We’ve shown those city slickers that living in the underserved parts of America with crappy, dying economies that have been sputtering out and suffering at the hands of a global economy and evil corporations ain’t so bad, now is it? Or is it.
How far away is the closest interstate, highway, airport, train station, and other means of connection?Ever go to the gas station close to those things? May want to rethink that. Those are going to be your highest risk areas.
There’s a certain percentage of the population that can’t participate in the Stay at Home orders. It’s not their faults and they should be treated with the utmost kindness. They are taking huge risks. If you are a member of this population there are ways to assess how high risk your workplace is (if you’re interested). The actions of everyone else helps to make up for that by creating distance and reducing the number of people available for transmission at all. I know that’s a little messed up, but that is part of the theory behind it.
What is the median age of your area? Serious question though. Also, how old are you? Yes, this disease is affecting young people and those with conditions that make them more vulnerable. But I want you think about what kind of threat you are posing to the other people in your area by being a vector. If you live in a dark blue area, even if there hasn’t been a reported case in your county yet – staying home or social distancing is protecting this vulnerable population. You don’t want to have helped transmit the first.
(Update 5 April 2020) What Is Your Social Distancing Score?
You have thought about population density. You have thought about your median age group and how that plays into susceptibility of your area. The actions of those around you also put you at risk. In the flattening the curve check ups on New York, Pennsylvania, and New Jersey I talk about how important social distancing is right now and how big of an impact it is going to have on what we see in the future, such as the one vs. two peaks in New Jersey. But remember that not everywhere can social distance. Pay attention to the areas graded “F” as we address poverty below and in this post here.
Do you live in a multigenerational household or live close by to family? Do you see them often?
You absolutely need to be trying to stay home. These stay at home orders are critical to you. Illnesses like this can spread through families like wildfire. We love our families, right? Keep our families safe. If you are an essential business employee, it is even more important that you protect your family and isolate from them if possible. In many cases there is caregiving. This is addressed more in this post.
Disease outbreaks are worse in areas where poverty is not appropriately addressed. If you live in an area like this, you need to take stay at home orders seriously and the problem is, you can’t. And it’s not your fault. Our government and humanity are failing you.
What is determined to be essential and how do they determine whatpercentage of the workforce can be considered essential?
Oh. See, here’s the fun part. They don’t. They think of essential services, not the total number of employees this prevents from participating in social distancing. The state governments will figure out why this is really really dumb pretty fast, especially since many are now seeing hiring booms in those fields (like gas stations and weed delivery). I’m not an economist or a business person. People need to eat. This will be a strain on efforts that has to be monitored.
If people are interested in hearing me rant about the topics I’m actually an “expert” (by degrees and academic research/teaching background only) in let me know. If you are I’ll actually go back and edit this rant and dress it up a bit.
Thank you to anyone reading this. Without you this is just a shout into the ether.
