"The sky is falling. I'm not afraid to say it. A few weeks from now, you may call me an alarmist, and I can live with that. Actually, I will keel over with happiness if I'm proven wrong," wrote Dr. Cornelia Griggs in her March 19, 2020, OpEd in The New York Times.
Four years later, we can safely say not only that Dr. Griggs was not wrong but that her honest rendering of the first months of the COVID-19 pandemic in New York City, now captured in her appropriately named memoir, The Sky Was Falling, can help us make sense of the most catastrophic medical crisis we have seen in our lifetimes.
How soon is too soon to revisit this dark era? In the case of The Sky Was Falling (Simon & Schuster) let me reassure you: while Dr. Griggs does not sugarcoat the heartbreak of doctors, nurses, and all medical staff during the pandemic, nor the terror and loneliness of patients, she also reminds us that these tender times were rife with moments of emotional discovery and purpose. Over and over, as I read this book, I found my experiences as a doctor and mother validated and thoughtfully rendered. This important book chronicles what no statistics can: a day-by-day evolution of understanding, told with compassion, from someone with a front-row seat.
The book begins in February 2020, when COVID-19 is more a rumor than an actual threat. Dr. Griggs is a pediatric surgery fellow in New York City with a few months of training left before she can take her young children to rejoin her husband in Boston. Her parents help her juggle single parenthood with her every-other-night call schedule, and she has little time to contemplate the coronavirus. She has a patient whose lungs are unusually friable; her neighbor is stockpiling cleaning supplies and masks, but she also acknowledges a layer of American denial about this novel coronavirus. When other mothers accost her at an extravagant four-year-old's birthday party, she recognizes this touchstone moment: Nothing will be so carefree again for a long time.
Cornelia Griggs is a triple board-certified pediatric surgeon. She completed medical school at the Columbia University College of Physicians and Surgeons, where she graduated with Alpha Omega Alpha honors. She completed her adult general surgery residency and surgical critical care fellowship at Massachusetts General Hospital, where she currently practices. She is a graduate of Harvard College and earned a certificate in health policy from Harvard’s John F. Kennedy School of Government. Her writing has been published in The New York Times and many top medical journals, including the New England Journal of Medicine.
Author photo by Anelise Tubinis
Dr. Griggs journaled her way through the rollercoaster that follows, and we experience it with her: the nonsensical, shifting and sometimes contradictory safety guidelines from the government and her hospital, and the insecurity they engender; the flight from the City by those families who can afford it, and the disproportionate effect of the virus on people of color, sometimes whole families at once; the frustrating lack of testing and silent hope that one has already had it and might be immune; the way basic supplies like masks and gloves are rationed, and how tenuous it feels to rely on the same N95 mask for weeks; the mounting death toll and the arrival of refrigerated temporary morgues outside the hospital; the suddenly urgent need to update one's will. She writes of her isolation in her apartment and how hard it is to be without family. We hear from Dr. Griggs, the surgeon, the trainee, the friend and the mother. Her ability to consider how different the pandemic looks from these angles reminds us of the months in which we all dwelt in a state of high-stakes ambiguity.
As a pediatric surgery fellow, Dr. Griggs knows what she needs to do. She quotes Albert Camus, saying, "It may seem a ridiculous idea, but the only way to fight the plague is with decency." And this, she realizes, offers her a way forward in an uncertain time, when both the hospital and the government seem unable or unwilling to protect healthcare workers, and there is infighting about who is most on the frontlines. She decides she can continue doing her job with human decency, if nothing else. "The way I see it, human connection and compassion is possibly the only way out of this giant tragedy," she reflects. And with her family safely out of New York City for the time being, her world becomes the doctors and nurses she works alongside, united in purpose against COVID-19.
There is so much in this book. Dr. Griggs gives voice to nurses and attendings, to an environmental services worker who never misses a day at work, to her Black colleague's response to the murder of George Floyd and the way this makes her question her devotion to her work as a surgeon (during a pandemic!) in a country that does not value her as a person. We hear about small acts of extraordinary humanity and the necessity of supporting one another in this chronically understaffed hospital at the pandemic's epicenter – even when the administration seems unsympathetic to the daily realities and mortal danger of patient care.
What resonates most with me, as someone who wanted so desperately to speak out on social media the way she did but lacked the chops, is the way Dr. Griggs shares her emotional trajectory: from feeling like a hero to realizing she was a "sitting duck" without adequate protective equipment; from expressing herself confidently on Twitter to wishing she could just disappear when shamed by a fellow surgeon; having nightmares and contemplating medication for anxiety but eschewing this option out of fear of having to disclose a psychiatric condition to the medical board.
Dr. Lorna Breen, the ER physician who killed herself, is "all of us," Dr. Griggs states, citing unprecedented levels of mental anguish caused by witnessing so much death and experiencing so much helplessness without meaningful support (or even personal protective equipment). She writes that the combination of social isolation and fear of the virus while being required to confront it daily, is just too much to process in real time.
Meanwhile, she recognizes the escalating anxiety and depression in children and – as she does so well – balances her empathy for parents wanting kids to socialize without masks and her intimate knowledge of MISC-C, a post-COVID illness mainly affecting school-age children. "Parenting in a pandemic is a series of difficult choices," she admits. Even seeing her own family presents a relatable internal struggle over what is safe enough and what each of them needs.
By June 2020, and the end of her fellowship, Dr. Griggs admits, "My reserves of idealism about the medical profession are just about crushed." She is uncertain about holding a celebration, conflicted even at the end of the book about, as she puts it, having chosen her profession over her children. The pandemic stripped the complex illusion of balance for medical trainees who are mothers – she would have thrown away nine years of training had she left, with no clear path back to being a surgeon.
In addition to her reflexive consideration of multiple points of view, this book shows us the incredible gift of Dr. Griggs' unflinching honesty and her tireless drive to advocate for patients, nurses, physicians, and children. Ultimately, Dr. Griggs comments, "Bravery isn't the obvious-looking thing we imagine it to be. It's something very mundane, even pathetic in the moment." It's doing what needs to be done to keep others safe. For some, it meant leaving health care to care for family; fortunately for us, many others stayed, sometimes at significant personal cost.
Within these pages lies a story of true courage—showing up physically, emotionally, and politically in a historic time we want to but never should forget. In The Sky Was Falling, we have an invaluable account of how taking care of one another can bring us through a terrifying, traumatic time—and also a clear-eyed, cautionary tale about the future of healthcare.—Claire Unis
Claire Unis is a pediatrician and author of the memoir Balance, Pedal, Breathe: A Journey through Medical School. She holds a MFA in Creative Writing and leads writing, literature and narrative medicine classes for other clinicians.