The year is 79 AD.

The young man feels the faintest tremor beneath his feet.

It is the fourth time the earth has trembled this week.

He looks up at the mighty volcano in the distance.

Mount Vesuvius is speaking.

But nobody is listening, even those in its shadow.

Not yet. 1/

The year is 2020.

I knock, and then enter the patient’s room. Someone else is already in here.

The phelobotomist is finishing up. In her hand is a vial of dark venous blood.

A snapshot in time from which the day’s decisions will be made.

Both enlightening and misleading. 2/

The patient is lying on her side, facing the large windows that make up one wall of her room.

At first I think she’s asleep, but as I get closer I see her gaze is far away.

“I couldn’t sleep last night. A car exploded or something on the road out there. Sirens constantly.” 3/

“Exploded?” I’m skeptical, but I dutifully glance out the window.

Sure enough, I see a distant wisp of dark smoke over what seems to be wreckage. It’s too far away to see.

I tell her I’m sorry about her sleep being so disrupted.

I take a seat at the bedside. 4/

We talk about how she’s doing. Thankfully she’s feeling better overall.

She seems pensive and falls silent.

I have places to be, but instinctively I let this silence grow.

I used to loathe silences as unproductive. With time, I’ve learned that silence can be healing too. 5/

“It feels strange. I know this COVID thing is out there. I know so many people are sick. And I’m in here, and I don’t have it. But...”

She trails off again.

I still say nothing.

“It’s like that exploded car isn’t it? It’s far away but I know it’s there.” She sighs. 6/

This time she looks to me and I know she expects me to say something. The problem is I’m not sure what to say.

For so many, tragically, COVID-19 is an all-consuming inferno.

Away from the epicenter, COVID-19 is a shifting unease.

A distant volcano spewing distant ash. 7/

Except that’s all an illusion isn’t it? The virus isn’t “over there.” It’s potentially everywhere.

The only distance is the one that saves us.

The six feet in between.

“I hear you. These are scary times. You’re getting better. It’ll get better soon. This will pass.” 8/

She nods, and smiles.

I don’t know if she believes me. I don’t know if I believe myself.

Later that night I’m driving to another hospital for a different patient, urgent.

Hyperkalemia, acidosis, shock.

Homeostasis unraveling.

I’ll try to prop it up, and tilt the scales. 9/

As I drive, I take the freeway. It takes me a moment to realize it’s the same freeway that was visible from the hospital window.

Sure enough, I see wreckage up ahead, off to the side.

As I get closer, I realize the intensity of the fire that must have burned here. 10/

There are scorch marks and debris. The remnants of an inferno.

I realize that even from the window, seeing it burn, you’d have no idea until you were up close.

Until you feel the fire singeing the delicate hairs on your skin, and you breathe in the scorching air. 11/

Until you feel the PPE pressing so tightly the skin on the bridge of your nose is rubbed raw.

Until you cross the threshold into a world where bodies are stacked in refrigerated trucks, and cardiac arrests happen with a numbing regularity.

I drive past the wreckage. 12/

I watch it in my rear view mirror for as long as I can, feeling that same shifting unease my patient was trying to put into words.

Trying to clear my mind, I play a little music.

One of my favorite songs.

“Pompeii,” by Bastille.

Suddenly the lyrics have new meaning. 13/

“I was left to my own devices.
Many days fell away with nothing to show.

And the walls kept tumbling down,
in the city that we love.
Grey clouds roll over the hills,
bringing darkness from above.” 14/

“But if you close your eyes,
does it almost feel like
nothing changed at all?

And if you close your eyes
does it almost feel like
you’ve been here before?”