BEYOND THE MASK

An Interview With Ellen Matzer, RN, CCRN, and Valerie Hughes, FNP, RN

By Anthony T. Eaton 05/06/2022

Their newest book Beyond The Mask is a compelling work based on the COVID epidemic telling the stories of six fictitious healthcare workers based on the experiences of those who actually worked on the front lines.

Using their own background in healthcare and interviews with healthcare professionals around the country, Ellen and Valerie not only paint a vivid picture of how this virus spread but also the experiences of patients and those who cared for them.

Anthony: The last time we sat down, we talked about your first book, nurses on the inside stories of the HIV AIDS epidemic in New York, and we got a lot of great feedback from that. So, I’m excited here to talk about your new book, Beyond The Mask. 

The book is a mix of fiction and reality, and I love how you set the story up initially. Can you talk about how you two crafted that?  

Ellen: I’m going to say that probably 50% is fiction, but all of it is based on real stories. Out of the six main characters, three are real people, and their backstories are true. The other three main characters are compilations of people we have worked with over the years. We put the stories of different nurses that we interviewed throughout the country. 

Anthony: Where did you find the people you used to create those other characters?

Ellen: Mostly, I got these people on Facebook because there was a giant Facebook page about COVID healthcare providers. Nurses, especially, were venting about what was going on in their hospitals. Those stories came together from bits of what these people actually experienced.

Anthony: The opening to the stories is very vivid; how did that develop?

Valerie: That opening scene was something that I wanted to create to give people an idea about how. The virus might spread among regular people and also to set up a little anxiety. I’m hoping that that’s what it did.

Anthony: It did. Absolutely. When I read that, I was in the moment because I don’t think we think about those things. How diseases are spread, how germs work, and what we are doing as individuals to spread disease.

Valerie: I think about germs all the time. Exposure to germs can lead to a robust immune system, and then we get something like this where hand-washing and not sharing the air becomes critical. Droplet nuclei become supercritical. For the book, I wanted to give people the idea that these are regular people, and it could happen to anybody.

Anthony: Unbeknownst to us that we’re infected with something, spreading it to other people through just our normal social behaviors. 

In our first interview, we did talk about the parallels. Still, there are also a lot of differences from what we’ve seen in this pandemic. Today, we have social media and nurses venting. The public has much more access to what our healthcare providers are going through. 

Ellen: I think what we tried to portray in the beginning chapters of the book where the calm before the storm. In some respect, we had the calm before the storm with the HIV epidemic, but here I think it was more paralyzing. 

Health care workers began to notice odd things like suddenly PPE being locked up, then being rationed, etc. But if you watched the news, all you saw during 2020 was the numbers. How many thousands, tens of thousands, and millions of people died—the millions of infected people. It was almost like watching the election and how many electoral votes went to each candidate.

Valerie: But I also feel like it was numbing for many people. Many people started to look at it like they looked at the election and started writing it off. You can’t comprehend that amount of death unless you see it in person, which healthcare workers were doing. But the rest of the world was not.

Anthony: I would agree with that. The difference between the two pandemics is the HIV/AIDS epidemic came on slowly. There was a runway to massive numbers as opposed to COVID, which came on very quickly. It was only a matter of months before we saw these numbers that we’d never seen since maybe the great flu epidemic of 1918.

Valerie: I also think there were a couple of other significant differences between these two pandemics. The first is that the Coronavirus has the potential to infect anybody and everybody. It is basically spread by droplet nuclei; you can get it from the air. It is not what we call airborne but it is spread in the air.

The other is that it is not confined to a specific group, whereas HIV was confined to a cluster of groups of people who were considered disposable by the rest of society. And that’s a crucial distinction between COVID and HIV. Many people back in the day thought that gay men and women who were doing, sex work, were completely disposable. Immediately you believe people are worth something, or you don’t.

Apparently, lots of people think that some people are disposable. And so, this whole thing about humans being worthwhile only applies to some people, and that’s a real stark difference.

Ellen: Valerie and I tried not to get very political in this book, but we did start to see that there were a lot of minority people that were considered disposable that did not have access to care, access to education, access to testing.

Valerie: This is a long-term problem and not something that happened because of COVID. COVID invaded these communities because of a lack of education, ignoring issues. The failure to educate children so that they know anything about science, anything about hygiene.

Anthony: We have known for a long time that there is a lack of access to even basic preventative healthcare for people who are minorities or poor. I think this really did shine a big spotlight on the haves and have-nots. The people who had a public platform or were recognizable who came down with coronavirus had the means to get the best care possible, whereas the Hispanic woman who works as a maid in the hotel didn’t have that.

Valerie: Right she makes too much money for Medicaid. So, she doesn’t have any health insurance because they only let her work 35 hours a week, which isn’t full-time. It’s a huge problem.

Anthony: It also highlighted a difference in our response. All of the resources that were thrown at this once it was evident that this was a big thing and we need to do something; resources were available.

Valerie: Big resources, huge resources. All funded by your tax dollars.

Anthony: How has the book been received since it came out?

Ellen: The people we know who have read it have enjoyed it, and there were some great comments on Amazon. There were some great comments about utilizing the fictional narratives to get the point across. 

We thought we might get crucified for having a fiction book for a while. When I was querying for ages, People were very interested in the manuscript, but only if we decided to make this book nonfiction. Two different agents asked why the book could not be nonfiction? And I said because the people who told us the stories and the struggles in the nursing community did not want to be identified by name, state, or the hospital where they worked.

We saw early on nurses getting fired for speaking up about the lack of PPE and wanting to use hospital scrubs instead of their own. There was no way anyone in 2020 would go on the record and be outspoken about what was going on.

Anthony: I Like that intertwining of fiction and nonfiction. I think you did an excellent job in blending the two. Did you run into any challenges in building that backstory, or did it come very easy? How did the two of you work on that together?

Ellen:  I think it honestly came very easy. I credit Val with most of the backstory, I tend to write dialogue, and I write as if I’m speaking it. 

I wrote dialogue, and then Valerie would handle a lot of what we call embroidery. I would always email her and say, this needs a little embroidery. Valerie is very descriptive about the environment, the rooms, and the places people live. And my focus was more on getting each chapter to end with a chilling revelation. 

Valerie: She liked the cliff-hanger part.

Anthony: You’re very skilled as writers. I hope you write more books for sure.

Ellen: There was never supposed to be another book after nurses, and then it just occurred to me that Nobody’s going to remember the very beginnings of this pandemic. I remember saying to Val; we have to memorialize this. 

As I heard some of those stories, I said, oh my God, I have to reach out to some of my colleagues who were still in the ICU where I used to work. They talked to me, and they told me these things were happening, and they would send me pictures of them. 

They went to a fishing store and wore those overalls that you were to go into the water to fish, you know, all this gear that they had to make and put together. Every single thing we were taught as nurses about was one mask per patient per time. You go in the room, wear a mask, wear gloves, come out, discard everything, wash your hands, and hand hygiene. Next time you go in, new mask, new gloves new gown, everything we learned about infection control was out the window.

Valerie: you think that only the inside of the mask is dirty. I’m sorry, the outside of the mask is really dirty. Cause you’ve been filtering stuff through that mask. So the outside of the mask is dirty.

Anthony: You think we learned anything about the school being prepared? Because I don’t think we realized in the beginning that we were going to have all of the shortages. So many things have been affected.

Valerie: Americans by and large thought this couldn’t happen to them. They thought this was a third-world problem. They said oh, Ebola, it only happens in Africa, or the original SARS, that happened in China, that doesn’t count, those people aren’t Americans. This really brought people up sharply and showed where our deficiencies are, that we were never ready for this.

I hope that there’s money being given to the public health services to ramp that up for the next time because I’m sorry to report. I think there will be a next time, and it will be in our lifetime.

Anthony: What is your hope for readers to take away from the book overall?

Ellen: Just as in the first book, there are several things. Number one is to recognize and memorialize who we lost. The story about Mo was actually a nurse that I did know. I think the early statistics of healthcare workers that got infected and died. I think we need to memorialize. I think we need to memorialize that hospitals were not prepared, the country was not prepared for this. I know that there was no pandemic team or emergency team that was assembled quickly to combat or quell this virus in any way. We just watched the numbers go up, and we watched the health care workers be totally startled by how quickly things changed, how quickly their place of employment switched over. 

An orthopedic unit became a COVID unit. We chose to do emergency room critical care in an orthopedic unit but that really happened. Recovery rooms stopped, surgery rooms stopped. And then there became tents, one tent, two tents, ten. People were in conference rooms; they made the auditoriums into facilities. The belongings that were not picked up, the refrigerated trucks that had to be brought in. Now for some, it may be a distant memory, but I don’t believe for a minute we should forget this.

Valerie: I hope it inspires somebody who reads it also may be to become a nurse. I would like it if people would realize that it’s an honorable and interesting profession.

Anthony: It is. And I do think that we as a society probably now have a greater appreciation. I know I do for those who are on the front lines of healthcare.

Ellen: Yeah, I think so too.

Anthony: Ellen and Valerie, thank you again for giving me the opportunity to sit down and talk about your book. I hope there are more books because I think you are very talented. 

Ellen & Valerie: Thank you

More Than 3,600 US Health Workers Died in Covid’s First Year. A frequently cited statistic is that nearly 1 in 5 healthcare workers have quit their jobs during the COVID-19 pandemic, according to an October 2021 Morning Consult report. 

Beyond The Mask is available on Amazon

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