Take The Stand
The other day I composed a quick ditty based on the Beatles song, When I'm 64, its opening going this way: When I get fever, cough and a sneeze, thinking it's the flu; shove me in the bathroom make me sleep on the floor, slide that mask right under the door. Then I feel better, give me the test, just to guarantee...Will you still need, intubate feed me, when I'm Covid-free. The entire parody is out there somewhere, complete with apologies to the Fab Four; but what proved more surprising was the response from one of my friends with links to the Bohemian Rhapsody parody, the Wizard of Oz parody, the Sound of Music parody, and on and on (I was fearful to keep scrolling down). My song was tongue-in-cheek and meant to lighten the mood a bit without taking anything away from the many families and workers actually suffering from this new virus. But a glimpse at the number of videos of political views and decisions about whether to keep staying home or not --and the time spent making them-- seemed to reveal that people are nervous, boisterous and anxious to get out and yet also peeking cautiously from inside as if wondering if this "hurricane" was over or if this was merely the "eye of the storm" (indeed, one of the lead protesters defying the stay-at-home orders in the state of North Carolina recently tested positive for the virus, likely causing many of the other people tightly clustered with him to be wondering if that cough and fever they might be feeling is something that they should be worried about). Therapist Lori Gottlieb tweeted something which she thought was also light-hearted about the virus and got this back: ...someone tweeted back at me: “Not funny.” It’s true; a global pandemic isn’t funny. But as we all take measures to protect our physical health, we also need to protect our emotional health. So what I responded with was this: “Everyone copes with horrible situations differently. For some, humor is a balm. It’s BOTH/AND: It’s horrible AND we can allow our souls to breathe.”
She goes on to add in her column in The Atlantic: Of course, it’s normal to feel anxiety right now, and while we need to allow ourselves the space to feel these feelings, we also need to give ourselves the space to let them go. Some anxiety is productive—it’s what motivates us to wash our hands often and distance ourselves from others when there’s an important reason to do so. If we weren’t reasonably worried, none of us would be taking these measures, and the virus would spread even more. But unproductive anxiety— unchecked rumination—can make our mind spin in all kinds of frightening directions. Instead of helping us to stay grounded in the present—I’m safe and making dinner; I’m snuggled up with my family as we watch this movie; I’m writing this column—our anxiety spins stories about the future that go something like I or someone I love will get deathly ill from the coronavirus. This kind of anxiety causes us to futurize and catastrophize, both of which take up a lot of emotional real estate. It’s a vicious cycle: The more we worry, the more we try to control our worry with something tangible, such as information. But clinging to our screens for the latest update has the opposite effect because it serves as fodder for more futurizing and catastrophizing. A daily update makes sense. But bingeing on up-to-the-minute news is like stress eating—it’s bloating our minds with unhealthy food that will make us feel sick.
This all may sound logical and able to be overcome emotionally --especially coming from a therapist-- but for many it is no more consoling than blah, blah, blah. If your rent is due or you're worried about a knock on the door, or you're exhausted because you're raising a disabled or disadvantaged child or you don't have online access to keep up the schooling, or you're faced with a spouse or parent with special needs (but you still need to work...if it's still available), or a host of other situations that produce true anxiety and do so seemingly 24/7, the emotional strain can more daunting. And it's equally stressful for healthcare workers, who despite all the cheers and the pots & pans banging and the sirens going off in recognition, are facing the virus almost full time (so noted when an ER doctor recently took her own life). Here's a view from a report in STAT by two residents deep into the crisis: Not long after we started our rotation, we discovered the Covid brain...the mindset that takes over when you step into a Covid unit...The Covid brain is in a constant state of high stress. We found ourselves more short-tempered than usual. The attending physicians we work with had previously applauded us for being patient and levelheaded. But we found ourselves on more than one occasion exchanging curt remarks with each other. Apologies were frequent, sincere, and free flowing to others, though less so to ourselves...Working in New England’s largest safety net hospital, we saw firsthand the disparities in Covid-19 mortality. Entire extended families living in close proximity without the ability to adequately isolate themselves were admitted to the hospital en masse. We had family members on various floors of the hospital. We got used to calling the hospital number to reach them, instead of their personal number. As we made call after call after call, we waited with fingers crossed for a patient to wean off the ventilator. Although we cheered for each one who was liberated from the machine, many needed to be reintubated. Short-lived moments of joy were often quickly replaced by disappointment, frustration, or both. And when we had exhausted all options, we stood in the hallway with a spouse or parent on the phone as a nurse held their dying loved one’s hand in the room. We wept for the families who grieved in isolation.
From The Atlantic came this from an ER doctor: For many people around the country, the virus is still an invisible threat. But inside New York’s ERs, it is frighteningly visible. Every day, in our hastily assembled COVID-19 unit, I put on my gown, face shield, three sets of gloves, and N95 respirator mask, which stays on for the entirety of my 12-hour shift, save for one or two breaks for cold pizza and coffee. Before the pandemic, I would wear a new mask for every new patient. Not now. There are not enough to go around. The bridge of my nose is raw, chapped, and on the verge of bleeding. My niece also works in an ER, sending me a picture of herself drenched in sweat, that after taking off her face shield, mask, and other protective equipment in order to lets her "scrubs" dry out a bit. And for those workers it is taking a toll. Said Bloomberg: Although these workers are being hailed as heroes, too little attention has been paid to how the pandemic will eventually affect them...In the intervening years, researchers have come to a new understanding of burnout — as something more akin to what soldiers suffer when they come back from war. In 2018, two doctors, Simon Talbot and Wendy Dean, wrote an opinion piece for STAT, arguing that both soldiers and health-care workers can suffer from what’s called moral injury, an often-debilitating burden of shame, sadness, anxiety and remorse. It’s brought on when a comrade or patient gets hurt or dies, and sufferers often feel that had they acted differently or done more, the harm could’ve been prevented. Many cases of so-called burnout, the writers argued, were really moral injury...Talbot told me in an interview that he usually works 80 to 100 hours a week. “The crazy thing,” he said, “is if you look at the time I spent talking to patients, touching patients, operating on patients, that’s probably only 15 to 20 hours.”
So what if somewhere in the back of your mind you rememberd hearing this from a doctor: The symptoms are all very common. Chills. Fever. Headache. Weakness and general debilitation. Loss of appetite. Painful urination. Swelling of the glands, progressing from minor to acute. Swelling in the armpits and in the groin. Respiratory weakness and failure...They are the symptoms of the common cold, of influenza, of pneumonia. We can cure all those things...unless the patient is very young or old, or perhaps already weakened by a previous illness, antibiotics will knock them out. But not this. It comes on the patient quickly or slowly. It doesn't seem to matter. Nothing helps. The thing escalates, backs up, escalates again; debilitation increases, the swelling get worse, finally, death. If that dialogue sounded eerily familiar, it might be because you had indeed read it before...40+ years ago. Here's what the author, Stephen King, had to say about the re-release of the unedited version* of his bestseller, The Stand: I'll spare you the story of how The Stand came to be written -- the chain of thought which produces a novel rarely interests anyone but aspiring novelists. They tend to believe there is a "secret formula" to writing a commercially successful novel, but there isn't. You get an idea; at some point another idea kicks in; you make a connection or a series of them between ideas; a few characters (usually little more than shadows at first) suggest themselves; a possible ending occurs to the writer's mind (although when the ending comes, it's rarely like the one the writer envisioned); and at some point, the novelist sits down with a paper and pen, a typewriter, or a word cruncher. When asked, "How do you write?" I invariably answer, "One word at a time," and the answer is invariably dismissed. But that is all it is. It sounds too simple to be true, but consider the Great Wall of China, if you will: one stone at a time, man. That's all. One stone at a time.
One stone at a time, one word at a time, one day at a time. These days and weeks and months have been difficult and stressful for many, especially those watching relatives being hospitalized or gazing out from a window in a rest home, unable to physically visit or touch or hug, even as they may be on the verge of taking their last few breaths. Let's open up, let's get out there, let's restart the economy, let's start burning through that excess oil, all of that sounds great if you're healthy and perhaps comfortable watching your Netflix and wondering what's the big deal about this virus that seems to only affect a small part of the population. Sure, it sounds great to get free stimulus money from the government, even if you're the L.A. Lakers or Ruth Chris Steakhouse (given $20 million) or Harvard (the world's richest university, which also has a $40 billion endowment fund, received $9 million) or even the Pentagon which is reportedly eyeing part of the "next" stimulus package; and throw in those "hard-hit" casinos (did I mention that Trump's international golf courses and hotels have also applied for relief checks from Scotland and Ireland, as well as locally in Washington, D.C., reported the NY Times). For the struggling everyday moms and dads, and the struggling storefront owners, and the struggling factory workers, and the struggling healthcare workers, and the struggling sanitation workers, stimulus money may as well not exist, or may seem little more than beads tossed out at Mardi Gras.
No matter what camp you're in (and in a recent UK study, The Conversation reported that people tended to break into one of three camps regarding the effects of the pandemic: accepting, resisting, or suffering), many people have found themselves struggling mentally, physically, and financially, while others seem able to watch all of this on the news with little more than a shrug of inconvenience. It is as if many in the world are screaming at the top of their voices and others are just putting in earbuds and getting ready to start fertilizing their lawns. No matter the camp, it is a time for compassion, a time to think that "we're all in this together" should be more than a catchphrase, and a time to think that no matter how healthy or comfortable we are today, tomorrow is another day and one which could just as easily find us staring at the sweaty face of a nurse or physician trying to help us get better. For me, it is a time to be haunted by the words of a song by Don McLean: Portraits hung in empty halls, frameless heads on nameless walls, with eyes that watch the world and can't forget. Like the strangers that you've met: The ragged men in the ragged clothes, the silver thorn, a bloody rose lie crushed and broken on the virgin snow. Now I understand what you tried to say to me; and how you suffered for your sanity; and how you tried to set them free. They would not listen, they're not listening still. Perhaps they never will.
*Stephen King noted that when this novel was first released the editors had him edit out 400 pages and even then, some reviewers considered the work "bloated" (King's own description of the book's reception in his preface). Those 400 pages are back and it makes for fascinating reading...only this 1155 page fictional tale tells of a pathogen that has a 95%+ rate of infection and a similar rate of fatality. As if the corona virus wasn't scary enough...still, the book does make for fascinating reading.
She goes on to add in her column in The Atlantic: Of course, it’s normal to feel anxiety right now, and while we need to allow ourselves the space to feel these feelings, we also need to give ourselves the space to let them go. Some anxiety is productive—it’s what motivates us to wash our hands often and distance ourselves from others when there’s an important reason to do so. If we weren’t reasonably worried, none of us would be taking these measures, and the virus would spread even more. But unproductive anxiety— unchecked rumination—can make our mind spin in all kinds of frightening directions. Instead of helping us to stay grounded in the present—I’m safe and making dinner; I’m snuggled up with my family as we watch this movie; I’m writing this column—our anxiety spins stories about the future that go something like I or someone I love will get deathly ill from the coronavirus. This kind of anxiety causes us to futurize and catastrophize, both of which take up a lot of emotional real estate. It’s a vicious cycle: The more we worry, the more we try to control our worry with something tangible, such as information. But clinging to our screens for the latest update has the opposite effect because it serves as fodder for more futurizing and catastrophizing. A daily update makes sense. But bingeing on up-to-the-minute news is like stress eating—it’s bloating our minds with unhealthy food that will make us feel sick.
This all may sound logical and able to be overcome emotionally --especially coming from a therapist-- but for many it is no more consoling than blah, blah, blah. If your rent is due or you're worried about a knock on the door, or you're exhausted because you're raising a disabled or disadvantaged child or you don't have online access to keep up the schooling, or you're faced with a spouse or parent with special needs (but you still need to work...if it's still available), or a host of other situations that produce true anxiety and do so seemingly 24/7, the emotional strain can more daunting. And it's equally stressful for healthcare workers, who despite all the cheers and the pots & pans banging and the sirens going off in recognition, are facing the virus almost full time (so noted when an ER doctor recently took her own life). Here's a view from a report in STAT by two residents deep into the crisis: Not long after we started our rotation, we discovered the Covid brain...the mindset that takes over when you step into a Covid unit...The Covid brain is in a constant state of high stress. We found ourselves more short-tempered than usual. The attending physicians we work with had previously applauded us for being patient and levelheaded. But we found ourselves on more than one occasion exchanging curt remarks with each other. Apologies were frequent, sincere, and free flowing to others, though less so to ourselves...Working in New England’s largest safety net hospital, we saw firsthand the disparities in Covid-19 mortality. Entire extended families living in close proximity without the ability to adequately isolate themselves were admitted to the hospital en masse. We had family members on various floors of the hospital. We got used to calling the hospital number to reach them, instead of their personal number. As we made call after call after call, we waited with fingers crossed for a patient to wean off the ventilator. Although we cheered for each one who was liberated from the machine, many needed to be reintubated. Short-lived moments of joy were often quickly replaced by disappointment, frustration, or both. And when we had exhausted all options, we stood in the hallway with a spouse or parent on the phone as a nurse held their dying loved one’s hand in the room. We wept for the families who grieved in isolation.
From The Atlantic came this from an ER doctor: For many people around the country, the virus is still an invisible threat. But inside New York’s ERs, it is frighteningly visible. Every day, in our hastily assembled COVID-19 unit, I put on my gown, face shield, three sets of gloves, and N95 respirator mask, which stays on for the entirety of my 12-hour shift, save for one or two breaks for cold pizza and coffee. Before the pandemic, I would wear a new mask for every new patient. Not now. There are not enough to go around. The bridge of my nose is raw, chapped, and on the verge of bleeding. My niece also works in an ER, sending me a picture of herself drenched in sweat, that after taking off her face shield, mask, and other protective equipment in order to lets her "scrubs" dry out a bit. And for those workers it is taking a toll. Said Bloomberg: Although these workers are being hailed as heroes, too little attention has been paid to how the pandemic will eventually affect them...In the intervening years, researchers have come to a new understanding of burnout — as something more akin to what soldiers suffer when they come back from war. In 2018, two doctors, Simon Talbot and Wendy Dean, wrote an opinion piece for STAT, arguing that both soldiers and health-care workers can suffer from what’s called moral injury, an often-debilitating burden of shame, sadness, anxiety and remorse. It’s brought on when a comrade or patient gets hurt or dies, and sufferers often feel that had they acted differently or done more, the harm could’ve been prevented. Many cases of so-called burnout, the writers argued, were really moral injury...Talbot told me in an interview that he usually works 80 to 100 hours a week. “The crazy thing,” he said, “is if you look at the time I spent talking to patients, touching patients, operating on patients, that’s probably only 15 to 20 hours.”
So what if somewhere in the back of your mind you rememberd hearing this from a doctor: The symptoms are all very common. Chills. Fever. Headache. Weakness and general debilitation. Loss of appetite. Painful urination. Swelling of the glands, progressing from minor to acute. Swelling in the armpits and in the groin. Respiratory weakness and failure...They are the symptoms of the common cold, of influenza, of pneumonia. We can cure all those things...unless the patient is very young or old, or perhaps already weakened by a previous illness, antibiotics will knock them out. But not this. It comes on the patient quickly or slowly. It doesn't seem to matter. Nothing helps. The thing escalates, backs up, escalates again; debilitation increases, the swelling get worse, finally, death. If that dialogue sounded eerily familiar, it might be because you had indeed read it before...40+ years ago. Here's what the author, Stephen King, had to say about the re-release of the unedited version* of his bestseller, The Stand: I'll spare you the story of how The Stand came to be written -- the chain of thought which produces a novel rarely interests anyone but aspiring novelists. They tend to believe there is a "secret formula" to writing a commercially successful novel, but there isn't. You get an idea; at some point another idea kicks in; you make a connection or a series of them between ideas; a few characters (usually little more than shadows at first) suggest themselves; a possible ending occurs to the writer's mind (although when the ending comes, it's rarely like the one the writer envisioned); and at some point, the novelist sits down with a paper and pen, a typewriter, or a word cruncher. When asked, "How do you write?" I invariably answer, "One word at a time," and the answer is invariably dismissed. But that is all it is. It sounds too simple to be true, but consider the Great Wall of China, if you will: one stone at a time, man. That's all. One stone at a time.
One stone at a time, one word at a time, one day at a time. These days and weeks and months have been difficult and stressful for many, especially those watching relatives being hospitalized or gazing out from a window in a rest home, unable to physically visit or touch or hug, even as they may be on the verge of taking their last few breaths. Let's open up, let's get out there, let's restart the economy, let's start burning through that excess oil, all of that sounds great if you're healthy and perhaps comfortable watching your Netflix and wondering what's the big deal about this virus that seems to only affect a small part of the population. Sure, it sounds great to get free stimulus money from the government, even if you're the L.A. Lakers or Ruth Chris Steakhouse (given $20 million) or Harvard (the world's richest university, which also has a $40 billion endowment fund, received $9 million) or even the Pentagon which is reportedly eyeing part of the "next" stimulus package; and throw in those "hard-hit" casinos (did I mention that Trump's international golf courses and hotels have also applied for relief checks from Scotland and Ireland, as well as locally in Washington, D.C., reported the NY Times). For the struggling everyday moms and dads, and the struggling storefront owners, and the struggling factory workers, and the struggling healthcare workers, and the struggling sanitation workers, stimulus money may as well not exist, or may seem little more than beads tossed out at Mardi Gras.
No matter what camp you're in (and in a recent UK study, The Conversation reported that people tended to break into one of three camps regarding the effects of the pandemic: accepting, resisting, or suffering), many people have found themselves struggling mentally, physically, and financially, while others seem able to watch all of this on the news with little more than a shrug of inconvenience. It is as if many in the world are screaming at the top of their voices and others are just putting in earbuds and getting ready to start fertilizing their lawns. No matter the camp, it is a time for compassion, a time to think that "we're all in this together" should be more than a catchphrase, and a time to think that no matter how healthy or comfortable we are today, tomorrow is another day and one which could just as easily find us staring at the sweaty face of a nurse or physician trying to help us get better. For me, it is a time to be haunted by the words of a song by Don McLean: Portraits hung in empty halls, frameless heads on nameless walls, with eyes that watch the world and can't forget. Like the strangers that you've met: The ragged men in the ragged clothes, the silver thorn, a bloody rose lie crushed and broken on the virgin snow. Now I understand what you tried to say to me; and how you suffered for your sanity; and how you tried to set them free. They would not listen, they're not listening still. Perhaps they never will.
*Stephen King noted that when this novel was first released the editors had him edit out 400 pages and even then, some reviewers considered the work "bloated" (King's own description of the book's reception in his preface). Those 400 pages are back and it makes for fascinating reading...only this 1155 page fictional tale tells of a pathogen that has a 95%+ rate of infection and a similar rate of fatality. As if the corona virus wasn't scary enough...still, the book does make for fascinating reading.
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