Pandemic Pitfalls

I read a good article on the physical effects of the coronavirus pandemic on our physical health recently. Yes, the Pandemic Is Ruining Your Body was written by Amanda Mull and published on January 14, 2021 in the Atlantic. In it, she addressed many of the ways that living in the middle of the worst worldwide health crisis in a century affect us as human beings who are struggling to be brave, squash fear, stay productive, and thrive, all without the help of our usual social institutions and personal interactions.

She acknowledges that for some of us, myself included, sitting at home virtually all the time, even when working hard, is a situation of relative comfort and incredible luck. We have jobs that allow us to use computers, faxes, cell phones, scanners, email, and videoconferencing to meet, greet, schmooze and therapize to our hearts’ content, just not in person. But at what cost? She says that in her own experience of working from home, she began to experience decreased hip mobility, low grade headaches, sore shoulders, a stiff neck, and dry skin. At first, she and her ailments felt isolated, because she was isolated. She could not see that her coworkers were doing the same things, stretching the same tired muscles and “gobbling up ibuprofen” as she was. Many have been sickened or even died from COVID-19. Those who have avoided those fates, says Mull,  are living through an extended disaster that at the least is painful, but at its worst can be catastrophic.

What are doctors and others seeing? Aches and pains come up for seemingly no reason and then stick around. People who work from home found themselves setting up what they thought would be a temporary home workstation that they might need to use for a few weeks at best, a few months at worst. I did this myself. Over the last year, as pandemic reality set in, I have changed my equipment configuration, furniture and workflow more times than I can even remember. Sitting in front of a too short table, shoulders hunched, laptop screen too low, keyboard at the wrong height, and normal implements not easily reached, makes work tough. This, as Mull says, “all while sitting in a chair meant to support a human for the duration of a meal, not a workday”.

We are also working longer hours. How can that be, I asked myself after I read this in multiple articles for the fifth or sixth time. If you must get up, get ready, drive to your workplace and then leave at a prescribed time once you are done, there is an eight or nine hour rhythm to your day. If you subtract some of the prep time and all of the commute time, you find yourself (and again, I can attest to this) working an extra hour or even two. As I wrote this, I finished a “normal” ten hour workday that was jam packed with patients, emails, consults, and reviews. It simply feels that work has been busier, more packed with tasks and with much less down time or break time then pre-pandemic. Let’s be honest. Everyone feels just a little twinge of guilt when they work from home. And Mull says, “expectations of productivity have increased” because you are there. Granted, some may be able to outfit a spare bedroom or home office with nicer and more usable equipment, but “for those living in cramped housing with kids who go to Zoom school and other family members who also need space to work, building a personal mini office simply isn’t an option”.

Does any of this bleed over into our emotional wellbeing and ability to cope with the social and mental stresses that this pandemic has caused? Of course it does. In the past year, many months of which I have worked predominantly at home, there has not been a workday that goes by without me hearing about folks who are anxious and can’t sleep. Not a single day. Much like Amanda Mull discussed in her article about the physical stresses that can lead to physical problems, I have seen the psychological toll that the coronavirus has had on our normal psychological and emotional worlds. While staying home, we have lost out physical connection to others. There is no chatter around the coffee pot or in the parking lot before or after work. We have been forced to use different “equipment” to connect with each other. As my rector opined at a recent annual church business meeting, “Well, Zoom gets the job done I guess, but it’s not the same, is it?” Screens are now our “windows on the soul”. Why? Because any time we are face to face with most people we know outside our immediate family, we are wearing masks. Unless you are extremely close to someone, it is hard to read real emotion from just raised eyebrows or crinkling crows feet. Why is this important?

Because stress, anxiety, depression, loneliness, and hopelessness kill. They are not dangerous in themselves just for the misery they cause, and the potential for catastrophic consequences like suicide. As Mull states in her article, depression and anxiety “are enormous risk factors for heart problems, especially among people over 50. Quarantine itself is also a risk factor. Loneliness and social isolation increase the risk of myocardial infarction and stroke by up to 30 per cent”.

What can you do now, today? Connect with others, however you can, however awkward. Call. Zoom. FaceTime. Text. Reach out to the elderly who have little social support. Spend some non-screen time with a child. Cook dinner, and then leave part of it in a basket for the neighbors next door. I know I keep saying this, but it’s true. This pandemic will end. We will get through this together. We just need to make sure that we come out of this ordeal as physically and mentally healthy as we possibly can.

Thoughts on Death, Part One

I posted yesterday about a chance meeting with an old acquaintance. With a simple question, he was able to make me think about my own state of affairs today, and to have the wonderful conscious thought that yes, indeed, I am happy.

Today, I turn my thoughts to death, not because I am depressed, but because I recently lost a medical colleague to a sudden heart attack, just days after he had left our employ and started a new job in the upstate area of South Carolina. There are certain thoughts that come up in one’s mind anytime someone dies. When a colleague dies, especially a colleague you have been related to in a supervisory context, these thoughts are varied, multi-layered, and complex.

Dr. B was sixty nine years old, eleven years my senior. It is always hard to supervise an employee who is older than you, but it happens more and more frequently in today’s workforce, where the average age of employees has risen across the board. Specific incidents sometimes arise that must be dealt with directly, and supervisors with their own authority issues may have a difficult time dealing directly with these issues. Also, as one ages, one tends to fall back on “the way things have always been” or “the way we have always done it”, and this may lead to conflict in the workplace when practice trends, productivity expectations, and operational use of new theories and practices are foisted upon all employees, seasoned and new.

In medicine, as in many other fields, we are taught to be lifelong learners, productive professionals, self starters, and industrious workers. We are taught in essence to tow the line, to be like everyone else, and to “close ranks” when adversity strikes us as a group. Like the “Thin Blue Line“, medical professionals look after each other, support each other, and have each others’ back, even as they try to fight illness and foster the health of all members of society.

Now, this does not mean that we as medical professionals always agree or always do things exactly the same way. We are trained in similar ways, some of us at the same programs by the same mentors and professors, but we develop our own practice styles as we age and as we become more senior in the profession. Best practices are guidelines that are generally regarded as the standard of care in most medical circles today, but there is plenty of wiggle room in medicine for the “art of medicine” to still shine through. Personally, I am glad for that.

All this to say, I guess, that we must strive to respect those who disagree with us, or who we disagree with. Especially in a professional group such as mine, it is imperative that we respect each other, have open dialogues when disagreements occur, and that we constantly try to improve the practice of medicine in general and our own take on it in particular. This is paramount in times of stress, such as the current period in medicine when electronic medical records, reimbursement, documentation and maintenance of certification grab more headlines that the latest cures for some obscure disease.

Death, and what it takes away from us, also makes us rethink what could have been. Did I really listen? Did I strive to understand the pressures from the other side, the other perspective? Did I give that situation a fair shake, or did I simply blindly impose my own value system on it and make a decision that was rigid and not completely informed? Hindsight is always 20-20, isn’t it? Death takes away our ability to rethink, reprocess, and correct course. Death is nothing if not final.

I wil be attending the visitation for my colleague on Thursday evening. Somehow, the little things that mattered so much two weeks ago, the scheduling issues and the specific patient problems and the interpersonal stresses and all the rest, do not seem so important now. Whether they were imposed on me from above and I was simply an agent of change, passing down information or rules to my supervisees, or things that came from inside me, doesn’t really matter now.

What does matter is that a colleague has finished his life’s work, albeit much sooner than he anticipated. He has listened, heard, and acted on the things that he could change for his patients, and he has done  his best. His toils are done.

He has taught me, like everyone I have ever worked with has, some important lessons. I will be a wiser man, and a better one, if I heed them and use them in whatever time I have left to live my life.

Rest in peace, friend.

 

Charles “Chuck” Baber III

August 31, 1946-December 13, 2015