Resilience in the Time of COVID-19

I first published these thoughts on 9-11-09. I thought I would share them with you again today in 2020 in a different context that is no less serious, traumatic and important to us and our mental health as Americans. In the first iteration of this column, I reflected on the tragedy of September 11th and how it had affected all of us. In 2001, we suddenly lost our sense of safety on our own soil. We lost two thousand nine hundred seventy seven American lives. My oldest daughter and namesake, now a young woman with five children of her own, rehearsing to perform in a show that did go on in spite of the hate extended to us by our attackers, was to turn seventeen years old the day after the attacks. It was a time of fear, grief, and pain, but also a time that saw Americans rally around and support each other in ways that we are still struggling to regain today.

It was a Tuesday in 2001, late summer/early fall in South Carolina. Bright blue sky, wonderful smells in the air, and just a hint of the changing season. Enough to make you wish for pumpkins and turkey and pan dressing and kicking piles of leaves and smelling smoke. Enough of all this to make you feel safe, free, and wonderful. Enough to make you proud to be an American. This time around, it was early spring of 2020, March, more bright blue skies and warming temperatures and the hope that this season always brings.

I was working in the mental health center that Tuesday morning, doing what I have now done every Tuesday morning for over twenty-nine years. I was talking to people with psychiatric illnesses, some of whom had been hospitalized against their will for reasons of dangerousness or potential for self-harm. In other words, my job that morning involved making sure that the most vulnerable among us were given a fair shake by the mental health system and the court system, and that if they had improved sufficiently, that they would be released from the hospital that day. How American, yes? In 2020, I was working a normal week, using my office in the mental health center to welcome patients, read emails, enjoy my coffee, all the normal things that I had been doing in that very space for years.

After the second interview, if memory still serves, a staffer ran into the room and told us that the patients and hospital staff waiting their turns to see us in the adjoining room were all glued to the television. It seemed that a small plane had just had a terrible accident, crashing into one of the World Trade Center towers in New York City. How terrible and sad, we all thought vaguely, going on about our work for the next few minutes, not thinking more about it at least at that instant. In 2020, we got wind of a viral illness that had originated in China, but that now appeared to be spreading to other countries. We learned that we had a small outbreak of illness caused by this novel coronavirus, way out on the west coast in Washington state, affecting a handful of people. How sad, we thought, not having any idea what was about to happen to us.

Soon, that same staff member came back with astonishing news. It seemed that the plane that had hit one of the twin towers was a much larger plane, maybe even a jet airliner. No, we all thought, at least to ourselves, how could that happen? Huge planes don’t just lose control and crash into skyscrapers. It just doesn’t happen. We soon went from fifteen cases that we were told would go away to dozens, then hundreds, then thousands of cases of the illness that were caused by this new virus, now called COVID-19.

The next few moments, really the next few hours, changed all of our lives forever. When we understood what was happening, as the first tower smoked and burned and helicopters began to buzz as did television commentators, we stood riveted to the floor, all of us standing up, restless and vaguely afraid but not knowing what we were afraid of, not knowing whether we should just go on about our days or wait to see if we were going to get new marching orders. Do we rush out and buy supplies, do we wash our hands, do we wear masks, do we stay at home? The crash of the second plane into the second tower, with the graphic video footage that almost all Americans have seen, was surreal. We were being attacked. The United States was being attacked. The coronavirus began its relentless march across our nation. We were again being attacked by something that we did not fully understand, to an extent that would only become clear later. I have always loved history. I thought to myself, if there had been the real time coverage we have now in 1941, this is what Americans would have felt like as Japanese planes bombed Pearl Harbor. Just like the Gulf War and other incidents in recent years, we were all witnessing history being made, terrible history that would affect everything from how we traveled to how we looked at neighbors who didn’t quite look like “us” any more. This time, we would shelter in place for many weeks, rarely venture out from our safe zones and fear even those who did look exactly like us.

We went through the rest of the morning in a fog. All of us wanted to make sure our families were safe. As crazy as it feels today, I believe that we all thought that attacks could happen anywhere the rest of that day, even in South Carolina. We made plans to attend church services that night, most of which had been cobbled together as prayer services for the victims as well as for the safety of all of us who remained in America that night, shocked, afraid and angry. My family did something else that a lot of other families did. We met for a meal of comfort food, harkening back to that age-old tradition of gathering around a table and breaking bread together, offering solace and strength to each other. In 2020, we gradually began to understand that these ways of comforting and supporting each other were potentially deadly.

One of the most symbolic things we did as the next few days and the real tragedy of it all became so apparent was to display American flags everywhere. We put them on our cars, on our office doors, on our windshields. Today, we wear masks, gloves and protect ourselves and those around us by these outward signs of the current pandemic. We follow arrows on the floor of supermarkets and stand six feet apart in checkout lines.

In 2001, we remembered that tragic day, September 11th, when so many innocent Americans died. We remembered and honored a new crop of American heroes who rose to the occasion in service to their country. We remembered when the American spirit, so often dampened, burned brightly at ground zero in New York City through dark days and even darker nights of digging, searching, rescuing, and recovering. We remembered the fear, the anxiety, the terror, the anger and the relief when we knew that the worst of the initial attacks was over, though the aftermath was just beginning.

In 2020, we remember the day we heard that the virus was coming for us. We honor those men and women who have worked tirelessly on the front lines, caring for the sick and the dying, exposing themselves to the risk of illness and death. We see the American spirit around the country in the nightly banging of pots and pans and ringing of bells that acknowledge healthcare workers. We once again deal with the fear, anxiety, terror, anger, grief and loss that have accompanied the first wave of this pandemic, even as we know that the second wave, the aftermath, may be coming again.

We remembered. We honored. We grieved. We remember. We honor. We grieve.

In 2001, we were not just fighting a war on terror. We were all struggling and fighting to regain a lost sense of humanity and brotherhood and common cause. We were fighting to be a global people who could live together and celebrate our differences as well as our commonalities. We were fighting not to be isolative and separate and exclusive in the global sense, for if we did so, we would all surely die one day, all of us the world over.

Today, we fight not just a war against the invisible enemy that is COVID-19, but against another assault on our humanity, our global brotherhood and our ability to support our survival. We once again see the stark contrast between our differences and our similarities, knowing that attention only to the former will kill us, and nurturing the latter will ensure our continued residence on Earth. We are learning that to live, to defeat this enemy that does not discriminate in its desire to infect and kill us, we must separate from each other. In separating, we bind ourselves tightly together to insure that all get the best chance at life.

I will ask that you take some time to reflect today. Take some time not to grieve just the losses we have endured due to COVID-19, but to consider the loss to humanity as a whole. As I write this, 7.7 million people around the world have been infected with the coronavirus. Four hundred thirty thousand have died. When many of us die, each of us dies just a little right along with them. Be vigilant. Be resilient. Do what you can, where you are, with what you have. Get help for physical symptoms, emotional trauma, sadness and grief. Be strong. Just like September 11th, this is a watershed moment not just for the United States, but for the world. We will survive it, and we will be the stronger for it.

Boredom

We have been in this pandemic for months that feel like years. Have you reread all the books from your childhood and college years? Have you put together every jigsaw puzzle from the storage closet under the stairs? Have you binge-watched every Netflix series that caught your fancy? If you have, then you have probably hit that emotional, physical and temporal wall that is boredom. I don’t have anything to do. I just want to go to sleep. Maybe I can find a snack in the kitchen. I should be cleaning or cooking or…
I think we’ve all felt it, experienced it, and dreaded it, but boredom is not something that is to be feared or even endured. I read a January 4, 2019 Time article by Jamie Ducharme recently called Being Bored Can Be Good For You-If You Do It Right. Here’s How. It made some good points and made me think more about how we can embrace boredom and even use it as a jumping off point for creativity and productivity if we just open ourselves up a bit.
Why is boredom, and the act of being bored every once in a while, so important? According to the Time article, boredom “is a search for neural stimulation that isn’t satisfied”. I believe that we sometimes panic when we have nothing to occupy our minds or stimulate us or provide novelty, but being bored pushes our own brains to create the novelty and stimulation from nothing. It forces us to be creative. I love to write, and some of my best ideas to explore have to come to me in such unlikely places as the hot shower on a cold morning, on a steamy trail walk by the river, or when sitting drowsily in the early summer sun in my front porch rocking chair. These down times can be a resting period, a respite from the daily grind that we sometimes do not realize we need. They can happen spontaneously. That being said, can one plan to be bored?
Absolutely. Now, I should say here, as did the author of the Time article, that one should not confuse boredom with relaxation. Acts that require concentration like yoga, meditation, or even putting together a puzzle, do not lead to boredom, even if they are relaxing. Boredom requires that one let the mind wander. No stimulation is necessary. Another crucial aspect of allowing yourself time to be bored is that you must unplug. Having a phone in your hand keeps you from ever reaching true boredom, while it paradoxically fails to truly entertain most of the time. What do I mean by this? Endless scrolling keeps our brains from working out their boredom and coming up with novel stimulation and creative thoughts. At the same time, the quality of entertainment we get from such unstructured time is nowhere near the quality of entertainment that we might get from diving into a good book with characters we truly care about and invest in.
Sandi Mann, a senior psychology lecturer at the University of Central Lancashire in the UK, says that we can become addicted to the tiny dopamine hits we get every time we pick up our devices. “Our tolerance for boredom just changes completely, and we need more and more to stop being bored.”
Planning for times that you will be bored may lead to increased creativity, new ideas to explore, and thoughtful reflection about the things that are important to you but that get pushed back by technology and busy schedules. Being bored may help you become more resilient. You may even find that this new creativity and idea generation gets you outside your own head and thinking about doing something that might benefit others. Read, doodle, listen to familiar music, doze in the sun, anything that will free your brain to be quiet, attentive and open to new things. You may be amazed at what you come up with.

Covidisms: Grudge Match

I was listening to the Chill Mix that comes up on my Apple Music every week, because, you know, COVID-19.  

One song that got me thinking today was To Have and Not to Hold, from Madonna’s album Ray of Light. What do I have and hold, right now, that I should let go of in this time of pandemic and uncertainty? 

I hold grudges. There. I said it. Out loud. On the internet, of all places. 

Yes, I have sometimes caught myself thinking about things from the past that have hurt me, people who have done me wrong, situations I was in that were negative and hurtful and poisonous to me and others around me. Instead of letting these go, processing them and moving on, I have held them to me tightly, jealously, letting them suck the life and light out of me. I have collected them, displayed them, if not to others, then to myself in my own mind and memory. Up there on their little wooden shelves like the cheap golden plastic trophies of my youth, reminding me of things that happened, yes, of course they happened, but things that no one else cares about, no one else even remembers. 

I hold these truths to be self-evident, that all grudges were created equal, with equal power to hurt the person who holds them, wanting things to be rectified, wanting things to be fair, wanting things to be as they were. Wishing that the things and the people and the situations that created the grudges in me had never been a part of my life in the first place. Wanting things to go back to being as they were before the injuries, to be normal again, to be happy again, to be free and easy and without conflict again.

But you know what? You know what this pandemic is teaching us, if we will listen? Nothing was ever as free and easy and happy as it seemed to be. It was an illusion. Nothing can ever be the way it once was, because we cannot go back and change the past any more than we can predict the future. What happened, happened. What we feel, we feel. What made us, made us. We are who we are now. We feel what we feel now. We love who we love and do our work and try our best to make the world a better place, COVID-19 and politics and famine and pestilence and volcanoes and tsunamis and hurricanes and all of it be damned. 

I am responsible for how I feel. No one else is. I am responsible for the baggage I choose to carry, no matter how heavy it is. I am the only one who can put it down, leave it behind, travel lighter and freer and at peace. 

In this uncertain time, in this time when a man who is almost sixty-three years old, who has almost lived longer than his father did, who could conceivably contract a deadly virus that could actually kill him quickly and without fanfare, isn’t it important, isn’t it mandatory, that we see the positive, celebrate the joyful, and live life free of the things that weigh us down and keep us wallowing in emotions that are fleeting as puffs of air? 

Grudges? I have ‘em.

What the pandemic has taught me?

They may be to have, but they are no longer to hold. 

Insomnia in the Time of COVID-19

I have talked about it before, but it bears revisiting this week. In the last three weeks that I have worked at home, I have heard several complaints repeated over and over again. One that is on everyone’s lips is this: “I can’t sleep.”

Now, I see a lot of folks who have depression, anxiety, trauma, grief and many other issues in my work, but there are certain kinds of symptoms that seem to be common across the spectrum of mental health illness or stress. When people get upset, their mood changes. They eat too little and lose weight, or they eat too much and gain weight. They notice changes in interest, motivation and energy levels. They isolate and have trouble connecting with those they love. They have a hard time focusing or paying attention to things that matter. Many of these symptoms might be present in anxiety disorders, mood disorders or even psychotic disorders. Still, the one thing besides a vague sense of anxiety that almost everyone is feeling, and complaining about in the midst of this pandemic, is the inability to get good, restful, restorative sleep. 

First, some normative data. What is normal sleep latency, the time that it takes most of us to drift off to sleep? Eight minutes is a good yardstick. How much sleep do we really need? One can read about numbers that vary wildly, but it still seems that most people do better with an average of seven to nine hours of sleep per night. How much of this needs to be REM (rapid eye movement) sleep, that stage of sleep where we actively dream? Well, if one gets nine hours of sleep and REM cycles repeat every ninety minutes or so, one could expect to have at least two good REM cycles per night. Twenty-five per cent of your total sleep time given to REM is about right for most people. 

Next, why is this important? Why do we need this much sleep anyway?  We think that sleep is important to maintain both good mental and physical health. While we sleep, our bodies repair and maintain organ systems and muscles and immune systems, and manufacture hormones. Memories and newly acquired information may also be cemented during sleep, so that this information can better be used later during waking hours. Getting the right amount of sleep may also be protective in guarding you against development of diabetes, weight gain, and heart disease. 

Why has sleep, or the lack of it, been such a constant complaint in the last few months as we navigate this COVID-19 pandemic? Many people are experiencing anxiety, which tends to make settling down, getting relaxed and falling asleep at night very difficult. This anxiety is low grade and chronic for many people, hard to describe but always there, and it tends to affect our ability to fall asleep, leading to what we call initial insomnia. This kind of anxiety and inability to fall asleep can build on itself night after night, becoming a chronic problem. 

Others may be battling depression, with superimposed grief over all the things that we have collectively lost because of the virus outbreak and its impact on our physical, emotional, vocational and financial lives. Depression sometimes leads to what we call early morning awakening. You are able to fall asleep just fine, as you are sometimes absolutely exhausted, but you find yourself waking up almost every night at four AM, not able to go back to sleep. 

Everyone wants to sleep. The quick fix, taking some kind of over the counter or prescription sleeping pill, seems to be the best answer. Not always so, I’m afraid. Sometimes one has to deal with the underlying anxiety, depression and grief that is depriving us of sleep in the first place. Sleep hygiene is also very important. You know, the steps that your doctor has told you to try, including not exercising in the evening, limiting late night eating and alcohol consumption, avoiding screen time for several hours before you go to bed. Regular bedtimes and awakening times are also crucial, as these rhythms tend to lead to more consistent and restorative sleep. 

During this pandemic, we are all a little out of sorts, our usual routines have been disrupted, our moods are different and our ability to relax is strained. Knowing what is normal, what is not and how to maximize our chances to sleep well each night will go a long way to help us not only weather this biological storm, but thrive as we get to the other side of it.  

Lend Me Your Ears

Okay, so I made it clear in my last post that I do not like really big, long term change. That’s just me. That being said, I have been in a maelstrom of rapid, relentless, major, workflow altering change, much as many of you have, over the last two weeks now. Sort of like that frog in the pot of water that is unaware that the temperature is rising until he starts to boil, we have been the recipients of a slowly gathering storm, pushing a tidal wave of change on us from way out at sea, knowing that it is coming but not having a clue exactly when it will hit, how much damage it will do, or whether we will survive it.

On top of that, we are now seeing reports of people actually dying from this COVID-19 infection and disease, not just getting sickened or inconvenienced by it. A young lady. A middle aged media executive, a child, an infant, a renowned neurosurgeon, a country music artist. In other words, people like us or people that we love and care about. Ouch. Much too close to home. Anxiety, More stress. Worry. Paranoia. Enforced isolation which leads to functional isolation which leads to real isolation even at home. Not good for the psyche. Not good at all.

I can handle this, I tell my bad self. I will not get sick. This could never happen to me. I’m too young to die. I’m in my prime. My brain, smart as it is in the area of fact assessment and reality testing, is also super duper good at deception. The person it is the best at deceiving is me. I do not feel sick, therefore I cannot get sick. I am able to handle this stress, and even more stress, without feeling it physically. I will not notice a thing, not one little thing that will give me a clue that maybe my physical or emotional systems are overloaded. Right.

A couple of weeks ago, my left ear started to feel a bit stuffy. Annoying, but not terribly debilitating. I chalked it up to the myriad allergens in the air in the southern United States at this time of the year. I had felt this before, sometimes saw it turn into a mild cold, and had developed a way to cruise through it. Daytime and nighttime cold medicine at the very start of this syndrome, plus nasal spray to keep me breathing enough to work and be productive, all for about a week or so, had always worked before. Dutifully, at that first little feeling of stuffiness and discomfort, I embarked on my standard regimen. I thought little more about it.

A week later, things were worse. The ear was more stopped up, I could not hear well on the left side, and there was an uncomfortable feeling of having one side of my head in a barrel. I knew best, I told me, and I continued to doggedly prosecute my tried and true regimen. More liquicaps, more spray, more time. Nothing doing, my ear said, we will not budge. The left side of my head, down onto my neck, around to my cheekbone, got numb. When I would talk to colleagues, albeit from six feet away, I felt that I was shouting. Conversations at the island in the morning with my wife were unsatisfyingly one sided unless I turned my head towards her and practiced a mixture of something like torticollis and lip reading. “This is one bad allergy season!” I pontificated. All the while, this was really starting to drive me nuts, with the changes at work, schedules upended, my wife getting back on planes to fly germs, I mean passengers, around the country.

Then I remembered an episode a few years ago when a similar thing happened, but a time that I felt that I lost ALL the hearing in the same ear. Total hearing loss. Nothing. Scary. I ended up going to an urgent care center that time, and as you may have guessed by now, I had a monster, hard, obstructive impaction of cerumen, that’s ear wax to you and me, in that ear canal, completely and utterly obliterating any path for air or sound to travel one way or the other down my ear canal. A little soaking and a splashing shower of irritation, I mean irrigation into a small metal pan, and I could hear! I had never felt that happy in my entire life.

Fast forward to this week. No hearing, numbness in my face, unsteady on my feet, oh my God do have a tumor somewhere kind of angst running amok among the COVID-19 particles , I finally remembered that episode. I go to Walgreens, buy some ear wax nuking stuff (No, they still don’t have hand sanitizer), and get to work. I won’t bore you with the tedious details, but after three nights of this intervention, one evening in the midst of a showering royal flush, out came an ugly piece of wax that had bugged me for days. I could hear! I was no longer numb! It was a miracle!

Funny thing, though, the right ear, the one that had felt pretty normal through all this, felt a little stuffy itself once the left one was crystal, drive a gondola down the ear canal clear. Oh, no, migratory aural tumor, I thought to myself, and had to smile. Really? Really? More wax nuking drops, two more days, then blessed relief. I am virtually normal now, if I ever was.

So, I quipped to my wife at breakfast the next morning, sitting at the island, and NOT turning my head as I could already hear her replies, I wonder if increased stress and anxiety can cause one to create more ear wax? Ever at the ready to end wanton ignorance in our little world, she snatched up her iPhone and searched for an answer.

I’ll be damned.

Turns out, increased stress and fear can cause the body to produce more cerumen.

WHAT?

PRODUCE MORE CERUMEN!

SEASON WITH CUMIN? WHAT?

NO! EAR WAX. EAR WAX!

Oh……

We are all overloaded right now. We are frogs in a pot. The temperature is rising, and we are in jeopardy of boiling if we are not careful. We think that we have seen it all, done it all, figured it all out because we are smart, successful, resourceful people. We have all the answers. We are large and in charge.

Wrong.

This is bigger than us. Tiny viral particles, too small for us to see, have brought our world to its knees. Our economies are reeling. Our social institutions are paralyzed. Some of us are sickened. Some of us are dying. Our bodies know this, the ancient parts of our bodies and those cells and systems that really HAVE seen it all and survived, they know this, even if our younger, smarter, more resourceful brains cannot accept it.

Listen to your body. It will tell you when you are maxing out your biological credit line. It will tell you when to slow down, when to meditate, when to eat, when to rest. If you do not heed it, it will find a way to get your attention.

Thanks for lending me an ear while I waxed eloquent.

Yes, I really went there. Be well.