COVIDISMS: There’s Got to Be a Morning After

Well, it’s been six months since this hell began for most of us. Life changed about mid-March. The pressures of pandemic life and racial unrest and climate change and monster storms and COVID-19 and political upheaval and all the rest of the plagues that currently beset us are almost too much to bear. Almost. But bear them we do, baring our souls when we need to, our teeth when we must and our hearts, always. As Master Yoda wisely taught us, in times like these, “No! Try not. DO or DO NOT. There is no try.”

Yesterday was the nineteenth anniversary of the brutal terrorist attacks on our country on September 11, 2001. Like many of you, I can remember the exact spot I was sitting in, the exact thing I was doing, the exact sameness of that morning, until someone told us to step into the next room. A group of caregivers, patients, doctors, counselors and family members were glued to the small television on top of the rolling cart, watching in disbelief as a plane hit the World Trade Center. A tragedy. A fluke. An accident. Until it wasn’t. Until another plane took that elegant, sweeping, graceful arc of death into the second tower in a ball of fire and melted glass and metal and a second plane full of people lost their lives in an instant. I listened to some of the phone calls from the planes and the towers last night, against my better judgment, and was absolutely devastated by the sadness, the finality and loss of it all. Lives and families shattered, a city reeling, responders who had been trained to handle anything that could ever happen, except this one thing. No one had ever used planeloads of people as weapons of war. I know that it is not good for me to watch and listen to histories of tragedies such as 9-11 after long weeks of work and stress, especially when I am home alone, but how can I not? How can we not hearken back to that time, that era, that innocence lost for us and for our children? NEVER FORGET.

Today is September 12th, and the thirty sixth birthday of a woman who I admire greatly. (Happy birthday, Greer. I love you!) My oldest daughter, who bears the Scotch feminine form of my first name as her own, has become a force to be reckoned with. (From Houseofnames.com: The old Scottish-Dalriadan name Greer is derived from the given name Gregor. The personal name Gregor, which is the Scottish form of Gregory, is derived from the Latin name “Gregorius” and from the Late Greek name “Gregorios,” which mean alert, watchful, or vigilant.) She is a daughter, a wife, a mother, a friend, a political activist, a party planner extraordinaire, a home schooler, a sister, and aunt and so many other things large and small. As I have written about before, she was performing in a production of Oklahoma! in Augusta, Georgia when 9-11 happened, and was about to celebrate her birthday with friends and family that year. I am quite sure that she has vivid memories of that year as we all do. There was a morning after for Greer, a birthday morning after, and there have been September 12ths every day since that fateful attack. Birthdays must be celebrated, even as losses must be mourned.

My wife has worked for Delta Airlines for forty years. She is very good at her job. She is a people person, remembers details that are lost on most mortals, and can anticipate things that others need before they know they need them. I know, because she does this for me at home all the time. Every time that I see she has left the coffee pot ready to brew the morning coffee for me the day after she leaves for a flight, or manages to fit one more container of that German shower gel I like into her bag on the way home from Frankfurt or fills up the fridge with just the soft drink that I have been craving this week or any number of things, I feel the love that she shows through her actions every day. She has gone back to flying after a voluntary two month furlough. Delta’s business plummeted ninety percent when this pandemic started, and some of her flights have less then three dozen people on them even now. The airline industry will survive, Delta will go on serving the transportation needs of many, but it’s going to be slow going. Some estimates say that the industry as a whole will not be anywhere near back to prepandemic levels of business for four to five years. In this time of COVID-19, political unrest, and commemorations of 9-11, do I worry about her as she flies from Atlanta to Amsterdam to Frankfurt to London to Dublin to Seoul and back again. I would obviously be a liar if I said I didn’t. We don’t dwell on it. It’s her job, it’s been her job for forty years, and she’ll keep doing it for another half dozen or so years and then retire. That is the plan. I believe in the plan. We simply cannot live our lives in fear of terrorists, viruses and world political unrest. We cannot, and we will not.

One cannot be a writer of any kind without reading.

(“Can I be blunt on this subject? If you don’t have time to read, you don’t have the time (or the tools) to write. Simple as that.”
― Stephen King, On Writing: A Memoir of the Craft)

To write, you must get out in the world and experience things that compel you to write and you must read. A lot. Widely. As I age, I find that for some reason my mind takes in the written word better in an audio format than it does by holding physical books or magazines or papers in my hands. Now, I still have stacks of books and reports and papers in every single physical space that I occupy in this life, from the living room to the bedroom to my home office upstairs to my office at the clinic. I pare these down excruciatingly slowly most of the time, and I severely chastise myself regularly for not being more diligent in doing so. Be that as it may, I have loved audiobooks since a physician colleague of mine turned me on to those long cardboard boxes of cassettes that got shipped to me regularly and that I would play in the car on my daily commutes starting back in the eighties. Now, of course, having passed through the cassette and CD phases, the industry is almost purely digital and portable and held conveniently in your phone, computer or tablet. I love this, in that I always have a book or essay or article at hand and there is little excuse for lack of time to read. What do I read? I love political books lately, given our collective angst in that sphere, as well as biographies, novels, and histories. Some of the titles I have enjoyed this year include Me, by Elton John; Leonardo da Vinci, by Walter Isaacson; A Very Stable Genius, by Philip Rucker and Carol Leonnig; You Never Forget Your First: A Biography of George Washington, by Alexis Coe; The Hardest Job in the World, by John Dickerson; Blindness, by Jose Saramago; and Front Row at the Trump Show, by Jonathan Karl. I am currently listening to The Second Mountain, by David Brooks. I also listen to podcasts, mostly on politics, but sometimes on other topics, on a daily basis. The pandemic has caused me to really sit down and evaluate how I use my time, every day, and the results have been eye opening. We waste a lot of time on things that, to use a football metaphor since it is finally fall, do not move the ball down the field. I am trying to rectify that in my own life.

It is Saturday morning as I write this, and football is starting back. I love football, but somehow this year I’m just not feeling it the same way, you know? Life is moving on, and time with it, and traditions and markers too, but things are different. Time will tell if we get back to normal, pre-pandemic normal, ever. One thing I am sure of is that life will go on. We will continue to live and love and work in some fashion, there will be babies born and some of us will die. As my wife and I have been learning by listening to The Great Influenza, by John M. Barry, things are bad now, but they could be orders of magnitude worse. All pandemics end, and the world will continue to turn.

A last thought. There were some good things about the seventies. This song was one of them that pertains to us now, more than ever.

Enjoy your weekend, and thanks as always for reading my Musings.

Rhythms

My mother buried her husband this past week, the second man she had to say a tearful goodbye to after her had endured a protracted illness. The first was my father, who passed away suddenly, almost violently, from a brain hemorrhage twenty five years ago. It got me thinking about a lot of things, as these events and times do. I began to think about them in the context of the rhythms that they settle into.

We are born into this world, we hope, the objects of joyful celebration, welcomed to the world with open arms and warm fuzzy blankets and the kootchie-cooing of adoring parents and grandparents. If we are lucky, we are loved. Undeservedly, unequivocally, unabashedly, unconditionally loved. We are cared for and nurtured. We grow and learn and succeed. One day, we head out into the world, adults who know nothing ready to control everything, only to finally realize that our true education has just begun. If we are smart and savvy, we learn even more about how things work, how to live and love in a harsh world that owes us nothing, nothing at all. We create, we procreate, we work, we amass, we collect, we build, we inhabit, we settle in for that delicious part of life which is the “we made it” part. We expect that “we made it” leads to “we earned it” leads to “we deserve it” which gradually morphs into “it will always be this way” and “no one can ever take this away from us”.  The train is heading down the track at a dizzying speed, wheels singing on rails and billows of black smoke trailing behind to darken the other fellow’s sunny skies, not ours. Not ours.

Then, a once in a century, a once in a lifetime event happens for the second, third and fourth time. The hurricane leaves nothing but concrete slab and green slime-infested pool at the edge of a sunny shore that once heard the laughter of children and now hears the wails of retirees who find that their physical address, what is left of it,  has moved over three streets. The lingering siren that warned of the monster heralds a dawn in which the rubble is piled three stories high, the muddied teddy bear and the family album strewn across a neighborhood that no longer has landmarks of any kind after the wrath of the mighty winds visited. A casket is lowered into the ground, a tiny one, and is covered with earth, covering hopes and dreams and sleepovers and play dates and senior proms and trophies that will never be displayed, all because of a stray bullet that was stopped by the innocence of a child.

We are born. We grow. We dream. We work. We love. We die.

The virus creeps in on Sandburg’s little cat feet. Yes, I can’t get that descriptor out of my mind in the past few months because it seems like everything that hits us, hurts us, kills us comes in that way nowadays, gliding on silver airplane wings to knock down buildings, hissed in a a quiet string of expletives designed to hold us down, or breathed quietly towards us, inhaled death. Quiet. Stealthy. Deadly. The rhythm of death.

I’m home. I work every day. I talk to everyone and yet touch no one, shake no hands, pat no one on the back, proffer no gifts except my words. The rhythms of this daily pandemic grind are cold and mocking. Upstairs to work. Listen to music that used to soothe but now just bores. Hear the rumble of the construction workers’ trucks and trailers heading into the area to work. FedEx truck by for the first of one, two or three routes that day, always before ten. UPS truck (What can Brown do for you?) close on his heels before noon. Construction guys to lunch, sans trailers. USPS truck chugging out and back, albeit later than usual these days. Rhythms. The daily grind of good coffee and hard work and tedium and our inexplicable complacency with mediocrity of leadership and one thousand deaths per day.

And yet, we do it.

And we do it again.

And we do it again,

until,

one day,

we understand

why.

The masks come off,

and we smile.

Plandemic

Remember when you first heard about the coronavirus? Were you watching the news on television, did you read a brief article in the newspaper, or did you have something served up to you via Google News? How did you feel? Perplexed? Anxious? Indifferent? Terrified? I know, trust me, it was probably a little bit of all of that rolled into one long, gaspy, chest-tightening, lump in the throat kind of fog that you found yourself in those first confusing days of what was an epidemic growing into a worldwide pandemic. It’s only in Washington state, we thought way over here on the east coast. It’s only a few people in a nursing home. It will be treated and contained quickly, and then it will “magically disappear”. Not so, I’m afraid.  As I write this, as of nine minutes ago, there have now been almost five million cases of COVID-19 in the United States, and one hundred sixty thousand people have died of the disease.

When you knew, really knew, that this pandemic was real and that it would eventually make it to your state, county, city and neighborhood, what did you do? Not what did you feel, but what did you do? My hunch is that on some level you began to plan. Maybe not even consciously, but on some level your brain started to play out scenarios that might happen, just like moves on a chessboard on the way to checkmate. There was, very quickly, the problem of finding and wearing masks. N95s, even simple surgical masks, were like gold. My wife, just like some of you, sewed a few cloth masks from an old Oxford shirt of mine, elastic at various lengths, some too tight on my ears, others just right. Bulky, blue-striped, sweaty, but effective. This very simple thing lead to other acute decisions that needed to be made: where and how to work, the potential for layoffs, how to help the kids finish up the school year, how to make sure that the bills were going to be paid, how to keep our families and those around us safe and well. We started to plan for a crisis that we thought at first would be like any other crisis. This epidemic soon to be a pandemic would sucker punch us in the gut, we would exhale, recover, and then move past the acute trauma, getting back to our old lives by Easter, Memorial Day at the latest.

When that did not happen, our brains, which had been humming in the background, running all those potential moves, went to the next step of our response. We had to come up with a continuation of our plan A, a more detailed, longer term set of reactions and actions that would get us through what looked to be a more involved medical and social crisis than we had dealt with for a long time. Some of us were laid off. Some of our businesses closed. We could not get a haircut. We could not go to the gym. We could not have a date night at our favorite restaurant. We could not visit. We could not hug. We learned the meaning of the thirty second commute and how to Zoom and work in Teams and find hand sanitizer. We were always planning, but to what end? How long? How so? For what reason, to what end? What next? What if? So many questions.

We have continued to plan. Now, we are facing not just working from home, but the very real prospect of working from home while educating our children. Six hundred dollars may have become two hundred dollars right before our eyes. Rent and mortgage payments are due. School supplies and books and pencils and possible laptops or tablets need to be bought. The internet access in our homes is not quite good enough for this whole distance learning thing. Assess. Analyze. Plan. Act. Repeat.

Are you overwhelmed yet? I know I am some days. What do we do in this, the worst pandemic in a century? Planning is key. A few pointers.

  1. Prioritize your obligations. Some things must be done. We know that. So just like the book Eat That Frog by Brian Tracy teaches, don’t leave the most stressful, most difficult decisions and plans to last. Do them first. For example, tackle how you will get your necessary bills paid first. All else can wait, right?
  2. Take care of those who depend on you. You know how stressed you feel? Your spouse or significant other knows it too. They might even feel worse than you. The kids? They are excellent little barometers of parental stress. They know. Don’t let them get overwhelmed but let them know some of what you are planning and doing and why. Work as a team.
  3. Make time for recreation and relaxation. I know, I know, there IS none. I hear you. We’re in Plandemic mode, right? We must plan, must schedule the time to do the things that are going to get us through this alive and healthy. I have learned one very hard but very important lesson over the years: no one is going to do this for you. You plan the time, you reap the benefits. Period. Do it.
  4. Reach out and connect to others. Call, message, FaceTime, Skype, fire up Teams, write a real letter! (Yeah, it will get there. This pandemic is going to last a while.)
  5. Get the facts about the pandemic. There is a lot of information and misinformation out there. You know that too. Don’t get embroiled in the religious, the political, the factional, the sectional, the cultural spins on this whole process. Learn about the science of this virus and the disease it causes. It is real. It exists. Don’t let anyone tell you otherwise. I have had people that I knew and worked with die from this disease. It’s no joke. That said, plan for how you can best keep you and yours safe and healthy until things start to go back to some semblance of normal. How long will that take? Truly, no one knows right now.

This is not an event that requires you to take a single punch, get up off the floor, and go back to your normal pre-pandemic life. This is a Plandemic. It is going to continue to require lots of rational thought, good decision making, and plain old common sense.

We cannot plan for an endpoint. When it comes, we will have one hell of a party, but for now, we must hunker down, learn all we can, make good decisions and wait it out. Stay safe out there.

Costco-vidisms, and Other Musings

I ventured out this week to get the tires on my car rotated and balanced at our local Costco. Now, I have been working at home most of the time since mid-March, with some time doing telepsychiatry and one clinical day on Fridays at the main mental health center office in Aiken. Other than that that, I have rarely ventured out at all, even to the grocery store, as my wife is the self-proclaimed “Food Lady” and does not require much of me in that department except for the occasional breakfast omelet making or steak grilling. I parked my Mazda 3 at the tire center side of the store, walked toward the entrance, donned my mask and got out my Executive Membership card, flashing it at the store employee as I made me way inside. So far, so good. What I saw shocked me, and at first I did not know why.

I could tell almost immediately that the store was different from the last time I had visited it, months ago. To my left, the wall made of fence-like material that usually held numerous, ads, signs and bolstered the stacking of merchandise, was free of any encumbrances at all. Clear. See-through, Airy, one might say. The height of the stacked merchandise on that side of the entryway was much lower than usual. To my right, the large screen televisions were socially distanced from each other. Granted as wide as these TVs are, they could be side by side and still be six feet apart from each other. Everything looked far apart, like one of those nightmares I used to have as a kid when everything looked over-sized and huge and menacing. I walked around to the auto service area, noticing on the way over that the rows of tables and chairs usually placed between the checkout line and the food court were all gone. Completely gone. I walked up to the auto checkin-checkout station and saw the high Plexiglas barriers that surrounded the desk and cash register area, little cutouts for exchange of paperwork and cards. After dropping off my keys, I made my way further into the store, back towards the seafood and wine and rotisserie chickens.

I was struck by the amount of merchandise that was NOT in the store. Granted, there was enough of just about everything you would come to Costco to buy, but there was not the excessive, pallet-driven environment of twenty four packs of everything, large bottles and over-sized boxes that made one frantic to overbuy while at the same time calculating available storage space back home. Huge fans whirred overhead. The entire upper third to half of the store itself was empty, clear, productive of good, proper airflow and circulation. I found the few items I needed, checked out, and walked towards the food area. My beloved vanilla-acai swirl, a treat reserved for tire rotation time, was no more! I was saddened by this loss in a silly, heartfelt way. Not having a seat to sit on or table to sit at, I stupidly walked towards the cardboard box corral, looked at my watch and figured that I could stand there for the remainder of my thirty minute wait time to get my car back. Which I did.

Why did this visit to Costco unnerve me? I got what I came for. I was not disappointed in the customer service at all. It dawned on me that this was the first time that I had decided to do out and experience the “normal” retail world in some time. At home, things are now routine. I work, eat, sleep, play, rest, relax and do almost everything else there. It is safe. I am healthy there. I do not feel threatened there. My world has not significantly changed there. Out in this new world, this world of distance and less stuff and six foot markers and Plexiglas everywhere, it is decidedly not normal any longer. I came to the realization, more vividly, that it may never be again. I went back to my home, calmer, more relaxed, feeling safe, but knowing that I will have to keep venturing out into this hostile landscape that some folks tell us will potentially get much worse before it gets better.

 

We have been attending church virtually for many weeks now. The Church of the Good Shepherd has learned, as we all have, to pivot with this virus, to use time and technology and virtual everything to stay connected with its parishioners and to try to keep us connected with each other. We have enjoyed “Good Morning Good Shepherd”, followed by a worship service that was at first quite traditional in its presentation, but that is now full of video and music and readings by parishioners and lovely tours around the summertime Summerville campus. We have even started having outside baptisms again, complete with baptismal font in front of the entrance to the church, masks and appropriate distancing and hand sanitizing.

Today’s service was especially poignant. The opening hymn admonished us to fight the good fight, run the straight race, cast care aside, and know that “Christ is all in all to thee”. Wise words of counsel in these very uncertain times, but oh so hard to do without much effort these days. Robert Lowry’s “How Can I Keep From Singing?”, sung in melodious tones by alto Rebecca Brune, was lovely beyond measure. Watch and listen to another wonderful version of this song here

Thro’ all the tumult and the strife, I hear the music ringing; it finds an echo in my soul-how can I keep from singing?

No storm can shake my inmost calm while to that refuge clinging; Since Christ is Lord of heaven and earth, How can I keep from singing?

 

Sometimes we need a little perspective. Watch this video if you feel that you are being put upon, that you are too stressed, or that we are facing more than any people have ever been forced to deal with and bear. It may change your mind, or at least put you into the river of time in the appropriate way and to appropriate degree. 

We rode our bikes on the Greeneway this afternoon in an attempt to get outside and do something physically good for us, as we love to do when we can. We ride this trail at least once a week now as times permits and always enjoy it. There are walkers, dogs, bike riders, in line skaters, singles and families using this wonderful community resource. It was very hot and humid today and we struggled on the uphill/out portion of the path, pedaling hard and getting a good workout. As the turnaround was in full sun, we rode a few dozen yards back up the hill and stopped to the side of the path, thought still on it and as out of the way as we could get, to drink some water and get ready for the trip back down to the start of the ride and the car.

Two other riders, one a middle-aged man and one a young man, rode towards us soon after we had stopped. With plenty of room to pass us on the opposite side, the older man called out in what I thought was a jovial tone, “Don’t stop in the dance floor, now!” They went on their way, down the short hill to the turnaround, then he came back past us, not really acknowledging us at all. The younger man, after turning around further into the neighborhood just beyond the end of the Greeneway, came back up the hill towards us as well. On the opposite side coming towards us, a family of five was walking along the path. As they arrived beside us at almost the same time that the young man was getting ready to pass us, he had to slow and stop to allow them to walk a few more steps past us so that he could safely whizz past us himself. This might have taken ten to fifteen seconds. We turned towards him and quipped that we needed to cool down a bit more before starting back and were sorry that he had to wait a few seconds to let the family pass. In an exasperated and exaggerated gesture, he lifted his head and rolled his eyes several times, sprinting past us on his bike, not saying a word. 

Now, as far as I know, the Greeneway is a community resource that is available to all, kids, families, novices riders, older riders like us and more. There are expected rules of trail etiquette, including allowing users of all skill levels to utilize the trail, and not blocking access or ability to pass for other users. When we stopped for water, we certainly did not mean to cause any impediment in access to anyone using the trail around us this afternoon, and the family that walked past us and engaged in friendly conversation certainly understood that. The young man who so rudely rolled his eyes at us and then sped past without a work of any kind, did not. 

If you are that young man in an Andy Jordan bike shirt who was so inconvenienced this afternoon that we shaved fifteen seconds off your out and back time, I apologize. I would only ask that you remember these things:

  1. We are in a global pandemic. Everyone is stressed. Everyone needs an outlet. Ours today was riding our bikes on the Greeneway with a heat index of 105. We meant no harm to anyone as we enjoyed that activity today. 
  2. My wife and I are in our sixties. We are happy to be able to get out and physically challenge ourselves in this way for exercise. You are not in your sixties. I would ask that even when you are displeased, that you respect your elders when showing that displeasure. 
  3. Lastly, I would hope that in this time of great stress for us all that you would develop a little more patience and show grace to those who are navigating this time with you. 

 

Tomorrow is a new week. I wish for all the peace and good fortune and grace that we are all going to need continuously as we move forward through this global crisis. 

 

 

 

 

Covidisms: Thoughts on Death

I did something last evening that I have never done before. I wrote a serious and heartfelt email to the New York Times and those who make the podcast The Daily, one of my favorite ways to start each day. This podcast has a way of finding and telling stories that get to the heart of what we are all experiencing in the midst of our lives, especially in these days of pandemic and racial strife and economic crisis. There have been many episodes of The Daily that have been poignant, thought provoking and moving, but two of the most recent ones from this past week hit me hard. I would like to share the end of the email that I wrote before I go further with this post:

The episode revisiting the situation in Bergamo, Italy, through the wise, thoughtful and emotional perspective of Dr. Fabiano Di Marco hit home. I lived in Italy for two years as a teen and my wife and I had planned a trip back to Rome and Florence in April, my first trip back to the country in fifty years. Of course, it did not happen. I felt a deep sense of sadness for the Italian people and the medical staff members who are trying to serve in the face of this pandemic.

Today’s episode about the grief felt by little Tilly for her grandfather hit me even harder. I am a grandfather of six kids, five in Chattanooga and one in Denver. I have not been able to see them for what feels like years, except by FaceTime calls. We are planning a driving trip out to Denver and back in late September, because I am not excited about getting back on planes, but we need to reconnect with our family and friends in other parts of the country. Hearing Tilly talk about her grandfather, coupled with the recent losses of one of our long time mental health center employees and another counselor whose clinic I used to consult with, made me very much aware that I could be that grandfather or that employee who contracts this virus and does not make it through the ordeal.

Your stories are powerful. For someone like me, who tries very hard to deal with the emotions by blogging, journaling, taking long hard bike rides or keeping up with the political craziness all around us, they force us to stop, to listen, and most of all, to feel. Ironic, isn’t it, that a psychiatrist would have a hard time feeling. Of course, the feelings are there, and when they are released by storytelling  and powerful emotions that you bring to life, the intensity of it all is almost too much to bear. It is so necessary though, and I know that full well.

Thank you, thank you, thank you, for getting the information out there, for telling the stories in such compelling ways, and for making us think, process, and feel. Yours is one of the first podcasts I listen to every day, and the ideas that come from it are some of the last ones I think about when I go to sleep at night. I appreciate what each one of you do. Please keep up the excellent work, knowing that we hear it, and we need it.

I wanted to express my thanks to the makers of this show because they provide a way for me to stay in touch with some very profound feelings during this time that I had simply rather not have. I feel frustration, I feel anger, I feel loss and grief, I feel elation, I feel dullness and boredom, I feel indignation, I feel sorrow, I feel pity, and I feel fear.

As I have mentioned in blog posts earlier this year and in followups afterwards, I will be sixty three years old on October 24th this year, God willing. At that point, I will have lived longer than my father, who died suddenly at age sixty two of a devastating brain aneurysm and cranial bleed. I never had much doubt that I would easily reach that point and that age, given the fact that I try to eat right, I exercise, I am trying to keep my weight and blood sugar and cholesterol and blood pressure down. All the right things that one must do to live a long life, barring catastrophe. I have been holding my figurative breath all the same, knowing that when I reach that milestone I will have a good cry, say a few words of thanks to my dad that I hope he can hear and go about the task of living productively until my sixty fourth birthday.

All of that held true until March of this year. Until the coronavirus upended all our lives, changed our daily routines, changed how and where we work, who we see, how we eat, how we travel, how we worship and how we connect with others. I have done what you have done, tried my best to make good decisions, protect myself and my wife from harm, continued my work to care for my patients the best I can given the circumstances, and kept my cool, for the most part. We have personally been so very blessedly insulated from the ravages of this plague. As far as I know, no one in my family has contracted this virus, no one I work with has had it, and only a few of my patients have, most of them doing well in spite of having the illness.

In the last couple of months, one of our long term mental health center employees, someone who was there when I started working in the center almost twenty nine years ago, contracted the virus and died. He left behind a wife and young son. A pharmacist friend of mine, who visited our offices every month to inspect our medication areas before her retirement, has just been released after a ten day stay with COVID-19. A counselor who once had a family clinic that I did medical consultation with in the early nineties recently contracted the virus, got very ill very fast, refused to be placed on a ventilator, and died quickly of COVID-19. The disease is starting to hit home.

I grieve these losses and setbacks for various reasons. I feel so badly for the families and loved ones of those who pass on. I rejoice over the victories of those who get infected but make it, all the while fretting over what long term consequences they may have to endure. I am sad that when someone like my counselor friend dies, not only because her life was most likely cut significantly short due to this illness, but because her death reminds me starkly that mine is coming too. She and I shared a slice of time, a set of circumstances, a place to talk and work, and a shared cause of promoting good mental health for the people we treated almost three decades ago. I sincerely hope that the work we have done together and that I continue to do goes on, but I am made painfully aware that we will not. We will end.

I do not fear death so much as I am not ready for it. Like everyone else, I am sure in my own feeble mind that this illness, this worst illness of its kind in the last hundred years, is not going to be the way that I will leave this life. It is not aiming for me. I will live a long life and become a grump old man who still likes to read and write and fish and take pictures and take walks by the river. Or will I? The uncertainty of these times is the biggest stress of all.

In watching this pandemic and how it is affecting all of us, I am reminded of a few basic things that we must attend to each and every day, as if it was going to be our last. Things that tend to shine through and demand our attention when someone dies and passes on, leaving their legacies.

  1. Relationships are important. Make them. Enjoy them. Nurture them. Attend to them. Water them like flowers in your summer garden and watch them bloom and dazzle with bright color.
  2. Find something that you are passionate about, and throw yourself at it with fury. Write. Paint. Play music. Heal. Preach. Teach. Mentor. Parent.
  3. Put others above yourself. Whether this viral illness is your ticket off this planet or something else gets you down the road, you will inevitably leave others behind. They, like little Tilly on The Daily podcast, will remember you. They will remember what you said, what you did, what you taught them, but most importantly, how you made them feel.
  4. As the recently departed John Lewis of Georgia said, get into trouble. Get into good trouble. Do the right thing because it IS the right thing. Do not waiver in your resolve to do this, because it is important.
  5. Know above all else that your reason for being here on this earth is not to glorify yourself, embellish yourself, surround yourself with riches and accolades and awards, and make yourself the center of the universe. (You are most assuredly not.) Your mission, your assignment, your reason for being is to do all you can, everything you can, in every way you can, with everything you have at your disposal, to make the lives of those around you, those less fortunate, those who are downtrodden and oppressed and neglected and forgotten, those who the world despises, BETTER. You have the power and the obligation to do that. If you do, if you truly do, then at the appointed hour you can meet death, smile, close your eyes and know that your time here has been well spent.

Stay safe, do the right thing, and live long, friends.

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.