Taking a break from COVID, racism, equity and other heavy things this week, my friends. It’s too much, what with RBG’s recurrent metastatic cancer and John Lewis’s death. I’ve been glued to my phone and computers all week, reading, digesting, observing, integrating, posting, connecting and conversing. I had at least three important ideas for the blog, and they all need to marinate longer.
But I still had to write! I owe letters to three friends, and they can wait. What needed doing tonight were five love letters to strangers.
Sometime this spring, while sheltering at home, I discovered More Love Letters. Their mission is simple:
Deliver hand written letters to people who could use some extra love via snail mail.
People submit nominations for letter recipients, and every month the MLL team selects five to post. Each recipient’s nominator writes a heartfelt request, and supplies an address. Letters are requested to be postmarked by the last day of the month (but I bet they’d take some tardy ones, because they are sent with love?). Tonight I wrote my second ever set of love letters, on washi tape stationery, of course. I may have more cards and tape than I will use in my lifetime, so I’m more than happy to share! Maybe next month I will include a blank card and envelope as a gift for the recipient to pass along—I’ll even put a stamp on it!
In this time of tumult and conflict, of heaviness and stress, reaching out to offer some light to others heals me. They will not know who I am (well, unless they happen to read this post, I guess), and I will not get a card back in reply. I get to write some encouraging words that might brighten someone’s day. But I do it for myself as much as for them.
Maybe you could use a mutual pick-me-up, too? Each one took less than five minutes. The words came easily, organically, and happily. “Holding you in light,” “Sending love and support,” “Wishing you everything you need in this crazy time.” Easy peasy, written sincerely–it feels so good. You don’t have to write to all five nominees—do what moves you. Maybe you’ll be inspired to also drop a note to your best friend, your colleague who’s challenged, or someone who recently crossed your mind, who’d probably love to know you were thinking of them.
Now is exactly the time to connect, don’t you think?
Oh and I have no financial or other interests in this organization. I just love that they encourage connection and snail mail, two of my favorite things.
Friends, I’m sad. I will not go home to Colorado next month. The family went already last month; it was a glorious 15 hour road trip each way from Chicago, with 7 amazing days in the mountains, my favorite place on earth. Because we had planned to be abroad that week, back in January we made plane reservations for a five day trip to my home state in August. And now I will cancel.
Cancelling a trip home is a big deal for me. But I cannot ignore the glaring imbalance of risk and benefit here. It’s a personal, emotional decision, but not without reason.
First, I agree that flying during this pandemic can be safe. It depends critically on everybody doing their part, namely masking up and staying on the ground if we feel sick or have a recent known exposure. I do not trust everybody to do their part. I don’t know who will lie on a symptom checklist or suppress a fever with medication in order to fly while ill. I don’t know who will pull their mask off right next to me for the duration of the flight. Sure, the airline can ban them from flying after we land, but I still have to sit next to them for three hours, wondering about their infection status, fuming at their apparent disregard for my safety and that of everybody on the plane.
Shock and Awe
Second, I have never seen a disease like this. The spectrum of illness spans from totally asymptomatic to 100 days in hospital, intubated and proned, on ECMO (heart-lung bypass) and dialysis, limb(s) amputated, before finally dying. Every organ system can be affected, including the brain. COVID patients in the ICU require sedation and paralytics to control agitation, psychosis and flailing. Some suffer catastrophic strokes. Upon discharge, if they survive, months of rehab still don’t guarantee any return to normal. It’s been only six months since the disease emerged; we have no idea what long term consequences or complications lie down the road for these patients, no matter what their illness course.
Statistically, my family and I have a low risk for complications and death if we are infected. We are young and healthy. Populationally, the old and infirm have the highest mortality risk. This is also true for flu. And, healthy young people die every day from COVID, just like they do during flu season. And death is not the only horrible thing that happens to COVID patients. Symptoms can last weeks to months, including cough, shortness of breath, profound fatigue, diarrhea, and mental slowness. There is no way to predict 1) who will get infected or 2) what their disease course will be. It could be anything, and there is no good or reliable way to affect the outcome. You could be totally fine or suffer long and hard before dying. And the mental and emotional tolls of suffering in isolation, for the patient as well as their loved ones, are the ultimate insult added to injury.
I have profound respect for this virus and this disease.
Third, it’s a five day vacation. We were just there a month ago. This is not essential travel. My kids are my life. If one or, God forbid both, of them got sick, or if my husband and/or I got sick and died, or if I infected my patients—if anyone, family or not, ended up suffering because I decided to take this trip—my soul could never rest.
In the end one question always helps me: Of the worst case scenarios at the end of each path at this fork, which would I regret more? I will be sad to not go home this time, yes. But I don’t know how I could take the responsibility of getting someone infected because I wanted to take a five day vacation and made us all get on a plane in the middle of a wildly uncontrolled pandemic. There is no question here.
The sadness is real, though. And it’s not just about the trip. It’s about life turned upside down, everything we took for granted—our safety and security—threatened. It’s about the immense uncertainty, the suffering all around us, the lashing out and fighting from stress and tension, the chaos. How will we know what do to about school? When will life be the f*ck normal again?
This is temporary. Life will likely not ever go back to what it was, but it will feel normal again, someday. It will take some years, all things considered. In the meantime, we are fully in control of our mindset and response in this moment.
‘Mindfulness’ has become a trendy buzz word, almost cheapened such that I hate to even write or say it. But the evidence is all but irrefutable for its benefits, especially in times like these. The practice is essentially to be with what is, right now, including how you feel about it, with acceptance and nonjudgment. So much easier said than done! And yet, in truly mindful moments, peace and clarity ultimately descend (or transcend, I should say). To look around at the chaos and suffering, and accept it as just the way things are, is the first step to managing it all. Living fully in the present moment allows us to distinguish clearly what we can control from what we can’t. We can claim and exercise agency over the former, and let go the latter, thereby suffering less and maximizing energy and resources to effect positive change for ourselves and others.
To really free ourselves from the anxiety and uncertainty of the present moment, to know what to dotoday, while we attend to the now, we must paradoxically also cast ourselves into the future. We must take the long, infinite view. What really matters today? What from today will really matter next year, and in five, ten, or fifty years? Will the disruption of remote learning for my privileged kids this year really make a difference when they are my age? Likely not. Will missing essential nutrition and social contacts, and parents’ unemployment this year, for kids in marginalized communities, matter later? Absolutely. Many of us will be okay no matter what. Many more of us will not. The disparities we see today cast long shadows into the future, and we must attend to them in current policy and guideline decisions.
We are all in this together, and what we each do affects everybody. This fact is inescapable. There will be more suffering and death, no matter what we do. Somehow we each must make our own peace with the risks, find freedom and joy, and exercise empathy and social responsibility, in the face of it all.
In this crisis we are called to be our best selves for one another. That ultimately includes individual, short term sacrifices for the greater good. I can give up my little vacation to help keep everybody healthy. I wash my hands like I have OCD. I keep my distance around people I don’t live with. And I wear. my. mask. I protect you, you protect me. Let’s all do our part, shall we?
Photo by Tobias Baumgaertner, Fairy penguins near Melbourne, Australia
I always wonder about you, dear reader. Where does this post find you, since we last connected? How are you?
It’s a good practice to check in with ourselves regularly. These nine weeks of sheltering in place have exercised my patience, awareness, and identity, among other things. What have they done for you? How are you?
For a couple weeks now I have felt all but overwhelmed by darkness. Infection and death rates have slowed, but they will continue to accumulate indefinitely. I worry that we will become inured, calloused, to the human toll. PPE is still in short supply at hospitals across the country. Thousands of my colleagues continue to risk both their physical as well as mental and emotional lives to care for gravely ill patients. They leave their families and support networks to become the sole supports for patients alone in the hospital, whose own loved ones may not visit, even in the hour of death.
Mostly I have felt burdened by the fighting. The shouting, protesting, mean memes, and ad hominem all around me, directed both by and at my friends and colleagues. Important reflections and insights arose this week that helped me see clearly the internal origins of my distress. I re-accepted and re-integrated these parts of myself. I was able to laugh out loud, exclaiming, “How fascinating!” I know I will necessarily repeat this discovery exercise ad nauseam, ad infinitum—such is life, karma says, also laughing. But for now I feel lighter, unburdened, more at peace.
So I thought about role models for peace. I feel so lucky to have so many. But one in particular shone in my consciousness this week: Dr. Vivek Murthy, our 19th Surgeon General. He has published a book, Together, in which he “makes a case for loneliness as a public health concern: a root cause and contributor to many of the epidemics sweeping the world today from alcohol and drug addiction to violence to depression and anxiety. Loneliness, he argues, is affecting not only our health but also how our children experience school, how we perform in the workplace, and the sense of division and polarization in our society.”
I recently watched a live interview with him conducted by Dr. Lucy Kalanithi, widow of Dr. Paul Kalanithi, who wrote When Breath Becomes Air. I listened with one earbud, watching in my peripheral vision, while hurrying around my kitchen, preparing chicken and assembling a salad, all before rushing to host a Zoom workout. It struck me that in stark contrast to my frenetic energy at that moment, Dr. Murthy presented only calm and serenity. He answered every question with love, joy, conviction, and equanimity. I noticed and marveled. Then I rushed around some more and got on with my evening tasks.
Looking back, I have felt this serene and loving presence every time he speaks. He has a way of making everybody in the room comfortable, welcome, and included. Even if he’s interacting only with a moderator, it feels like he’s speaking to me personally. He sees me, he gets me. He cares about me. In searching for the Kalanithi interview, I came across this lecture and discussion he gave at Stanford University in 2015. I hope you will take the time to watch (or at least listen). Notice how he shares stories of his parents, his patients, and people he met during his national ‘listening tour’ at the beginning of his tenure as Surgeon General. Hear how he sees and knows every one of these people in their whole humanity. Abraham Verghese, physician, author of Cutting for Stone, and another hero of the profession, moderated the Q&A, and also named Dr. Murthy’s equanimity—his peacefulness. Notice how Murthy validates questions asked by students and faculty alike. Observe his humility, juxtaposed with a resolute, unwavering point of view. Do you feel it? Does he not inspire you to be a better person?
Dr. Murthy and his wife, Dr. Alice Chen, have written an open letter to us medical professionals, in the midst of this global pandemic. Reading it, once again I feel seen, understood, and comforted. I feel true belonging in a proud and humble tribe of professionals, committed to service. They shine their light on all of us, so we may see the path before us more clearly and walk more confidently, knowing we’ got our peeps holding us up. This, in turn, gives us the strength and love to hold up others along the way.
I see the light tonight. It emanates from my fellow and sister humans, and it saves me.