What a Privilege

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NaBloPoMo 2020 – Today’s Lesson

I’ve said it before and I’ll keep saying it:  People are suffering.  Not everybody, but many, and many pretty badly.  A prolonged global pandemic, unprecedented political polarization, escalating agitation for social justice—any one of these would be enough to push us over the edges of our sanity, and yet here we are, surviving all three and more.

I know it’s a challenging day when I’ve handled three phone calls before getting out of the car at work in the morning, and in the afternoon I think Hallelujah and give joyful thanks for one patient’s globally negative Review of Systems and another’s 95% oxygen saturation.  But this is also the most fulfilling day.  I did good work today.

Like most primary care doctors, my message volume has increased by about 30-50% in recent months. Complex questions and issues require time and patience to think and talk through. Many cannot be readily answered or solved, and the uncertainty calls out all of our anxieties and defenses, insecurities and grievances. Every patient experiences this historic moment in a unique and acute way. As the storm rolls over the neighborhood, I see it land on each doorstep, knowing what’s already in the house—how the furniture is arranged, what’s in the closets, maybe even the state of the foundation. I am allowed inside, invited to inspect and advise.

What an amazing privilege to be a physician in this moment, to witness, and to help.  This is absolutely what I signed up for, what I’m called to, and what I trained for.  I promise to do my best, and we will get through it together.

Up and Accountable, You Hold Me

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NaBloPoMo 2020 – Today’s Lesson

What if Yoda sang love songs?  Does it not brighten your day just thinking about it?

Who holds you up?  Who holds you accountable?  Do they do it with love?  If you’re lucky like me and the same people do all three, you possess a rare gift.  I learned this again today and the realization sustained me, even through some hard conversations and decisions.

* * * * *

“I feel like garbage after I talk to her,” a friend told me today.  We commiserated around our mutual acquaintance, Dolores*.  Dolores constantly focuses on the negative—how we could always do this or that better, how this or that thing is never right.  She nit-picks and dissects.  It’s hard to be around Dolores; her positive to negative interaction ratio is 0 to infinity—or at least it feels that way. 

We like Apollo* better.   He consistently notices and shows us the good we do.  He points out our strengths to others.  And it’s not lip service—he truly sees, appreciates, and acknowledges how we contribute—we feel his sincerity and gratitude.  His ratio approaches 5 to 1, which is an important sign (driver?) of healthy relationships.

And Apollo’s 1’s, what are those about?  He tests us, makes us uncomfortable sometimes.  We clash with him sometimes on how to walk the talk, on the methods we choose to manifest our mission.  But because our relationships are healthy, because we know our ties are stronger than our tensions, we can negotiate in good faith.  We challenge one another to live up to our ideals—to defend our methods–we hold each other accountable, and we all benefit.

Like I said, lucky.

*not their real names

Exponential Risk

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NaBloPoMo 2020 – Today’s Lesson

Things are looking really bad again, folks.  Illinois saw more than 10,000 new COVID cases for the fourth day in a row.  Between the first and third weeks of October, COVID inpatient census rose 500% in one metropolitan hospital system, and it’s still climbing.  At this rate, we may run out of ICU beds by Thanksgiving.

I had more calls today about COVID (symptoms and/or exposures) than any day since the pandemic started.  Every call takes time to explain the profound importance of distancing, masking, and minimizing contacts, then the logistics of quarantine, testing, and contact tracing.  It’s totally straight forward in some ways, and completely convoluted in others. 

With rapidly escalating disease prevalence, every unmasked contact with a non-household (or ‘pod’) member carries exponential risk.  You breathe on me, I breathe on you.  We have now exposed each other to everybody we have each contacted in the past 14 days—we have merged our bubbles irrevocably in this one encounter, endangering everyone in each bubble and all of their extended contacts.  It cannot be undone.  This is the nature of a pandemic. 

I understand how hard it all is—how inconvenient, fatiguing, disruptive, and maddening.  Our masking and distancing, missing friends and activities, restricting our kids’ social lives, is all immediately and concretely costly to us, and only distantly and abstractly beneficial to others (and us).  Still, it is what we can do to slow the spread of a deadly virus that has infected more than 10 million Americans, and will have killed more than 240,000 of us by tomorrow.

Avoid these 9 pitfalls to stay safe.

If you want to pod, follow this guide closely. 

We can stop all paths of the virus through us.  But it takes all of us.