Category: Reflections on Life, Being Human, and Medicine

Reflections on a variety of topics. My hope is to stir your thinking and perhaps even give you things to talk about in regards to what it means to be human, about life in general, and often times on the practice of medicine.

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Reflections on Life, Being Human, and Medicine

Unsettled

I am fidgety. Unsettled. 

It is a really odd time. We have dropped clinical volumes in anticipation of the wave of illness that is coming and also to protect our patients (social distancing). This means that the cardiac units in the hospital and our cardiology clinics are an eerie quiet. And this is unsettling.

The unsettled feeling started last week with the social distancing. I have always loved a snow day. You would think that I would welcome the chance to be at home and just get caught up on things or just to not do much. But this is different. It all just feels wrong. I am still trying to figure out how to best deal with things inside myself.

I like to think of myself as someone who is rational and calm and able to handle stress. In this situation I am filled with an anxious and nervous energy. It can have a tendency to consume me.

I am a googler. It seems like I have become accustomed to thinking that I can find answers to anything online. Whenever there is an issue, I grab my phone or computer and begin looking. In the midst of this pandemic, there is no end to what I can find. I can read and read and read. It isn’t helping. I understand a lot more now, but it still doesn’t help with the unsettled feeling – the nervous energy – the idea that I am sitting here – and should be doing something – but there is not something to do – at least yet.

Sometimes I decide that the best thing to do is to get away from the screens. I should get off of all the social media and news feeds for a while for the sake of sanity. Put it down. Do something constructive. Or just do something. Last night one of the Star Trek movies was on television. Sarah saw it on the guide and put it on. It helped. For a little while my nervous energy matched what was on the screen. That was a little bit better.

I started this week in clinic. At first it was a normal clinic day and it felt good. I could feel the pressure to see patients and keep up and I had real tangible medical problems to bite into. Doing the usual felt good. But then as the day progressed COVID 19 issues started taking over. The clinic began to thin as we cancelled many of our clinic patients. We have been rescheduling or shifting patients to electronic visits to protect them from exposure (more social distancing.)  My day shifted to regain the odd – not right feeling.

I get it. It is not a snow day. It is not where we can all just hunker down under a blanket and feel warm and cozy and safe. It is not just going to go away in a few days or when the snowplows catch up. It is a time unlike anything we have dealt with in our lifetimes. There is a threat that is hanging out there and while we don’t want it to come the anticipation is hard. I have even heard of people saying that they just wish it would hit and be over with. I am not so sure we are going to want that when it does hit however.

It makes me think of the odd feeling that can come in the air before a thunderstorm. You can just get the foreboding feeling. You feel like you need to run for shelter. Animals always seem to feel that more strongly than we do.

Tuesday morning an odd thing happened.

I was getting ready to head for the hospital to do rounds on our advanced heart failure inpatient service. Our beagle Malley got up with me. Malley gets up with me many mornings. She is not a “morning dog” however. She generally gets up and then collapses on the sofa or her dog cushion as I go about getting ready. This Tuesday she got up and walked across the house and then laid down on the tile floor blocking the doorway to the garage. She has never done that before. It was almost like she was saying, “You are not going to work today.” I made some breakfast and settled into a chair. It was only after she decided I wasn’t leaving yet that she left her guard post. She moved over to her bed and curled into a ball. 

I finished breakfast and went to her bed to pet her. She stayed curled up as if to say, “Fine. If you are going to ignore me, do it at your own risk. I think you should stay home. Just go.”

I don’t know that Malley truly understands everything that is going on. She hasn’t been reading my twitter feed or the daily hospital COVID-19 updates or the news reports. But she does have an amazing way of reading me. I think she senses even more than I do the nervous energy in me. She clung to me during my cancer treatment and recovery. She knows whenever something is not quite right.

Things are not right. But what are we to do?

The threat is real. The reports from Italy and Washington State and New York are disturbing. My twitter feed is not good. The growth is exponential. We must every one of us take this seriously and do our part to flatten the curve, reduce the exposure, and not be the one to spread the virus. It is here and it is growing.

So how do we deal with these feelings inside of us?  I am not sure I have all the answers but here is my best go at it for now:

  1. Acknowledge them.  Writing this blog has been very helpful for me. It is ok to admit that you are anxious, nervous, bugged, on edge or filled with strange nervous energy. I find that I feel awkward and unbalanced. I stumble on my words and feel eloquence slipping. All of it is a result of the odd time and impending but not personally realized threat that is looming over us.
  2. It is good to be physically active. Match the nervous energy with physical exertion. There is no ban on going outside for a walk or a run. 
  3. Pray. That and reading Scripture helped me this morning. For me today it was Psalm 93 reminding me of the greatness of God. He is bigger than this. That sustains me.
  4. Play games. Read a book. Watch a Star Trek movie. Have a Harry Potter marathon. Or maybe I should pull out, “Das Boot.” (My girls will laugh about that one! It is a great movie! Believe me!) Put together a puzzle. Build a fort out of blankets. Do something together with those who are in your household. 

We will get through this. The current stage is the awkward and anxious time of nervous energy. It is okay. You’re okay. I’m okay. And God is more than okay. He is still in control and still on His throne. And He still loves us and cares for us.

Categories
Being human Reflections on Life, Being Human, and Medicine Reflections on the Christian Life

How Do You Live in Uncertain Times?

These are interesting times. The Coronavirus Disease 2019 (COVID-19) is shutting down a lot of our world and activities. I get asked what I think about it. I think the most honest answer is, “I don’t know.” 

How do you deal with uncertain and potentially hard times?  That is what this blog is about.

There are dozens of very well written articles about COVID-19, the importance of limiting spread, the risks of a rapid spike on overwhelming healthcare resources, how to reduce your risk, etc… I too have read many of these articles. I don’t need to add anything to that body of literature.

But how do you handle uncertainty about the future?

 As I look with wonder at everything that is going on it makes me wonder what it must have been like to live through other times in our history. This is not the 1st time that humans have had to deal with very hard times. 

The polio epidemic comes to mind. Interestingly, 98% of the people who contracted the poliovirus had only minor or mild symptoms and no neurologic effects. But in 1-2% the virus entered the bloodstream and attacked the nerves resulting in paralysis and death.[1] “Because so little was known about the virus or its inconspicuous mechanism of transmission, fear and near panic occurred as parents forbade their children from attending public places where large numbers of people gathered.”[2]

Sound familiar? 

We know more now. We do know about transmission and how to prevent spread.  That is not the point I am trying to make. The point is that we are not alone in history in what we are going through. And for me that seems comforting. 

Human beings are resilient and strong. Within them is strength greater than we expect. 

I think of the 1918 influenza epidemic. It was called the “Spanish flu” because the outbreak in Spain received more publicity than elsewhere. It was actually the 1st  H1N1 outbreak. One flyer during the time instructed people: “There is no medicine which will prevent it. Keep away from public meetings, theatres and other places where crowds are assembled. Keep the mouth and nose covered while coughing or sneezing. The attendant shall put on a mask before entering the rooms of those ill of the disease.”[3]

My grandfather’s family contracted the Spanish flu. As a child he became the man of the house. At the age of 11 he became responsible for running the farm and caring for his ill parents and siblings. His father died and then he continued on running the farm. I cannot imagine this. What must it have been like for him and for his family?

Human beings have great strength.

I have seen it in Sarah and in her mother. Sarah’s mom was a person who could fall prey to worrying about things. She had good reasons to do so. She had suffered the amazing tragedy of losing three of her children all from different and unrelated illnesses. She also was a survivor of childhood polio having been one of those 1-2% who contracted near fatal paralysis. Somehow she survived but had to contend with post-polio syndrome her entire life. For her, life was never certain.

Sarah’s father became very ill. He was in the intensive care unit and we didn’t know if he would survive. I was anxious about what this stress would do to Sarah’s mom. On top of everything that she had already been through, certainly this would unravel her. 

It was absolutely amazing how she responded. She didn’t panic. She was like a rock, stable and steady throughout the whole time. She was like a soldier. One minute soldiers might be fussing about minor things and then in the heat of battle with explosions all around them, they march forward with outrageous courage and strength to just do what must be done.  In that time, I saw an amazing and strong core within her. She had depth and strength. She could deal with whatever she had to deal with. When the “explosions and chaos” were at their worst, she could just do whatever needed to be done.

So how do we deal with the stress of these uncertain times?

  1. Understand that we are not alone. Human beings throughout the ages have faced many very hard and scary things. I find this quite comforting. If those before had the strength to endure and walk through the challenges before them, I can too.  I call upon their strength to help me remain calm and strong regardless of whatever may come. If you would like to read more about this here is a link to another of my blog posts: https://www.linkedin.com/pulse/established-1950-gone-now-michael-dickinson/
  2. God is still on his throne. When evil persons attack, the Scripture reassures us that, “The one enthroned in heaven laughs; the Lord scoffs at them.”[4]  God is not surprised by this or by any of the tragedies that might strike us. We do not walk through this alone. We go forward with a belief in a God who has created all things and who sees all things. “For God gave us a spirit not of fear but of power and love and self-control.”[5] He also tells us “Never will I leave you. Never will I forsake you.”[6] At my core, I am able to not be shaken because I have a firm belief that there is more to my existence than just what is happening here. I hope that you too can find comfort and strength in this.
  3. Look beyond yourself. This is powerful. How can you rise up in strength in the midst of the chaos? Can you too be a soldier that shines in the midst of the battle? What are the needs around you? There is a tweet now gone viral (>1 million hits) about a woman helping an elderly couple get groceries. I want to be like her. Will you? Or are you going to be another crazy person buying a year’s supply of toilet paper? Look for the needs. In your anxiety use that energy to look at your friends and neighbors and their needs. For those of you who are believers, how are you going to show the love of God in the midst of the disruption in your lives and schedules?
  4. This too shall pass. We do not know exactly what is coming but we do know that we will get to the other side. When you cannot say anything else, you can say this, “This too shall pass.” And just keep moving forward.

[1] https://www.historyofvaccines.org/timeline/polio

[2] https://www.jospt.org/doi/pdf/10.2519/jospt.2004.0301

[3] https://en.wikipedia.org/wiki/Spanish_flu

[4] Psalm 2:4

[5] 2 Timothy 1:7

[6] Hebrews 13:5