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Frustrated about COVID

 

Frustrated?

                          

First is fear. Fear is always driven by that which we cannot control. The yearning for calmness follows fear like a donkey being led by a carrot. The Donkey never reaches the carrot. Calmness seldom extinguishes fear because of frustration, which roots and grows in fear. Fear is an excellent fertilizer for the weeds of frustration.

 What is it that has most of us frustrated about the COVID-19? Is it that we need to exercise social distancing until healthcare authorities give the all-clear signal? Perhaps it is the frustration related to staying home for some undisclosed time. Maybe we feel that the US government is not doing all it can to help the nation survive the economic calamity resulting from the order to stay home and avoid contact with people in our jobs. Some people might be disturbed that the FDA has not approved any drugs for the treatment of COVID-19; more critical is that drug companies have not developed any medications for the treatment of illnesses that emerge from any coronavirus infection. The list of reasons to frustrate anyone is infinite and exhaustive. It’s the all-of-it that is creating anxiety and despair. Why? Because we cannot control any of it. We are at the mercy of the unknown.

 I have the honor of caring for people during this healthcare crisis. Yes, I used the term people, not patients. People have backstories, and there are plenty of them. Some of these stories are uplifting; some are sad and disturbing. Listening to the stories allows practitioners to identify the problems. Telling the stories will enable people to feel better. A physician cannot render a proper diagnosis unless people are allowed to tell the entire story; bits and pieces just won’t do.

 Crisis brings out all of the physiologic demons that live within us. The unknowing is the catalyst to churn the anxiety to its highest revolutions per minute. Once at top speed, adrenaline pours out from our adrenal glands, and corticotropin-releasing hormone flows from our hypothalamus — these two hormones set in motion the reactions to acute stress. In a single episode of stress, we all benefit from the body’s response. Cortisol is released after twenty minutes to help the body recover from either fright, fight, flight, or psychosocial distress.

 Unfortunately, during the COVID-19 pandemic, the stress is episodic and unrelenting. Chronic illnesses become overexpressed and deadly. People who have an underlying subclinical disease may begin to display symptoms in the throes of a thunderstorm of distress. The bottom line: chronic unrelenting episodic stress will create a body with physiologically competing forces within it.  Like it or not, death competes with life every day.

 The immune system is the most robust physiologic system in the body. Once overactive, it often can and will end life. The virus ends life by overstimulating the immune system into a massive iteration of its everyday antiviral activity. The quest to find pharmaceuticals to stop the virus from replicating is, in a sense, trying to dampen the immune reaction to the onslaught of an enormous viral load. In the feeding frenzy, the immune system attacks our cells to eradicate the virus (which is a pathogen housed intracellularly). The immune system is exponential and fractal at the same time. Immunicide is possible in the wrong circumstances.

 Exploring an unknown world can be rewarding as well as devastating. Those who benefit from the unknown follow others who have not survived; the difference is that they change course at the crucial moment that determines success or failure, in this case, life or death. I wear a mask and gloves in public, spend less than three minutes within a three feet zone of a stranger while gloved and masked, and after my encounters with the environment, I use bleach diluted 1:10 to decontaminate everything. Bleach is my friend and yours.

 In our office, we have similar behaviors: disinfecting the virus is always an iteration of the same source equation. Follow the rules because it gives you a sense of control. The illusion of control is as compelling to our psyche as reality with control. Wearing a mask and gloves helps protect you from others and simultaneously protects others from you.

 What about the rest of it? How are we going to survive the economic devastation both individually and as a nation? When hospitals lay off thousands of employees, close floors, and physicians close their practices, how do we get healthcare? Do we ever get back to handshakes and hugs? Do we go to packed movie theaters, bars, restaurants, and gyms? Do we get back to family reunions and company bar-b-ques?

 Exploring an unknown world can be rewarding as well as devastating. Those who benefit from the unknown follow others who have not; the difference is that they change course at the crucial moment that determines success or failure. It is an iteration of the same source equation, only smaller and bigger at appropriate times. Be supportive of your neighbors’ quest to wear gloves and masks; stay distant and close at the same time; find new ways of doing the same old thing; and be selfless in a selfish time. The success of all of us is dependent on the success of each of us. We are all in this together.

 The economy is resilient regardless of the stimulus. Health is not. Be mindful in all ways. And remember, we are all in this together.

 

 

Doc


 
Posted by The Stone Institute News at 2:05 PM
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