Thursday, June 25, 2020

The Five People You Meet in a Pandemic

[bonus points if you get the Mitch Albom reference]

I haven't been writing.  People are telling me they miss my ridiculous writings about ridiculous bike adventures.  I miss that too, or at this point I miss the idea of missing that, because it all seems relatively small and pointless right now, but at the same time not, if it's the glue that holds everything together, as small and pointless in the grand scheme of the world as it may be.

Back in March I started screenshotting some of the conversations I was having (anonymized) because I wanted to be able to look back and remember, or show other people, how incredibly strange and angry and scary this time was. I think in neurophysiologic analogies here - the initial stress response of elevated cortisol (March), sustained for so long that HPA axis dysregulation sets in and you're left instead with chronic low cortisol, unable to cycle through it's normal diurnal valleys and peaks. That's where we are now, a sustained low level anxiety that we don't even notice half the time.

But I sat down, not even with the intention of writing, and this is what happened. Maybe because I recently finished 11 years of post-graduate training, and this is where we are now. Maybe my brain finally wanted to try and create some sensical structure out of its frustration. Maybe it will help you understand the FHCW in your life, although everyone's experience is different.

There are the constant "how are you holding up?" texters. I have a visceral reaction to this followed by a sense of guilt because I know they mean well. I have a feeling you want me to reassure you that everything's ok. That we're all fine and our healthcare system is fine and I'm fine so you can go back to what you were doing now, place a checkmark next to "check on XYZ person" on your to-do list. "Hanging in there" seems to be a safe response, vague acknowedgment that things are not normal. If I ruminate on this for too long, I'll get mad that people have all of a sudden decided that my job is hard and I need to be checked on because there's a pandemic, when I've been doing hard things as part of my job all along. They're just different and more dangerous-to-me hard things.

There are your colleagues. Who it's like you're attached to with a lifeline but the rope is very very long; it offers some connection but at a distance, the commiseration is quieter. Everything and nothing have changed. You're still doing your job.

Then there are other friends who've disappeared: people I previously regularly engaged with in-person or online. They haven't disappeared from real or virtual society judging by their social media, just from interactions with me. I see you, posting pictures of your trips and group activities. I'm not here to shame you. We all have to make our own choices. But your sudden purposeful avoidance of me signals that my existence in my role is a reminder to you that you're screwing me over every time you go to the bar or cross state lines to mountain bike and stop at 5 gas stations and convenience stores along the way, and maybe seeing me makes you feel a little guilty.

There are the few people who still constantly ask you to do things, or if you're going to XYZ event. I only have blank stares for them. And internal questions that I'm too tired to ask, or just don't care to know the answers to. The possibilities that run through my head in rapid sequence: do you assume I've just given up on controlling this, like the rest of the society? And should I? Do you not care if I give this to you, as you know very well that I work in a petri dish of it? Do you not care if you give it to me? Do I think way too much about this?

There are the few people who've come out of the woodwork who just seem to know what to do. Strangely they're not people who were super close friends. They subtly open the door to talking by letting you talk about what you want to talk about. Public health and science and healthcare and stupidity and systemic breakdowns. The things that are really wearing you down. It's a daily check-in without being a check-in. You know who you are. I would've spent a lot more time very alone in my head without this outlet you've provided.

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