I'm returning to my surgical roots to talk about what’s on our minds: uncertainty, disease, and death. Here are some lessons from 30 years of talking to patients and families about situations that are now very real for us all.
- This is a marathon, not a sprint. When a loved one is critically ill, many families tend to hover 24 7, sleeping, eating, and moving into the hospital. But you simply cannot sustain that intensity, you wear yourself out, diminishing the resources you provide to your loved ones. The Covid-19 pandemic is going to continue for several weeks and months, running around with your hair on fire is going to leave you exhausted, physically, and mentally long before the race is over. It is essential to take a breath and pause. Begin to act in a more deliberate, mindful way. For all of you who want to be more attentive and focused, this is the time to apply those skills. For those who worry about their health, this is the time to apply yourself to diet, exercise, and sleeping. Eat a sensible diet, move about; you can walk and still maintain “social distance,” get enough sleep, and yes, wash your hands. Soap and water work better than Purell and soap and far easier to find in the store.
- First responders run towards the problem and help others. With an infection, it is the collaborative response of the herd that makes the difference. The government will provide the necessary institutional responses, but that pales compared to the response you as an individual supply. You are a first responder. When facing the uncertainty of diseases, like this infection, we feel out of control, and that makes us more fearful. Empower yourself to control the things you can. Your role is to be careful with your hygiene, limit your person-to-person contact, be a good citizen. Part of being that good citizen means recognizing that first responders have new roles, it is not just police, firefighters, nurses, and physicians. It is the delivery guy, the FedEx worker, the subway conductor or bus driver, the person at the neighborhood bodega. These are the people who will keep our infrastructure up and running, show them the respect they deserve, and help them out. Support your local business, your neighbors, your neighborhood.
- One of the things families often do when sitting and caring for their loved one is study the various monitors, trying to read through the tea-leaves of a change in the pulse, blood pressure, or oxygenation. While it is an attempt to gain control, it rarely works. It is time to take a break from the 24-hour news cycle. This problem has been developing for some time, and it will be with us for a while. Nothing changes so quickly that you need to have hourly updates. They serve only through repetition and attention-getting graphics to make your more fearful. Choose one or two sources of reliable information, and that means the CDC and Dr. Fauci, and check-in just once or twice a day. Watching the market or the talking heads that know little more than you is no different than those families asking whether the pulse going from 90 to 95 means anything. If you were considering a digital vacation, now is a good time. In reality, the news you can use is hyperlocal, from your block or neighborhood, and it isn’t on CNN or Fox.
- Finally, one of the great problems for patients’ families is regret. The belief that if they had just done this differently, their loved one would be in such a bind. While it may seem temporarily adaptive, it is not. You cannot change what has already occurred. Listening to pundits and politicians take highly politicized points of view to ascribe blame doesn’t change anything. Covid-19 is here, our governmental agencies are beginning to pull together, Monday morning quarterbacks will not help us resolve our current problem, first responders, and again, that means you, will. There will be time to review what we did wrong, but it is not now.
The world has changed; while we are painfully aware of our fragility, remember this great country has survived Spanish Influenza and two world wars. The way you feel today is no different than the generations before us that woke up the day after 9-11, or Pearl Harbor, or any time we have required a unified response. It is time for your first responders to take a deep breath, put aside the things you cannot change, and do your part. For the moment, it only requires us to wash our hands, be mindful of others, and refashion the parts of your life that you can.