The other day, one of the physicians I work with said that the peak for the COVID-19 outbreak would be about 18 weeks from now, considering everything we’re doing to try to slow the spread and keep the hospitals functional. My first thought was “working from home for 18 weeks” and “how far out is 18 weeks?” End of July btw.
I had to step back and look at it another way. Gratitude. I have a home I’m comfortable in. I have a job that allows me to work from home. I have a job where I can be productive at home. I have a refrigerator full of food. I have a husband I kind of like who gives me both distance and company. I have four adorable fur-kids who make me only a little crazy with clicking nails and rough-housing. I have a library in my home and still have a pile of books I haven’t read yet. I have a good internet connection. I have Netflix AND the Criterion Channel so I can go low-brow or high-brow depending on my mood. I have writing projects to do.
My bills are paid. My and my family’s bellies are full. I am grateful.
Note the me, me, me, I, I, I? Yeah, need to step back again.
I work with 25 residents/fellow who are trying to learn medicine and how to help people make it through health crises that aren’t even pandemics. They are in the hospital, in the thick of it. A few have had to be tested for the virus after developing a sore throat. If anything happens to any of them or to any of the physicians I work with every day, it will be devastating, not just for me, but for the future of humanity. They are our future, and they are out there with minimal protective gear. We’re doing our best to get them the gear they need. But they’re out there anyway. I’m grateful for every one of them. They are my priority right now. I’m not going to fuss about bills and food and the lack of social interaction. I’ll fuss about them. Not just for 18 weeks, but for as long as it takes.
A pandemic. Heck yeah. Social distancing. Yep. Coping with a pandemic and social distancing without responsible federal government. Hell yeah. I admit I’ve been torn. Part of me thinks gosh what’s the difference between this and your old-fashioned flu season? I mean it’s been years now that I’ve gotten medication from a doctor for any viral symptoms. It’s always go home and ride it out. Every year people with old-fashioned flu die. Plus we made it through SARS (the first) and H1N1 without society shutting down or hoarding toilet paper. What?
On the other hand, I understand the need to rein in the spread because if all the people who are not immune to the disease (everybody) got sick, then our health care system will crash. I do understand all that. I also understand the illness is devastating for old people or people with compromised immune systems or heart/lung conditions. I have scar tissue in my right lung after my massive pulmonary embolism oh so many years ago which has not resolved, still there. So I need to be careful to not get it, I suppose.
The one thing I do know for certain: social distancing is not good for me. As much as I have a need to isolate and take a break from society and people and stress on a regular basis, I also thrive on contact with people I enjoy, including my coworkers and everyone at work. I don’t like working from home. I don’t like only contacting people through email or texts or Zoom. It’s not good psychologically for me, an admitted introvert. I can’t imagine a genuine extrovert managing this. I am having a certain amount of difficulty with depression as a result of this. Depression and crankiness.
At the same time, I’m sleeping more than six hours a night and my work day has been cut down to literally 9 hours (including an hour lunch break) instead of 12 hours (including drive/bus time). Physically, this is good for me. I’m not pain free. But I am less fatigued by the pain. I could lay down and go back to sleep right this minute, but it would be from depression, not pain. Physically good. I have to remember to be grateful for that. Psychologically challenging. I have to remember to be mindful of that.
Last week I was at a conference for medical education, and one of the main topics was the opioid crisis. I admit I never really understood what the crisis was. Doctors over-prescribing is what I thought. Or inappropriately prescribing. For example, there is very little evidence that opioids help people with chronic pain; actually no evidence and to the contrary, chronic pain is a contraindication to prescribing an opioid. However, I know there are people with chronic pain out there desperate to try anything. Obviously addiction is the big thing. The real crisis, however, is that doctors are prescribing without a plan for getting their patients off opioids. That’s when you hear about people getting drugs illegally or switching to heroin. That’s when you hear about people losing their lives in every way possible. So a prescription without a plan. That’s the crisis. Yes, doctors have to prescribe responsibly, but they also have to have training in understanding and recognizing addiction, about implicit bias for prescribing, and what conditions will actually benefit from a prescription.
As a chronic pain patient, I’ve rejected pain medications. The side effects far outweigh any benefit I’ve had. I’ve come to terms with the knowledge that there isn’t a magic pill. Not everyone gets to that point, however. Furthermore, there are times that an opioid prescription is appropriate. My only advice is if you decide to take an opioid for even a short term condition, such as breaking a leg, ask your doctor directly what his or her plan is for taking you off opioids. They can’t be withdrawn without a plan, and if your doctor has no plan, don’t accept the prescription. As bad as chronic pain is, withdrawal from an opioid is worse. Being addicted to an opioid (which isn’t even helping your pain) is worse. You can still function with chronic pain. You can’t if you’re addicted.
The crisis is the lack of education for medical providers to take their patients off opioids. That’s the crisis. Prescriptions, yes, addiction, yes. But the real crisis is the lack of education, the lack of plans.