The Spirit and Healing (and Healing the Spirit)
As news stories flashed around the world of sickness and death from coronavirus, a growing unease settled in. It was stealthy at first, like an unwanted visitor. But as death tolls rose, so did my dread. The intruder at my door became agitated, ready to break down my defenses and barrel into my home, threatening harm to me and my family. As it turned out, my fears weren’t unwarranted.
What began in my mind as worry, morphed into physical discomfort. In the beginning, I convinced myself I was fine – stress was expected during a pandemic, especially among healthcare workers. But as my symptoms escalated, they became harder to ignore. My head ached from crying (or trying not to), my jaw muscles were sore from clenching my teeth, and my chest felt like a weight had settled permanently on it. Most of the time, I hid it pretty well. But occasionally, my sudden, uncontrollable outbursts of tears exposed me. Early in the pandemic, I overheard my insightful husband Paul tell a friend on the phone that I was “doing okay, but mourning what was coming.” As usual, Paul knew my truth long before I did.
I drove my middle son back to college in March 2020 to bring his stuff home. He’d left most of his belongings in his dorm room, clinging to the hope that he’d be allowed to return to campus for his last semester. Back then, we were all still optimistic. We couldn’t fathom that his four years of hard work would culminate in us clustered around our TV, watching a virtual graduation ceremony on spotty internet.
The mood in the car was somber as a radio reporter declared that the world was “at war with a virus.” Highway signs flashed inhospitable messages: STAY HOME. The ferry to Long Island, normally filled with carefree vacationers crowding the small bar and sunning on the deck, was eerily empty. The few fellow travelers on the ferry with us chose to remain in their vehicles. In my mind, this small thing symbolized the grave situation we faced. In a society of increasing polarization, from white supremacy to police brutality, what people truly needed was to come together. The virus had succeeded in forcing a country, already fiercely divided emotionally for political, economic and social reasons, to separate physically. When we arrived at my son’s desolate campus on that beautiful sunny day, where students should’ve been throwing frisbees and laughing together on the lawn, we felt like characters from a dystopian novel about the end of time.
How do we breach this divide, made worse by the pandemic, when isolation is now encouraged if not enforced? Before the viral threat demanded physical separation, many were already socially isolated – cocooned in “safe” communities away from different colors, religions, or beliefs cultivates – intent on maintaining otherness. Black men especially have been othered – unjustly vilified as violent and dangerous thugs (most egregiously evident when they stand against racism). With horror, I came to realize that while I was warning my sons not to accept rides from strangers, black parents were teaching their sons to be careful about the ever-present danger of white people (including the ones sworn to protect). To not instill this caution would be negligent, even deadly, given the alarming mortality statistics of black youths (not to mention their disproportionate representation in prisons).
Racism influences every facet of life from housing to healthcare, a fact made shamefully apparent during the pandemic where non-whites contracted and died from coronavirus at significantly higher rates than whites. Health outcomes are even worse for the uninsured, who are disproportionately black and Hispanic. Add to this a lack of access to nutritious foods and crowded, polluted living areas without open spaces and it is easy to understand this increased mortality. The enormous economic and social disadvantages of nonwhites in America has resulted in a sick and vulnerable population.
Lives depend on us coming together, not separating apart. Racism won’t go away if left unchallenged, if we remain hidden in safe, all white communities. Silence is acceptance, as clearly stated in Holocaust surviver Elie Wiesel’s 1986 Nobel Peace Prize speech. “We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented.” We must always take sides. Children aren’t born with prejudice. And as they grow up, exposure to different cultures can protect them against developing it. It’s hard to hate black people if you have family members who are black. It’s hard to dislike Muslims if your best friend is one.
Hate is taught. But love can be taught, too.
I believe change will happen when we see others as we see ourselves. I readily acknowledge this isn’t easy. In my experience with difficult patients (even those I strongly disagree with) when I truly listen to their stories I can always find some common ground. Even among the racists. Even among the misogynists. Even among pandemic-deniers spreading misinformation that has undoubtedly prolonged the pain and suffering of the pandemic. Sometimes I have to try harder to get past the rough exterior they’ve built up to hide their own anger and shame. But when I do, I always find some goodness. I’m forced to confront my own judgmental mind, and shift them out of the other category. I know I’m not unique. We all have capacity for empathy and inclusion. After all, we have so much more in common with each other than we have differences.
In early 2020 America squandered the opportunity to make the preparations many other countries had after the pandemic was declared. Instead of a uniform plan, individual states made up their own rules, many ignoring pleas from scientists urging them to act swiftly to contain the virus. As a result, where people lived became a crucial factor in their risk of dying – just as the color of their skin did. Mixed messages from social media and the government bred distrust and fear, further polarizing an already deeply divided country. The virus thrived in this media.
Americans wanted to believe we had a magic shield protecting us. We quickly tired of social isolation, seemingly less tolerant to the loneliness, boredom, and inconvenience of hunkering down than other countries. As the panic of the first days of the pandemic receded, we became numb to the shocking numbers – thousands of deaths every day from coronavirus. We desperately wanted to get life back to normal. We missed friends and family. For some, this need superseded caution. They gathered together anyway, assisting the virus in its biologically-driven impetus to flourish.
As the weeks turned to months, grim headlines declared hospitals over capacity with escalating daily death tolls. Freezer trucks, parked outside, served as temporary morgues. The media reported that doctors would likely need to ration resources. I worried about the emotional cost to health care workers forced to make impossible decisions. As I waited with the rest of the world in morbid anticipation, I felt guilty that I wasn’t collapsing into bed at the end of each day, as my exhausted urban colleagues were. I listened in horror to stories of traumatized medical students and residents racing between patients, performing futile CPR. Self-doubt re-surfaced: Am I strong enough for this level of intensity? Could I rise to the challenge if I needed to? Did I have what it would take? I didn’t know the answer to these questions and was awed by young people still choosing a path in medicine.
Our fragmented healthcare system impeded the robust response the pandemic required, with deadly consequences. Americans with medical conditions unrelated to the virus refused to seek care not only because they feared the virus, but also because they feared exorbitant medical bills at a time of financial uncertainty. Healthcare avoidance is most apparent in black Americans who, despite being more likely to succumb to coronavirus, are twice as likely to forgo care. The same is true for low-wage workers, who are both at high risk for viral exposure on the job and also more than twice as likely to be uninsured. In America, uninsured people die. It is unconscionable that, in a country that excels in caring for medical emergencies, Americans are dying at home with treatable illnesses. Lack of access and affordability of medical care impacts everyone’s health: When people can’t afford testing or treatment during a pandemic, the virus spreads quicker.
Paul got sick with Covid just after Christmas, held hostage for weeks as he languished in bed, groaning in pain whenever he changed positions. Before he got sick, I’d spent nine months worried about the intruder I was certain lurked at my door. I tried unsuccessfully to banish from my mind the horrors depicted on the news – communities ravaged, people dying alone in overcrowded hospitals. At the time, I was sure that many of my patients wouldn’t be able to care for moderately sick relatives at home, especially if they were also sick. Caring for Paul made it painfully evident to me how a family with minimal resources might easily succumb to this virus. It became frighteningly clear how rapid it could spread among families in apartments and crowded homes, where isolation simply wasn’t possible. I’m heartbroken thinking about people who suffered and died alone for fear of exposing other family members.
I know I’m lucky. I never worried I’d be fired from my job or that my family would lose health insurance. I never felt alone, thanks to the support of friends and family who waved and blew kisses through the door as they dropped off food and necessities. I’m forever grateful to the oxygen delivery driver who braved our rural dirt road late one bitter Friday night, likely preventing Paul from hospitalization. I’m grateful for his doctor’s availability, checking in frequently by text. But, I’m also outraged by the systemic injustice revealed by the high rates of illness and death among racial minorities and the poor. Paul was just one sick person and, although his illness was grueling, it didn’t end in tragedy. Paul had the advantage of privilege, of skin color. Millions of others were not so fortunate, leaving behind countless grieving loved ones. The loss is unimaginable.
Healing from the physical and emotional scars of the pandemic won’t be easy. As a traumatized society, we must find ways to mourn our great losses together. When raw grief loosens its painful grip over time, we remember how precious life is. We show our gratitude to those who helped us past our heartbreak. As medical providers care for their communities, friends and neighbors, it is impossible (if not inhumane) to force emotional separation. Instead, the pandemic offers a rare opportunity for ordinary people to come together and act for the good of others – not only their loved ones and neighbors but for the whole country. We are all struggling. We need each other.
Always the optimist, I look for (and find) small miracles arising in the midst of suffering. In my role as physician, I counsel people every day on stress management and wellness – the very foundation of good health. With no guidance from me, much of what I’d advise is actually being lived throughout America right now: people have slowed down, simplified, and connected with their loved ones, even if only virtually. To escape the confines of home, Americans are venturing outdoors into nature, something our distant ancestors knew intuitively was restorative and essential for good health. They are searching for (and finding) a sense of meaning. They are fortifying the spirit, which will go a long way in maintaining health.
Almost instantaneously, the world is also more mindful. Vigilance over the virus has made everyone pay closer attention – to what they touch, to their immediate environment and to the people around them. Neuroscience shows that mindfulness improves our health by re-wiring our brains to be less reactive and more accepting. I expect this mindfulness will seep out into other areas of life, too. Mindfulness fosters an appreciation of the miraculous world we live in – a planet that holds both suffering and beauty, just like each one of us. When we look for the good and then share it with others, it provides hope – a necessary component of healing.
Advances in medicine will undoubtedly help end the suffering. But, in addition to developing new medications to treat critically ill patients, widespread testing availability, and a broad scale vaccination program, we must have a health care system that supports prevention and provides universal care. Our country’s early failures don’t have to define our ultimate response to the pandemic. As we witness friends and family filing for unemployment and losing their health insurance, we can no longer deny that our tattered safety net is in urgent need of repair. As we see the racial disparities in infection rates among our black brothers and sisters, we must be outraged that skin color is a greater risk factor for death than poor health. We can no longer ignore the inequality rampant in our society and, even more shamefully, in our healthcare system.
When I move beyond my fear and worry, it’s hard not to be inspired. Years from now, I hope to remember this as the moment when America woke up – that in our grief we pulled together and demanded change. I hope we commit to remodeling our failing healthcare system – that the tragedy of the pandemic serves as the final impetus to provide universal healthcare for all Americans. To accomplish this, we will need to raise our collective voices and be heard. We cannot remain silent.
I also hope that America finally embraces her identity as a melting pot through equality, tolerance and compassion. It isn’t too late to revive the American dream of liberty and justice for all. In my vision of the future, the change begins locally with people reaching out to help their neighbors, as is happening all over the world right now – as happened to my own family when my husband got sick. These acts of kindness spread with greater tenacity and speed than the virus. As we recognize our common humanity in our neighbors (even those that look and act differently), we will no longer be able to turn away.
In my dream of the future, I tell my grandchildren that, despite the pain and suffering of the pandemic, this was when their world truly blossomed beyond our greatest expectations to become the kinder, more beautiful place they now live in.
Like most Americans, I desperately wait for the end of this tragic chapter in our history. Inspired by selfless acts of bravery and compassion, filled with anticipation and hope, I long for a chance at a new beginning – for both our sick society and for illness from coronavirus. Our nation’s health depends on it.
Our own lives depend on it.
©2021 Jennifer Baker-Porazinski
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