Panic and Perspective
I struggle with anxiety. I think it’s been around my whole life but it definitely ramped up after a severe illness in 2011 where I spent about a month on a ventilator. It gets harder to tell yourself that your fears aren’t real after you have gone into unexpected septic shock that even your doctors couldn’t catch. It took me years to even acknowledge that I had lived through a trauma and to start working through it. I am still working through it. The COVID-19 panic has been confusing as I came to terms with a weird truth — that my inner voice of fear might actually be right this time. I have found two articles (from Vice and the Washington Post) on how to deal with this existential threat if you have anxiety disorders . Don’t dwell. Try to maintain your routines. Don’t panic. Don’t obsessively check for updates.
But those articles don’t answer my big question — what if your anxiety is right? I’m sitting here with damaged lungs wondering if I am in that “higher risk” category articles keep gesturing vaguely at. My anxiety isn’t redirected. It is about exactly this. I’ve stopped commuting and am basically self-isolating at home. Can I visit friends? Can I go to the grocery stores? I know I have to be careful, to get the flu shot every year, to avoid smoky rooms. I will do almost anything to avoid being on a ventilator again. If anyone could just tell me what that was. But with illnesses, especially new ones, certainty doesn’t really exist.
I have spent years studying human disasters, epidemics, failed settlements, all kinds of horrible things. In them I found a weird comfort, that no matter how bad things got people fought back, people worked together, and at least some people survived. The world kept spinning. It was a way of working through anxiety — I couldn’t stop picturing the worst possible scenarios so I went to the source and tried to figure out what the worst possible actually looked like. It’s also a way to connect with people in the present and across time, to understand them on a human level. But, somehow, all of this work (including 6 months volunteering in an exhibit about the 1918 Spanish Flu) have left me spectacularly unprepared to deal with the reality of COVID–19. Learning about uncertainty and fear is very different than living it. Helen Branswell, a reporter writing about epidemics since 2003, sat on an expert panel a week ago and said “It’s bizarre but I find myself startled. Having written about the possibility of something like this for years, I still find myself really startled that it’s happening, and I don’t know why that is.” No amount of learning about something like this can prepare you for when it actually happens. I logically know that uncertainty is inevitable in these situations even if everyone is doing everything that they can. I know things often don’t look as bad in retrospect as they do at the time. But I also know that sometimes they end up much worse.
People keep comparing this to the 1918 flu pandemic, when we didn’t have ventilators or IVs and when some fatalities may have been from aspirin overdose. We know so much more now. But that doesn’t mean we are prepared. The essential truth of any crisis is that, no matter our tools, it all hinges on how well we come together to implement those tools. No technology can save us if there is no a real “us” to begin with. These divisions are always apparent, especially to the people most affected by them, but right now they are impossible for even the most privileged to ignore (though some are certainly trying).
Trauma, at least for me, always feels like a surprise when it’s triggered. Even when I think I see it coming, it hits like a train. I had the worst panic meltdown of my life Tuesday night talking about the newly declared state of emergency in MA and whether or not I should stay home from work. I have been stressed and on edge for a while, trying to weigh my anxiety and my health issues to figure out if I am over or under-reacting. But, that night, my own anxiety was compounded by that of my parents. We were all panicked and acting from our past trauma. When I couldn’t breathe and had to be ventilated, I was (blessedly) unaware. They were not. They remember everything. This virus and this uncertainty has really sent us reeling. We are terrified that I will get sick again. We are scared to be anywhere near a ventilator, to hear its rhythm and all the alarms we fell asleep to, me heavily sedated and them taking turns on the narrow recliner in my room. We are scared we couldn’t be together in the hospital this time. We are scared because we know what it means to not be able to breathe. To rely on a ventilator. How fast a even healthy young person can become completely helpless and how desperately you need the time and attention of medical providers to carry you through. But when hospitals are overloaded, as they have been in Italy and China, such time is in short supply. Accounts out of Italy say that wartime triage methods are being applied, that the oldest or most frail patients are not being ventilated at all. Doctors acknowledge this might happen in America. It’s a horrible calculation, but it is also an agreed upon ethical approach — you have to help who you can. But I know that as a weird medical situation 10 years ago, I would not have been afforded that extra care in an emergency. I worry I would not get it now. I don’t know if that worry is reasonable. I cannot imagine the pain of having to make these decisions.
After years trying to force my anxiety to listen to me I am now trying to listen to it, asking if it is right to be scared this time and, if so, what should I do? The advice I’ve found, though not what I was looking for, still matters because we have to prioritize are mental health, too. But what if you are terrified because you know what it means to be really sick? Because you are at legitimate risk? And I am not even close to being the most at risk — my immune system is pretty solid, I have insurance, I don’t have to keep working, I am living with my parents and do not need to pay rent — I can stay home basically as long as I want to. I know that I might be overreacting. I am about as lucky as a person could be in this situation. Except the knowing of what this could mean, for me and for other people. Except for the fear. And the damaged lungs. As I retreat from the possible threats of trains and offices, I am not in a place to reach out and bodily help others at risk. I don’t know what I could do anyways. But I can offer empathy and some level of understanding, some level of solidarity. I can try to maintain perspective, to not descend into panic, and to support my friends and family as they try do the same. I can communicate why it’s important to not dismiss this, even if you think you are not be at risk.
Because some of us are terrified. And not in a hoarding all the toilet paper way, in a visceral way. A knowledge that we carry in our bones, our lungs. A thing we know. There is nothing else that feels like not being able to breathe and no feeling I would more like to forget. All I can wish for you is that you never have to feel it. I can’t tell how much I am crying (I keep crying) for my own fear or because I know that there are thousands of people feeling that fear right now. I suppose that isn’t new — people get sick all the time. But right now I know it, I see it in every article and report. I am praying to something, someone, to help them through it.
Wash your hands. Stay inside when that’s advised, if you can. Look out for the people in your life. And consider them, consider how your choices can affect others, how acting with caution can keep them safe, how you can offer understanding to those who are terrified because they know what this might mean. And remember this too after we have “recovered”. Because, as patients and researchers increasingly recognize, trauma does not leave after you get physically better. There are layers of recovery. I got off the ventilator for 30 minutes at a time, an hour, twelve hours, and then had the tracheostomy tube in just as a precaution. I got that out, the hole began to close, I began to eat and drink again, got my stomach tube removed. Now, except for the scars, you would barely know. But that visceral fear will never fully heal. And, as, much as I sometimes want to forget, I am also grateful for what lingers. Because something very bad happened to me but then something very good — I survived. I love history because I want events to be recorded, to be remembered, to matter. I am grateful that this profound event is written in my lungs and in my scars. But I also wish I could put it down sometimes, step away, get some sleep, and maybe run up stairs a little bit easier. I wish that for you. Step away, find some peace, get some rest. As this gets scarier, you will need that rest. And when we move into the after, be patient and make space for those dealing with their own personal aftermaths. I can still be thrown into the midst of mine nine years later. This will not end cleanly, or soon.
No matter how safe you think you are, remember two things — that so many of us are not safe and that you are probably a lot less safe than you realize. Do not dismiss those of us who are scared because we know, either from the things we have learned or the things we have lived, what this might mean. Do not dismiss yourself either, because soon you might know too. Do not let anyone convince you that the actions taken do not matter. Do not forget the way that our leaders and institutions acted, or failed to. Hold those in power accountable, especially because we won’t all be there to do it. But don’t fall into jokes about the apocalypse — you don’t get out of this so easy. There will be an after and most of us will still be here. We will have to work together to remember what happened, what went wrong, to deal with our pain, to move forward. We cannot dissolve into panic because we have to get through this and, once we do, there needs to be a reckoning. A serious examination of the failures of short-sighted and egotistical leaders, the dangers of disinvesting in public health, the absurd fact that if we close schools some kids will not have enough to eat.
I know I sound gloomy. I genuinely cannot tell how much of this is a reasonable response based on current events and what I know about past pandemics and how much of it is coming from my fear. Even though I am taking more cues from the fear than usual, I still can’t let it run the show. I very much want to be wrong about all of this. I hope it ends up looking like we all overreacted. But that doesn’t mean we did overreact — it means we took action and it worked. Pay attention to what happens and the lessons we take away because they will shape what happens the next time. And, unfortunately, the one thing I am absolutely sure of is that there will be a next time.
For years, the 1918 pandemic was famous among historians as the one that nobody remembered. It was too painful, too much, life had to just be gotten on with — there was a collective forgetting. Now we are trying to dig it up, to find lessons and make them useful right now (there are definitely lessons to learn). But history doesn’t quite work that way — if you haven’t paid attention before, if you don’t know the context, you’ll miss a lot of important parts. Experts want to make sure we understand the differences too and that we understand the most essential lesson — that we have to come together to address this. Half-formed understandings will not help us. That is the risk of forgetting. Do not let this be forgotten too.
Do not hide from the big questions and from the scary truths — they won’t go away. What are we going to learn from this? Will it make us worse, more scared and more fractured, or can we learn the right lessons? Fear can show us when to take notice but it makes terrible choices after that. Don’t let it drive. Focus on what helps you feel connected and maintain perspective — this is just one piece of our world and of our lives. At some point, it will be another piece of our history. What will people learn from us?
