COVID-19 Cloistered Syndrome
By Dr Mahjabeen Islam
Toledo, Ohio
I am terrified of, and at the same time fascinated with, blindness and imprisonment. Only because I know I couldn’t handle either. Thus 48 Hours, Forensic Files and 20/20 are my favorite shows. The point when the murderer is sentenced has a particular impact on me because of the essential impossibility, in my mind, of spending 30 years or life in prison without the possibility of parole.
The cycles of dread
Even though we are cloistered in luxury, it feels like incarceration. The human mind takes a while to process trauma but knowing this does not seem to reduce its impact. My mind goes through these cycles of dread. Starts with the morning when the bed is a magnet and I am steel. Email’s been checked, Whatsapp’s been checked, articles have been read. And then the mental persuasions begin: “Come on get out of bed, it’s gonna be ok” and variations of the same.
Each day is more onerous than the last, because the case-rate and fatalities are so much higher. On March 1st 2020 there were 89 Coronavirus cases in the US. By March 7th there were 446, by March 14th 2,776, by March 21st there were 23,432 and by March 31st 186,258 people were infected! And as of April 2nd there were 243,134 cases in the US and 5,864 deaths, and on April 8th 427,824 cases and 14,721 deaths. We used to casually use the word exponential, now we see it every day.
So one option is not to watch or read anything related to the COVID-19 pandemic. But that doesn’t work for me. And this week it is people we know who are in the ICU; statistics are so different from when a disease hits home like that. And as the days go on, those episodes of paralyzing dread become sickeningly familiar.
Sunlight the savior
Even a twenty-minute walk does wonders. “I can do this” and “this too shall pass” become fulfill-able mantras. Just the pre-walk is like a one-hour vacillation of the fight between the “go” and “don’t go” voices in my head. And the sinking realization that it has come to this; an activity and numerous others that were automatic in the past are actual projects now.
Bankruptcy
A physician colleague just posted something hilarious and horrid: “if this saga continues, I will have something in common with Donald Trump, Chapter 11”. And speaking of Trump there is first the specter of small businesses going out of business and then suffering Trump’s press briefings.
Small businesses are seeing a 70-80% reduction in activity. And this applies to a large swath of businesses from manufacturing to medicine. A bipartisan CARES Act 2020 was passed but has run into all kinds of snafus, and the immediate provision of $10,000 to small businesses and the Payroll Protection Program seem like they may not materialize or will arrive when irretrievable damage has been done. The consequences of this are not just small businesses filing bankruptcy, but millions of people losing their health insurance. Which in turn make a recession a definite, and the Second Great Depression a probability. Scaling back, pre-retirement or retirement plans are so much more palatable when they are done on our time; having them shoved in your face just worsens that cycle of dread.
Trump
Never fails that when I am trapped in the kitchen cooking dinner, Trump’s press briefings are on and all channels carry them. It is hard to comprehend that the President of the United States would deflate reporters, call the World Health Organization names, peddle hydroxychloroquine repeatedly, fight with all things Democrat, alter facts whimsically and be altogether delusional. With the reverberant theme of “it is this way because I say it is”. And the citizenry has no recourse. “The CDC recommends face masks but I won’t be wearing them” is Trump’s typical of “do as I say and not as I do”.
All this time
Time was that vacations and staycations were just so awesome. Now time hangs heavy and the voices that propel to action feel shrill. I used to dream of a sabbatical when I would write my book. That the day is filled with telemedicine, cleaning, napping, cooking, the news and bed makes my self-worth tank. And I re-read those self-affirming memes that soothingly forgive you for essentially becoming a lump of lard.
Fat on the other side
I’m very fat-phobic and my children accuse me of wanting to commit fat-icide. My mother and aunts were fabulous cooks; and round and rolly to prove it. And it was so plain that most, if not all, famous chefs are obese. So I figured I would dislike cooking and that would take care of any roundness that might threaten me. One of the memorable things of this cloistering will be that I discovered the joys of cooking. The family appreciating the meal every evening, is truly one of the greatest joys I have ever felt. Fortunately for me, I don’t have a sweet tooth and am not a stress eater; quite the South Beach lo-carb diet queen.
That I have never been skin-and-bones is all my mesomorphic build, genes and metabolism-as rationalized by all overweight folks. Used to weigh myself once a week, now it is every day. The cycles of dread, my molasses like inertia, the specter of a financial fall, the sadness of the national and global death toll and the fury of how this pandemic could have been handled differently will all be there. But at least I won’t be fat on the other side.
(Dr Mahjabeen Islam is an addiction medicine and family medicine physician in practice in Toledo, Ohio. Her email is mahjabeen.islam@gmail.com)
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