The Shower of Shoes
By Mahjabeen Islam MD
Toledo, Ohio
My first major trauma was at age 12 when I lost my brothers to a car accident. I remember thinking that life would be a cakewalk thereafter. How could it possibly get worse? But it did. Five years later my father died while playing tennis. My tack changed suddenly, and thereon, I have waited for the other shoe to fall. And life has delivered. Again, again and yet again. Personal issues and struggles are one thing; for them to be partnered up with a national and global fiasco feels like Bugs Bunny flattened out by a truck.
Witnessing a pandemic
We would read about pandemics in books of history and medicine. To see it unfold before our eyes, and to live in the richest country in the world with five million infected and over 160,000 deaths is surreal. And if masks are not worn there could be 300,000 deaths by December 2020 . How wearing a mask infringes on one’s liberty is still difficult for me to comprehend. What I do know is that this refusal is bare selfishness. I did telemedicine with a patient who called with classic Covid-19 symptoms. “We went to a winery and all the people that went there are Covid-19 positive”. I asked if they had been wearing masks. “Of course not!” she said, a touch derisively.
My little neighborhood will contribute to the 300,000 deaths also. Two houses down, they’ve brought a portable swimming pool and the children are squealing as they jump in the water. And the adults enjoy their beers sitting in clusters. Masks you ask? Duh!
A pandemic of dysphoria
I was never into parties and used to create excuses not to attend. This strange time brings the aphorism that man is a social animal into painful focus. That I cannot jump up and even go for lunch with a friend, only serves to deepen this strange dysphoria. Michelle Obama has been frank about her low-grade depression. In each patient visit I make sure I ask about an increase in anxiety and depression. It is remarkable that the reply is essentially always in the affirmative and I have to determine whether my advice, professional counseling and/or medication are needed. Perhaps this state of being dispirited is the result of tackling the assault at us at so many levels-social, emotional, financial and physical.
After my father’s death, I followed the textbook and dutifully suffered a major depression. And have always lived in fear of a recurrence. I recognize that this dysphoria is different and that I am not alone. Perhaps that is what adds to it. It is so rare to come across people who are loving this leisure; if there were more of them, perhaps they could do a collective yank and the blues would disappear.
Backyard chai
Utilizing her vacation, a cousin who lives in Philadelphia decided to visit family in Ohio. I hastily put together chai on our patio and felt this great mood change after she and her husband left. And now my backyard chais are a wonderful treatment option for the Covid blues. Just need cloud cooperation; sometimes “taking a raincheck” becomes literal.
An epidemic within a pandemic
Addictions in general, and opioid use disorder in particular, are greatly worsened by social isolation. And these strange times call for social isolation. Opioid overdose deaths were over 70,000 in 2019 and over the last several years we have recognized that opioid use disorder was an epidemic in the US. The shameful governmental response to Covid-19 has had a downstream effect on the epidemic of opioid use disorder.
The greatest obstacle to recovery has been access to treatment and during the lockdown and subsequent scaling back of activity at treatment centers, the epidemic within the pandemic got a lot worse. People are also using alcohol to treat the multiple struggles that have suddenly surfaced. Unemployment, social restrictions, financial stringency, isolation, family dysfunction, illness/infection, depression, anxiety push people for the reprieve that alcohol gives. The health care system is so flawed and overwhelmed that the opioid epidemic is necessarily taking a backseat to the Covid-19 pandemic.
The year of death
I do not recall a single year in which every other day brought the news of deaths of people that we knew, the way that 2020 has. A classmate and another classmate’s wife died of Covid-19. My best friend’s mother died of natural causes. A classmate’s 32-year old daughter died recently, leaving a 17 month and a three- year old child. And the volley continues reliably. I have a momentary fear of checking my phone, for fear of having to write “To God we belong and to Him is our return”, again.
Recognizing racism
Perhaps the only good part of 2020 has been the Black Lives Matter Movement. While the mind rages against the brutal murder of George Floyd, the heart knows that his blood was not in vain. And that of innumerable innocents through decades of police brutality and institutionalized racism. But the road is long. And we must see this through.
With the weird dysphoria that Covid-19 has created and the repeated assaults one has had to suffer; I don’t have to wait for the other shoe to fall. They're falling one after another; a veritable shower of shoes.
(Mahjabeen Islam is an addiction and family medicine physician practicing in Toledo Ohio. - mahjabeen.islam@gmail.com )
