July 11, 2020
There is so much to discuss that at times I don’t know where to begin. As a physician, and a citizen of the world community, I feel a passionate need to add my voice and alarm everyone about this very pivotal point in our history. It is literally a matter of life and death.We have reached a sad milestone in the U.S. of having over 130, 000 deaths due to the COVID -19 pandemic. U.S. cases of this infection reportedly top 3.1 million. It was only a short while ago that America was the number one nation that everyone in the world wanted to enter. We have now become the pariah of the world, where the European Union has recently banned Americans from entering their perceived safer harbors. Interestingly, #45 once called Haiti and other African countries S-hole countries. Interestingly, based on the leadership coming from the White House, this country is clearly distancing itself from any vision of greatness.The virus is ravaging possibly 30 plus states including Florida, Arizona, Nevada, and Texas. We are finding that both the young and old can die from the virus. And although NY has reopened its economy, we are not moving forward as quickly as planned. This has much to do with our own lax social distancing and mask wearing practices. Each of us is responsible to wear our masks and wear it correctly. The masks need to cover both the nose and mouth in the presence of others. It is not just for the chin.
This nation-wide health crisis has ridiculously become a political thing where people want to express their rights not to wear masks and not social distance. I think the president of Brazil may be regretting this mindset since he is reported to be positive for COVID. The medical and psychological consequences of this illness are multidimensional to both the young and the old. Wearing a mask should be a symbol of love and care for one another. My need to write about this topic comes from the concern I have over the alarming number of infections that are being documented all over the country. And I am concerned that as the numbers of infections and death rates go up, we will need to be prepared to help our families, friends, and co-workers deal with the anxiety, and suffering that comes with this pandemic. There is a significant loss that this pandemic leaves behind. And we need to find concrete ways to offer encouragement and hope in addition to the prayers said for our loved ones.
The reality is that this pandemic will be with us for an unclear period and longer than we expected. This is unfortunately contributed by the issues I mentioned above. Because of people ignoring rules meant to save lives, this first wave may never go away even as people are talking about a possible second wave in the Fall.I have both patients and friends who have suffered loss from this pandemic. As I wrote above, the loss is multidimensional, including loss of both mental and physical health, productivity, and unfortunately, life. We, as a community, both secular and spiritual, need to prepare for grief that will come, and discuss ways to help people carry that burden of grief. Our preparation must include psychological, emotional, and spiritual care that we can provide one another. I believe that preparation is a spark that can ignite hope. Appropriate preparation can help us look forward to the future. I believe that everyone at some level can learn how to help someone process the long-term impact of this nation-wide trauma. We can do so with compassion. But compassion can be such nebulous word. So, let’s discuss some concrete ways to demonstrate compassion when someone is suffering.
Let’s begin with Space. I say we give people space to process their experience letting them know that what they are going through, be it anxiety, sadness, or the experience of loss, is a natural process. To grieve is a natural response to a loss. When the writer of the Book of Lamentations writes, “Let him sit alone in silence, for the Lord has laid it upon him,” (Lamentations 3:28), I believe this reflects the need we all have as individuals to process an emotionally traumatic event in a healthy way. People may also need to give themselves permission to grieve without feeling shame or guilt depending on their cultural views about expressing grief.
In providing support, we don’t have to find the right words for such moments because more times than none, the appropriate words, like the proverbial needle in a haystack, are almost impossible to find as much as we may want to say something comforting. But being available to listen and share the moment with the suffering individual may make all the difference for them. That is the beauty and blessing of the human connection. It is the art of being there for someone while they are in their pain.
And if there is silence, lean into the silence. We need to be comfortable in the silence of the moment if that is how the suffering is expressed. What do you think is the most important thing you can give to someone to show that you care? I have told people in the past that the most important and invaluable thing we can give to anyone is our Time. Like so many invaluable things, it is so limited and precious. What we do with it is very very important since we only have a limited number of breaths and a limited number of heart beats. Finding quality time to spend with those who are hurting is an invaluable thing to do.
Acknowledge and Validate the experience. This allows a person to feel that they are not weird or strange. Validation can be a simple sentence such as “You have every right to feel as you do” or “I can understand you feeling that way in light of what you shared with me.” Some people will commonly ask as they are speaking “You know what I mean?” when trying to describe how they feel. Please don’t be quick to say yes. Even if you think you may know what they mean, it wouldn’t hurt to have them explain what they mean in their own words. And this is similar to quickly saying, “I know how you feel” when maybe you don’t. You may have an idea based on your own past experience, but remember, this is their experience, their moment, their feelings. Not yours or mine. Give them their space. Validation, if done well, provides the right balance between respecting the experience as that person’s own and that the experience is part of the human condition.
Let them know that they are not alone. I think the idea of being alone can bring a sense of despair and hopelessness. Hopelessness has been correlated with suicide. I am presently treating someone for anxiety and depression. More than medication, one of the most effective things that I have done is to let my patient know that although I am not walking in their shoes, I am walking with them and will continue to do so until we get to the other side of their illness. We can be that supporting rod a person needs as they walk through their dark valley of what may feel like death.
I have found it useful to ask a person the question, “Is there any more you would like to say?” This lets a person know that you are sincerely interested in what they are going through. You are again giving them space and time and not rushing them. Interestingly, I have also found that when a person feels that they have all the time in the world to speak, they often run out of things to say, as opposed to when they are feeling pressed for time. We can give a Word of encouragement by reminding people of their resilience. We do this by mentioning the hard things that they have gone through and what has allowed them to get through to the other side of prior griefs or hurts. This is not the same as quickly providing advice.
Finally, we must offer Hope by mentioning the obvious; that this moment in time will end. There is life after this pandemic even if it may be a different life, filled with new precautions and that ultimately, they will get through this. Remind them that healing takes time, it is a process. But it does happen. And we are there to offer tangible help along with prayers.
Pierre R. Arty, M.D.