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rustandyearnings · 3 years

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How This Ends

Loan Tran

Two weeks into quarantine I read an article in The Atlantic titled, “How the Pandemic Will End.” It still felt wildly early to make any predictions about the future and the course of the virus. It has been now over a year that I have been trying to write a response to what I read, not because of any substantial disagreement but I foresaw then what I know now to be true, that after nearly a year of pandemic life: none of this simply ends.

There are no numbers and statistics, CDC guidelines, or even well thought out epidemiological reports that captures the depth of what it means that over 2.75 million people have died from COVID-19; over half a million of them alone in the U.S. We have witnessed a year that has made everything that was terrible before, much, much worse. And we know how we got here—especially being in the belly of the beast— we know all too well what regimes of power are capable of in their commitment to greed and profit. If you are like me or if you love people like me, you may know too that the world has come to an end many times before. What is different about this ending? If anything?

It was mid-March. My partner and I were on our way to the beach for her birthday. During our drive, we got news that the airports were starting to shut down and we were uncertain of the rumors about the National Guard being deployed to ensure compliance with stay-at-home orders. The beach was still there, and still sweet as always. We celebrated her the way we love each other; we ate delicious food, we laughed. She made her family’s shrimp: Lee Adam’s Shrimp. Which is comical, she says, because this was the only dish he would ever cook, and he got it named after him. Meanwhile, the family functioned because of women who made everything else possible. Such is our lives.

The Atlantic Ocean on the coast of North Carolina in mid-March is wind-swept, vast, very quiet. The sand becomes these large mountains to be trekked over before the water meets your eyeline. But once you see it, you know exactly where the ocean departs the sky. It was terribly cold. Yet, I was grateful to be by the water as our world began to shake us into conference calls and organizing meetings. Within just a few short hours of our Governor declaring lock down, we had formed the United for Survival and Beyond coalition. And knowing the year we were going to have and coming out of years of pavement pounding work, we were already exhausted. Deeper than the exhaustion is the truth that we must stick together, and we must find a way to continue on, especially now, with the cards so clear on the table: some of us will live and some of us will die. And there will be no logic to the madness.

The political work is instinctual to me; it makes sense in any crisis to bring together as many people as possible to understand a situation and to then take action. But the political work is also sometimes slow moving, even when we are all speeding and incredibly busy. So, I did other work that I felt, by my own standards, was more tangible. Like organizing a group chat of the queers I know who need medication on a regular basis. Or joining the local Mutual Aid Groups (and then promptly leaving all of the groups, which was simply a matter of exiting the Signal threads). Making a phone tree that was unreasonably the size of a phone book itself was an early action, too. And of course, cooking. There have been gallons upon gallons of pho. And gumbo. And at least 1,000 meatballs. Anything to attempt at satiating what I knew would become a growing hunger inside of me for a normalcy that still has not yet returned.

Things were deteriorating quickly all around me. By March’s end, my mom and I are on hold with her retirement company. She wants to get her money out of her account before the stock market steals it all away. This economic system routinely comes tumbling down for her; and often does it too line the pockets of the already ultra-wealthy. She has earned her retirement from working at the same alterations shop for over 20 years. She is paid for the time it takes to hand sew sequins onto wedding gowns that cost more than her year’s entire salary. She makes the inseam of your boutique jeans go from 32” to 30” with you never knowing the difference. She helps make people feel good, never questioning their own frivolousness in paying someone else to replace a missing button on their jacket. Her job has treated her well. This pandemic was beginning to test it as she’s filed for unemployment, without assistance from her bosses. The alliances that had shaped her life up until this point were beginning to fall apart, as is the case for so many of us.

It would become easier in the summer, but even then, the sweaty walks and the sitting outside in the beating sun just to eat a meal with someone who I wasn’t also sleeping with most nights began to tire me. I was unsatisfiable. I am lucky to have eaten many good meals, celebrate even more pandemic birthdays, and have extra money to keep supporting my parents’ and sister’s bills in between our socially distanced visits. Things would seem relatively calm for some weeks, when I felt like the weather wasn’t badgering on me. Which is to also say, that when things felt turbulent, it really just meant I was incredibly sad.

As I’ve been writing this piece in my mind, mulling over—as I usually do—which details feel relevant enough to evidence in words, the world around us has danced to the precipice of something new and back again. In between it all, I have had some of the most elaborate dreams of my life, the dreams at the heart of how I wish life could be.

I am home in Viet Nam. The sky is a dreamy pink, small stripes of orange and some residual blue as the sun sets and the moon takes over. I am sitting by the water and before me stretches a few miles of the bay. On the other side, mountains: spotted gray from granite and green from trees. I think to myself, “this is beautiful” and I take out my phone so I don’t forget what this looks like. My mom is here with me and it is quiet and perfect. Standing in line waiting to buy coffee from a street vendor, I think to myself, “wow, I get to be here,”; there are children and their parents who look my kin weaving around my stillness on the side of the road. I smile at someone I clock to be like me: a little odd, short haired, sweet looking in the face, stern and tough but kind in spirit. Then I wake up. It’s a dream. And all I know is that it’s a beautiful, perfect dream.

While time stretched and I could dream and I could travel in my mind, buoyed by my memories, telling stories that after the 3rd or 4th re-telling feels almost untrue, time also pulled me back to reality. To the everyday where I had few answers for the big question of: what now?

So what of time now? What is its worth? And what is worth it? I wear a watch every day still and I check my calendar still. And I still want Fridays to feel how Fridays are supposed to feel, still: they should release me. I still want to wake up slow on a Sunday, my favorite day, still. Things feel numbered and open all at once. Do I measure the worth of my life in this way or that? Do I consider tragedy to be where we start or is it having a witness to it that makes the clock run? Do I count the pints of soup I have made? What about the distance between us? There have been more cardinals than usual, but I’m really not counting. I do miss the children in the streets and the laughter beaming from their hands. Making sense of quiet and calling this place, my ever-growing city of just nearly 270,000 people, a ghost town seems a little defeatist; some days it seems just right, and some days it feels like an opening: to stop counting the time.

There is a slowness of this period that I have come to appreciate, even as it frustrates me. The slowness to remember and reconsider and re-learn the basic unit of relating: care; to care for each other and to care for ourselves. And we are being subject to the realities of care’s absence: there are millions of people—while they toil and make our world turn, even against the heaviest measures of despair—are disregarded as undeserving of housing, of health(care), of food, of life itself.

These systems of violence and domination continue to evolve, as showcased by this next phase of neoliberalism, with its elite colors and sloganeering. Coca-Cola racial justice investments and Nike’s you can do it to end racism and NFL’s $250,000,000 check to shut it (what, exactly?) down. Our task is more urgent than ever, yet there is still, simply this: you and I making a road where perhaps previously there was not, where perhaps previously there were, and it had been bombed or torn apart.

I am on the eve of my second pandemic birthday. And between the last time I dared contemplate how this ends and this moment now, there have been attempted coups and multiple mass shootings; there have been more vaccines distributed in the 1st world and essentially none for our sisters, brothers, and kin to the global south. Schools in my city are reopening and the people who suffer are made to blame each other.

A pandemic of this kind, through which a virus has served as the vehicle sounding the sirens of human plight, has the potential to lure us towards conclusions about the ever-deepening crises of white supremacy, patriarchy, and capitalism that will be regretful for us in the long-term. Namely, while it is true many things are outside of our control, like how a virus may mutate or transmit, there is so much more that is within our control.

We have witnessed that even in the middle of a pandemic, our people have risen up across the globe to declare that there must be another way to live. What deserves to be said again and again is that on one hand there is the science of this pandemic and the science of greed which profits on sickness; on the other is clear the science of solidarity; the science of organizing; the science of returning people back to each other; a sense of attention, a regard for care, an interest in ourselves and each other and the planet as people and places worthy of a world different than what centuries of violence and domination have conditioned and forced us toward.

At last, I do not know what the end of this pandemic means. But it seems to the hopeful, revolutionary optimist in me, that we have tried our raggedy best this year. I have appreciated more than ever our attempts at an honesty we may not have been willing to demonstrate. It seems to me that I haven’t been the only one to lie about how much I don’t know. And if you are looking for a script right now, about how to be, or how to cope, or how to regard yourself as belonging to those around you who do not look like you or speak like you or understand as you understand, I hope you’ll remember that there is no one else to make the future but us if we are to see ourselves in it.

I am embarrassed by my desperate need for things to return to normal. I am so desperate that I lay awake at night: wanting something I know I cannot have and the intelligent part of me knows that if I could have it, it would not be good for me or the people I love. The desperation is also a grief, fear, fatigue. But I also lay awake some nights taking audit of my gratitude; that beside me is my lover deep in restful sleep, that somehow in the morning our hands always find each other; and when we get out of bed, to make breakfast, or step outside: there is another day that affords me the time to learn how to be more human, and perhaps that is what this is worth. And those of us who still have it in us, and even those of us who feel that we have lost it, we must help this situation by becoming more and more human, as that is the only way I would want this to end.

This piece is dedicated to my dear friends who have kept me this year, in particular Zaina, Mindy, Margo, and Nadeen. It is also dedicated to our beloved Elandria (E) Williams, may they continue to rest in piece and know that we are taking their mandate for us to care, seriously. It is dedicated to the best pandemic pal and partner I could have ever asked for, who has also vowed to return the favor next pandemic, Chantelle. This is dedicated to the streets, to the uprisings, to all people everywhere who believe life doesn’t have to be this way, that we are so much more—these people include city workers, educators, youth and students, organizers, healthcare workers, and more. Thanks for the example of your lives.

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stephenmccull · 4 years

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Using Stories To Mentally Survive As A COVID-19 Clinician

Dr. Christopher Travis, an intern in obstetrics-gynecology, has cared for patients with COVID-19 and performed surgery on women suspected of having the coronavirus. But the patient who arrived for a routine prenatal visit in two masks and gloves had a problem that wasn’t physiological.

“She told me, ‘I’m terrified I’m going to get this virus that’s spreading all over the world,'” and worried it would hurt her baby, he said of the March encounter.

Travis, who practices at the Los Angeles County + University of Southern California Medical Center, told the woman he knew she was scared and tried to assure her she was safe and could trust him.

Asking many questions and carefully listening to the answers, Travis was exercising the craft of narrative medicine, a discipline in which clinicians use the principles of art and literature to better understand and incorporate patients’ stories into their practices.

“How do we do that really difficult work during the pandemic without it consuming us so we can come out ‘whole’ on the other end?” Travis said. Narrative medicine, which he studied at Columbia University, has helped him be aware of his own feelings, reflect more before reacting, and view challenging situations calmly, he said.

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The first graduate program in narrative medicine was created at Columbia University in 2009 by Dr. Rita Charon, and the practice has gained wide influence since, as evidenced by the dozens of narrative medicine essays published in the Journal of the American Medical Association and its sister journals.

Learning to be storytellers also helps clinicians communicate better with non-professionals, said writer and geriatrician Dr. Louise Aronson, who directs the medical humanities program at the University of California-San Francisco. It may be useful to reassure patients — or to motivate them to follow public health recommendations. “Tell them a story about having to intubate a previously healthy 22-year-old who’s going to die and leave behind his first child and new wife, and then you have their attention.”

“At the same time, telling that story can help the health professional process their own trauma and get the support they need to keep going,” she said.

Teaching Storytelling To Doctors

This fall, Keck School of Medicine of USC will offer the country’s second master’s program in narrative medicine, and the subject also will be part of the curriculum in the new Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, which opens its doors July 27 with its first class of 48 students. (KHN, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Narrative medicine trains physicians to care about patients’ singular, lived experiences — how illness is really affecting them, said Dr. Deepthiman Gowda, assistant dean for medical education at the new Kaiser Permanente school. The training may entail a close group reading of creative works such as poetry or literature, or watching dance or a film, or listening to music.

He said there’s also “real, intrinsic value” for patients because a doctor isn’t only being trained to care about the body and medications.

“Literature in its nature is a dive into the experience of living — the triumphs, the joys, the suffering, the anxieties, the tragedies, the confusions, the guilt, the ecstasies of being human, of being alive,” Gowda said. “This is the training our students need if they wish to care for persons and not diseases.”

Dr. Andre Lijoi, a geriatrician at WellSpan York Hospital in Pennsylvania, recently led a virtual session for 20 front-line nurse practitioners who work in nursing homes. Two volunteers recited Mary Oliver’s 1986 poem “Wild Geese,” which reads, “Tell me about despair, yours, and I will tell you mine. Meanwhile the world goes on.”

Sharing the poet’s words helped the nurses relieve their pent-up tensions, enabling them to express their feelings about life and work under COVID-19, Lijoi said.

One participant wrote, “As the world goes on around me I mourn seeing my aging parents, planning my daughter’s wedding, and missing my great niece’s baptism. I wonder, when will life be ‘normal’ again?”

Processing Fear To Provide Better Care

Dr. Naomi Rosenberg, an emergency room physician at Temple University Hospital in Philadelphia, studied narrative medicine at Columbia and teaches it at Temple’s Lewis Katz School of Medicine. The discipline helps her “metabolize” what she takes in while caring for COVID-19 patients, including the fear that comes with having to enter patients’ rooms alone in protective gear, she said.

The training helped her counsel a worried woman who couldn’t visit her sister because the hospital, like others around the country, wasn’t allowing relatives to visit COVID-19-infected patients.

“I’d read stories of Baldwin, Hemingway and Steinbeck about what it feels like to be afraid for someone you love, and recalling those helped me communicate with her with more clarity and compassion,” Rosenberg said. (After a four-day crisis, the sister recovered.)

Dr. Pamela Schaff (right) discusses narrative medicine in the Hoyt Gallery at the Keck School of Medicine of the University of Southern California, as Chioma Moneme, a student in the class of 2020, looks on. (Credit: Chris Shinn)

Close readings can also help students understand the various ways metaphor is used in the medical profession, for good or ill, said Dr. Pamela Schaff, who directs the Keck School’s new master’s program in narrative medicine.

Recently, Schaff led third-year medical students through a critical examination of a journal article that described medicine as a battlefield. The analysis helped student Andrew Tran understand that describing physicians as “warriors” could “promote unrealistic expectations and even depersonalization of us as human beings,” he said.

Something similar happens in the militarized language used to describe cancer, he added: “We say, ‘You’ve got to fight,’ which implies that if you die, you’re somehow a failure.”

In the real world, doctors are often focused narrowly, devoting most of their attention to a patient’s chief complaint. They listen to patients on average for only 11 seconds before interrupting them, according to a 2018 study in the Journal of General Internal Medicine. Narrative medicine seeks to change that.

While listening more carefully may add one more item to a physician’s lengthy “to-do” list, it could also save time in the end, Schaff said.

“If we train physicians to listen well, for metaphor, subtext and more, they can absorb and act on their patients’ stories even if they have limited time,” she said. “Also, we physicians must harness our narrative competence to demand changes in the health care system. Health systems should not mandate 10-minute encounters.”

Telling The Patient’s Whole Story

In practice, narrative medicine has diverse applications. Modern electronic health records, with their templates and prefilled sections, can hamper a doctor’s ability to create meaningful notes, Gowda said. But doctors can counter that by writing notes in language that makes the patient’s struggles come alive, he said.

The school’s curriculum will incorporate a different patient story each week to frame students’ learning. “Instead of, ‘This week, you will learn about stomach cancer,’ we say, ‘This week, we want you to meet Mr. Cardenas,'” Gowda said. “We learn about who he is, his family, his situation, his symptoms, his concerns. We want students to connect medical knowledge with the complexity and sometimes messiness of people’s stories and contexts.”

In preparation for the school’s opening, Gowda and a colleague have been running Friday lunchtime mindfulness and narrative medicine sessions for faculty and staff.

The meetings might include a collective, silent examination of a piece of art, followed by a discussion and shared feelings, said Dr. Marla Law Abrolat, a Permanente Medicine pediatrician in San Bernardino, California, and a faculty director at the new school.

“Young people come to medicine with bright eyes and want to help, then a traditional medical education beats that out of them,” Abrolat said. “We want them to remember patients’ stories that will always be a part of who they are when they leave here.”

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

Using Stories To Mentally Survive As A COVID-19 Clinician published first on https://smartdrinkingweb.weebly.com/

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gordonwilliamsweb · 4 years

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Using Stories To Mentally Survive As A COVID-19 Clinician

“She told me, ‘I’m terrified I’m going to get this virus that’s spreading all over the world,'” and worried it would hurt her baby, he said of the March encounter.

Travis, who practices at the Los Angeles County + University of Southern California Medical Center, told the woman he knew she was scared and tried to assure her she was safe and could trust him.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Please confirm your email address below:

“At the same time, telling that story can help the health professional process their own trauma and get the support they need to keep going,” she said.

Teaching Storytelling To Doctors

He said there’s also “real, intrinsic value” for patients because a doctor isn’t only being trained to care about the body and medications.

Sharing the poet’s words helped the nurses relieve their pent-up tensions, enabling them to express their feelings about life and work under COVID-19, Lijoi said.

Processing Fear To Provide Better Care

The training helped her counsel a worried woman who couldn’t visit her sister because the hospital, like others around the country, wasn’t allowing relatives to visit COVID-19-infected patients.

Something similar happens in the militarized language used to describe cancer, he added: “We say, ‘You’ve got to fight,’ which implies that if you die, you’re somehow a failure.”

While listening more carefully may add one more item to a physician’s lengthy “to-do” list, it could also save time in the end, Schaff said.

Telling The Patient’s Whole Story

In preparation for the school’s opening, Gowda and a colleague have been running Friday lunchtime mindfulness and narrative medicine sessions for faculty and staff.

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

Using Stories To Mentally Survive As A COVID-19 Clinician published first on https://nootropicspowdersupplier.tumblr.com/

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dinafbrownil · 4 years

Text

Using Stories To Mentally Survive As A COVID-19 Clinician

“She told me, ‘I’m terrified I’m going to get this virus that’s spreading all over the world,'” and worried it would hurt her baby, he said of the March encounter.

Travis, who practices at the Los Angeles County + University of Southern California Medical Center, told the woman he knew she was scared and tried to assure her she was safe and could trust him.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Please confirm your email address below:

“At the same time, telling that story can help the health professional process their own trauma and get the support they need to keep going,” she said.

Teaching Storytelling To Doctors

He said there’s also “real, intrinsic value” for patients because a doctor isn’t only being trained to care about the body and medications.

Sharing the poet’s words helped the nurses relieve their pent-up tensions, enabling them to express their feelings about life and work under COVID-19, Lijoi said.

Processing Fear To Provide Better Care

The training helped her counsel a worried woman who couldn’t visit her sister because the hospital, like others around the country, wasn’t allowing relatives to visit COVID-19-infected patients.

Something similar happens in the militarized language used to describe cancer, he added: “We say, ‘You’ve got to fight,’ which implies that if you die, you’re somehow a failure.”

While listening more carefully may add one more item to a physician’s lengthy “to-do” list, it could also save time in the end, Schaff said.

Telling The Patient’s Whole Story

In preparation for the school’s opening, Gowda and a colleague have been running Friday lunchtime mindfulness and narrative medicine sessions for faculty and staff.

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

from Updates By Dina https://khn.org/news/using-stories-to-mentally-survive-as-a-covid-19-clinician/

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