Grasping to Regain Control in a Pandemic… From the Seat of my Bike

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These past several weeks my fellow healthcare workers and I have witnessed the rise of our COVID-19 case count, followed by hospitalizations and ICU admissions, and as this has happened many of have felt a mix of emotions. Speaking from my own perspective, I’ll tell you that it has been completely demoralizing. We saw this coming, and we witnessed a complete lack of leadership from our government to help avoid this from happening. Rather than embrace science, the current leadership chose to enact a neuroradiologist’s belief in herd immunity, and completely gave up on measures to contain the virus. He traveled the country to some of the hardest hit cities and held non-socially distanced rallies, refusing to set an example to his followers of wearing masks, maintaining social distance, and other responsible behavior. That is not in dispute. And the cases continue to rise, followed by hospitalizations, followed by ICU admissions, and followed by deaths. The weight of frustration and moral injury resulting from fatal decisions of our leadership is almost too great to bear. We didn’t have to be here. We could have chosen a different path. We still can. But man, this is heavy.

Meanwhile, we go to work everyday, trying to take care of people during the chaos of the pandemic, and it is easy to feel an immediate complete loss of control. Scrolling my #medtwitter feed, I read and feel the collective sense of futility. I feel my own sense of futility. My emotions have cycled between joy, anxiety, sadness, anger, and depression, with on average many more days in the anxiety/sadness/frustration side of the spectrum. My fuse is short, and I worry that my own moral injury will seep into the lives of this amazing team of doctors and nurses with whom I work. Do they see the despair I’m feeling inside? Can my patients sense it too? I implore myself to embrace aequanimitas, and honor my Oslerian training, but struggle with this every day.

How do we escape this spiral, both for individual and the collective good? For over half of 2020 this has felt like an indulgence. I put everything aside, including my own health and wellness, indulging in poor nutritional choices, neglecting the bike, giving up riding my bike with friends, and this has been to my own detriment. It hasn’t helped me accomplish more. I have not published more. In fact, I’ve experienced a complete drought, a spiral, and lately have been searching frantically for an escape ramp from this spiral.

I believe that the greatest sense of despair comes from a complete lack of control. I mean, it’s a pandemic. By virtue of this there is no control, at least until we have leaders who embrace science again. I cannot control what is happening in the daily news. I cannot control the fact that people still don’t believe this is a real crisis and something that we all need to work together to overcome. I cannot control whether our country will rise to the occasion and save ourselves. In this, all I’ve been able to do is pray — and honestly for the last year I’ve made this a regular habit, to give these struggles and fears up to God, and lately I think I’ve been able to see many of these prayers answered. My family and colleagues remains healthy and safe. Our country has a restored path forward even though it will be difficult.

And one of the things I have been praying over was how to escape my own moral injury. I’ve had several answers to this, from friends reaching out and reconnecting, and messages of support that seem to come out of nowhere. And this morning when I got on my bike for a the first morning workout in awhile, and felt the answer come over me. This realization that in a powerless situation, it may really come down to taking back a little bit of control over something small, something I can do. Survival through these times may come down to taking back the little things I can control to nourish my soul.

This weekend I witnessed something incredible, and completely not pandemic-related. I witnessed this live Peloton bike competition by my colleagues in my field, racing for people who live with pulmonary hypertension and to raise awareness about this disease. I witnessed them going all out, putting ego aside, and giving it their all, for the good of the community. They allowed us to escape. They helped me to dream again. And then I allowed myself to start dreaming of 2021 and returning to the bike and trail next year. And the road to 2021 starts now and it starts here. Somehow today I felt that resonate in my soul in a way it has not in quite sometime.

At work, I can devote my entire energy to caring for people in my clinic and when I’m in the ICU, caring for those who are critically ill, and serve on the COVID-19 front lines in this fight. And I will limit my daily news intake (this has been my biggest substance of abuse). And at home I can work — hard — on rejuvenation. Maybe just maybe, by indulging in restorative activity, from planning for 2021 and making that plan a reality, working out on the bike and in the gym (and in the kitchen), going for self-care through sweat, I can take back just a sliver of control amidst the chaos of life now. Day by day, pedal stroke by pedal stroke. Week one. Day one. #LFG. Let’s go.

What do you do to help gain some sense of control when faced with challenges that seem overwhelming? How do you nourish your soul?

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