it is what it is

My friend has taken a fortnight’s leave from hospital work and might extend it if she needs to. She is a specialist in Internal Medicine. She is in her fifties and her mum is over eighty, hypertensive and diabetic. She says she can’t expose her mum to the corona virus.

She talked anxiously about this with me for nearly two weeks before taking the step. It’s an ethical dilemma that many doctors have faced since the onset of the pandemic. It’s an individual decision, but there isn’t always a choice because there are legal contracts, apart from your own pricking conscience.

Doctors and others in the medical field are now referred to in the media as soldiers. The analogy fits only up to a point. Soldiers and their families know from the outset that they may have to die for the country; doctors and nurses don’t. It’s not common or expected that we die in the line of duty.

So there is fear of being infected, of passing it on to family members and fear of dying from it. Added to that, there is anger about not having enough protective equipment, anger towards patients – some of whom are acting entitled out of their own fears, and anger against the world for not acting fast enough to control spread of the disease.

Doctors working with infected patients are now reaching out for help in dealing with all these emotions. Used to keeping emotions under control, doctors have no experience with an overload of anxiety, anger, sadness, and a sense of danger, though nobody minds the physical exhaustion much because that’s not unusual. But this time even that has been excessive.

Psychiatrists and psychologists are offering online CBT ­– Cognitive Behaviour Therap­y – or at least basic counselling ­– to these overwrought people.

What is CBT?

It’s a way of changing a person’s negative view of his problem and the way he consequently responds to it. The therapist focuses on the patient’s thoughts, beliefs, associated emotions and attitude towards the situation he is facing. The goal is to identify the problem, think of possible solutions and choose the best one. Something like this:

  • How do you know this thought is the truth?
  • Why do you think it can’t be wrong?
  • What is the worst-case scenario if your belief is correct?
  • What’s the best?
  • If someone else asked you for advice with the same worries what might you tell her to do?

All this takes time. Held to this line of reasoning, the patient starts seeing the situation a little more realistically. He gets that there are serious limitations to his power to effect all the changes he wants. He gradually reaches a level of acceptance: it is what it is. There might be an associated sense of loss, sadness or helplessness in this, but it’s better than a constant anxious muddle in his head I suppose. It’ll keep him going so he can do his job as a doctor, nothing more, for that’s the need of the hour.

Many doctors have died from contracting the virus from patients. What could have been done differently? I don’t know what to think anymore. In any case, reviewing the past won’t change the present, though it might help in planning for the future.

We often don’t realise that the world is a decent place only because of all the little cogs in the wheel of this composite entity called People functioning as a whole. Every worker fills a need. There is a division of labour that exists in all societies – bees, ants or us – and we contribute our mite to the whole. Right now it’s the turn of doctors and nurses, and of people who supply food and other essentials, to do their bit.

If we think the corona pandemic is a wake-up call we ought to listen, learn and change. If we choose to treat it like the pandemics that have come before and say “this too shall pass” and go back to exactly what we were doing before the pandemic, well, I’ll have to find the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference, to quote Reinhold Niebuhr. I hope we don’t go back to being our blasé selves.

For the time being it is what it is, and governments are trying their best to deal with its effects. Meanwhile, we have all been forced to live the epicurean way, and some of us may develop a liking for it and continue with lathe biōsas even after the pandemic is over!

9 thoughts on “it is what it is

  1. I am dealing with the same dilemma. However I am making sure I am protected but things happen so fast and if there is a sick person collapsed in front of you we are trained to run and help with or without protection.
    At the end I feel this is what we were trained to do and when we are called to do our duty I find it difficult to all away.
    I will do everything to protect myself and my family.

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  2. Very different point of view.
    Interesting to know about CBT.
    The points listed to identify problems and solutions are very good.
    All in all, well written, Good work 😊
    Keep up the good work.
    I mean, the direction is good.

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  3. Ours is the biggest Democracy and we have many challenges which all common people do not understand. It is impossible to please everyone. Your direction is good and hope people who already know it will follow it.
    Simple things like distancing are not followed but we are asked to get our supplies from within one kilometre of our residence. It is difficult if you are a senior citizen and you find the place unhygienic and not following the rules. Fortunately we are blessed to be able to order on line and ready to accept what ever is available. The younger generation lack patience and get frustrated very easily. But this too will pass. Let’s hope for the best.

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  4. Well written and insightful. Doctors have always had the problem of shouldering the weight of other people’s problems. But now during this pandemic, more factors have been brought into play, leaving the doctor uncertain and undecided. The daughter of a friend of mine doing her PG in Pulmonology, quarantined herself for two weeks before returning home after a one month stint at work.

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  5. CBT = philosophy of life indeed! This blog is so timely. Doctors are human too and not super human, invincible or Gods as we make them out to be. My prayers for all of them and others who are in the frontline fighting this pandemic. Policemen too are braving all odds and staying away from their families to control the spread of the disease – sometimes extending beyond their line of duty. My friend’s newly engaged daughter-in-law is risking her life as a pathologist. God be with all such people.

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  6. Firstly to all the people on the front line trying to save lives I would like to thank them for trying their best to save lives and keep COVID19 from spreading. It is a sad thing that governments all over the world have no plan in place for a pandemic like this but choose to spend so much of our tax money on nuclear plants instead of healthcare. Nothing will change till everyone of us stand up. It’s hard times indeed for everyone to watch their loved ones die leave alone the pain every medical worker has to deal with the large scale of death rates all over the world it definitely must be affecting their mental, physical and emotional well-being. I can’t imagine what it must feel to make all those difficult decisions. All over the world people working in health care are having to leave their homes to safeguard their families, it’s a great sacrifice to make. CBT will definitely help and since most of them are going to be suffering from Post-traumatic stress disorder (PTSD) like the soldiers for world wars. Thanks for writing this thought provoking blog DR. You state the facts in a very honest way. May we all learn from the pandemic that we are all one no matter what background we come from and if we don’t use our minds and hearts to work together to make a better world and be grateful to mother earth we might land up in worse times than this.

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