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!