Staring at the Sun — The Age of COVID-19

It is April 18th, 2020. I am writing this piece in New York City, the current world epicenter of the COVID-19 pandemic, listening to the most recent updates on the number of cases and deaths from COVID-19. In the city where I was born, educated, raised a family, live and made a career in Psychiatric Oncology at Memorial Sloan Kettering Cancer Center. In New York City alone, there are now at least 130,000 confirmed cases of COVID-19 and close to 14,000 deaths due to the virus. About 1,300 patients were admitted to the hospital here today, and 507 people died here of COVID-19 today. But this is a global pandemic affecting more than 185 countries, a global tragedy. 2.4 million COVID-19 cases reported worldwide, 165,000 deaths. Numbers and statistics like these that I quote cannot provide the human dimension of this tragedy. So many lives have been dramatically affected by personal loss, grief, and paralyzing fear. My younger brother, an intensive care physician, struck by the virus but recovered. My sister-in-law, the wife of an infectious disease physician, struggled in the hospital to breathe. Friends, colleagues across the globe, have lost parents, siblings to this virus. Dying of COVID-19 is unfortunately often a difficult death, a respiratory death marked by air hunger, and a sense of drowning, limbo under sedation while intubated for as many as 20 days or more. Death with no family members present. A death alone was mitigated in part by compassionate and caring nurses and doctors who sit with cell phones and video apps in an attempt to allow for that last goodbye. And as a last resort, someone like me, or one of my clinical staff holding that patient's hand and providing the comfort we hope might approach what a son or spouse might provide, being family to our patients in their last moments of life. For those of us who are on the so-called frontlines, death is everywhere and constant and inescapable. For those of us sheltering in place at home, we too are bombarded by death, contagion, plague, and near panic fear of death. The virtual loss of our lives is only preceeded by the actual loss of our “normal” everyday lives in the world such as work, community, socialization, touching, hugging, eating together, and just being together. Our cultures themselves are at high risk of extermination. Our species is at risk of extermination — we are engaged in a life and death struggle with viral particles of RNA for our place as biota in the biosphere. We are in the grip of “Death Terror,” The salience of death has never been more intense or non-remitting.

This COVID-19 pandemic is forcing us to “Stare at the Sun” too long. We try to look away, but it is there wherever we attempt to avert our eyes. This Death Terror is punctuated by episodes of grief and sadness and tears. It is also punctuated by amazing acts of heroism, compassion, love, humanity, joy, laughter, gratitude, and self-forgiveness.

Life and Death

It was 1 year ago, almost to the day, that we watched the Notre -Dame de Paris Cathedral ablaze in flames and collapsed in ruin. How could the Notre Dame Cathedral of Paris be no more; just cease to exist? The shock then was a revelation that nothing is permanent. That all things must pass. Now a year later, we are painfully learning, on a global scale, that human life, our own lives, now, are vulnerable and at risk of ending at any moment. We cannot avoid what has always been the truth of our existence of our lives. We can no longer easily avoid the imperative that in living and creating our lives, we must do so in the context that death is a part of life. We must develop our attitude toward both living and dying throughout our lives. We must strive to find meaning both in our lives and in our deaths. Death makes life and living more precious and urgent. Death helps teach us what is truly important in life and who we are as human beings. This COVID-19 pandemic has taught us that nothing is more important than love, family, community, and communication. I will never greet my grocer, or postman, or taxi driver again without a sense of appreciation for the essential role they play in my life and in our communities. I will never sit with friends and share a meal in a restaurant again and not smile and appreciate the joy of communion and connection. I will never again find the need to pay full price for clothing in a fancy department store, now that I've spent the last six weeks in the same set of sweat pants and tee shirts! I will buy stock in Netflix (I'm likely a bit late on that one). I've resolved that I will constantly express my love and gratitude to all the people I love in this world. Tell my son how much I love him and how proud of him I am every day, so that there's no need really for last words. Everything that might need to be said will have been said.

I've also resolved that I do not want my family to have to endure a ZOOM funeral, but frankly that will be up to them and not me.

Finally, the issue of accepting mortality. During this pandemic, I have been thinking a lot of my late parents. They've come to mind for several reasons. Initially, I tried to put this unprecedented pandemic into some relatable historical context. I began to think of my experience, our experience, with this life changing, life threatening pandemic, as being somewhat analogous to the experience of my parents during the Holocaust. At first, there were rumblings that something dangerous was coming, and then at some point, a decision had to be made, a drastic step taken to try to survive. For my parents, as teenagers, it was fleeing to the Polish forest to hide and shelter with a group of about 150 partisans fighters and families. Their sheltering in place was not as luxurious as ours. No beds, no showers, no food delivery, no internet. They only had the forest floor to sleep on. They never knew when they would eat again, or when Nazi forces would find them and kill them. They hid for 3 years. I began to understand that I can shelter in place in my home and work from home for several months if necessary and that what we were experiencing in terms of inconvenience and fear had to be placed in context. One day, about three weeks into the pandemic, I walked into my kitchen to make coffee and found myself talking aloud to my parents. “Mom, Dad, can you believe this is happening?” They didn't answer, but my conscious aware self-answered. I cried as I spoke aloud, thanking my parents for the gift of life. The randomness of who was affected by this pandemic was without justice or value. Randomness was truly random. The fact that my parents survived the Holocaust and that I was born was as close to a random miracle as I could imagine. I could easily have never been born, never existed, and never have had this life. I cried as I expressed gratitude for having this remarkable and unique chance to exist and create a life and experience this life; and no matter what happened, joyful or tragic, or how long I lived, I realized I would not have given up the opportunity to experience this one life I was given. At that moment, I decided to give up my suffering, and to accept the beauty and love in this world, despite the tragedies and dangers.

A Change is Gonna Come

Everything in impermanent; and that includes pandemics and wars as well as well performing economies and life itself. And so, this COVID-19 pandemic will also one day be over, and we will return to a perhaps new normal life that resembles our pre-Covid-19 lives. Hopefully, it will be to lives that have been not merely traumatized but also somewhat transformed for the better. A “Change is Gonna Come” and hopefully it will be with a renewed sense of love, compassion, gratitude, kindness, and care for each other and our planet.