The New “C-Word”

Every now and then, I have a word or a phrase that I can’t get out of my mind, sort of like a song that plays over and over in your head, also known as the “earworm.” A few years ago, it was that infamous c-word in medicine: cancer.  After my diagnosis, it floated around in my brain constantly, occupying my innermost thoughts and frequently entering my verbal dialogue. I recall once, a colleague greeted me in the hallway:  “Hey Heather!  How have you been?”  and I immediately thought:  “Hi!  I’ve got cancer.  How about you?”  Somehow I managed to change my response to simply, “Hello.”

Being a physician diagnosed with cancer didn’t make it any easier; in fact, I found it was potentially even more challenging.  In spite of my training, or perhaps as a direct result of it, I had a tendency to overinterpret every test result, assuming the worst.  Although I had complete trust in my doctors and my care team, I still felt the need to go to PubMed and research each and every diagnostic test, surgical approach, and treatment regimen for breast cancer; at one point it became information overload and only clouded the picture rather than providing clarity.  All the while, even to this day, my internist brain tends to magnify every minor symptom I have as somehow related to cancer; even more so since I know of the rare presentations of recurrent or metastatic disease.

Now, fast forward to the year 2020 and the c-word has most definitely been replaced, at least for me:  Coronavirus.  COVID-19.  Not only it is the innate fear and stress and uncertainty surrounding this horrible entity that keeps it stuck in my mind, but also the constant barrage of emails, news reports, text messages, and social media all relating to the same topic; information overload, once again.  COVID-19 has been circulating around in my brain for months, eerily similar to how I envision the viral particles themselves floating around in the air for some time after an infected person coughs or sneezes.  I began to think that even if COVID-19 has not infected my body (yet), it has certainly infected my mind, even my dreams.  My daughter shared with me a dream she had, where she was trapped inside our house and a vicious wolf was prowling around outside; after hearing more of the details, I told her I was fairly certain the wolf represented the pandemic.  Early on, I had a recurring dream whereby I leave my house to go to work or the store and I am attacked by a stranger in a dark coat.  Lately, in my dreams, every person is wearing a mask and standing at least 6 feet away.

In a similar fashion to coping with a cancer diagnosis, I soon recognized that I simply needed to get my mind off COVID-19 now and then, too.  Not only a mental health break from thinking about it, but a break from the news media, social media, and flood of email too.  While I realized that as a physician I need to stay informed, I set aside specific times to do this.  I can turn off the TV and handle the news in doses; last week, I had a window of time where I went into the kitchen to cook dinner, opened the music on my phone and listened to one of my favorite playlists as I prepared food for almost two hours.  I emerged from that experience not only with a tasty home cooked meal, but I also felt strangely refreshed, energized; later, I reflected upon how powerful it was to take a break from the news.  And music, in general, is another way I helped ease anxiety in 2016.

Come to think of it, the other coping mechanisms that I utilized for cancer work well for this new c-word, too.  Such as exercise; my gym is closed, so I’ve been running around the nearby lake again and riding my bike, too.  And of course, when stressed, I need to connect with family, friends, and my faith community all the more; whether it’s Zoom or Facebook or WhatsApp, technology has been a godsend here, even if we do suffer from Zoom fatigue from time to time.

Then, there’s humor.  But wait; can one honestly find mirth in the midst of a pandemic?  I would say yes, based on the memes and social media posts that have actually made me laugh out loud.  Such as the “social distancing dress” with a 6 foot wide hoop skirt attached to it, or the list of COVID-19 pick up lines.  My favorite being, “Baby, do you need toilet paper?  Because I’m your Prince Charmin.”

As always, there is writing. To quote Anne Frank: “I can shake off everything as I write; my sorrows disappear, my courage is reborn.” This is especially meaningful considering her situation was somewhat akin to ours, being trapped inside. Whether it’s a blog or a social media post or just a few lines in a journal every day, writing is therapeutic, and should be used early and often throughout these stressful times.  

Finally, after my diagnosis, I found that I actually looked forward to going to work and seeing patients; it was a welcome distraction and also gave me a sense of purpose.  The same is occurring right now.  I feel well, I am coming to my office every day, evaluating roughly half my patients virtually by video or phone; I can still provide needed and necessary care. If there is anything good to come out of this pandemic, embracing telehealth might be one of them. Medicine was falling behind the times in terms of leveraging technology to benefit patients, and this virus has certainly been a catalyst for change.  

And although I am still working, I will set aside time every day to engage in one of the wellness activities listed above. Because I fear once this is over, or even now in the midst of it, mental health may be our next pandemic. This includes doctors and nurses and other health care providers impacted by COVID-19, on the front lines and beyond.  Sharing our coping mechanisms widely may be the best “mask” or “hand sanitizer” we have for prevention.  

With this in mind, I’ll keep pressing on, and I’m waiting for the day when this new c-word is replaced by another one.  How about these:

Containment.

Control.

Cure. 

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