From Pandemic to Endemic.

Tom Conran (my grad school professor) wore several hats when it came to his doctoral course on counseling people with serious illnesses.  Some nights, he showed up as a talk show host, interviewing panels of guests who were given “death sentences,” by their oncologists.   Somehow each of them managed to live well past their expiration dates.  Dr. Conran wanted his studentsto learn each and every one of those “somehows,” and pass them along to future seriously ill counselee’s.  On other nights, he was a swashbuckling medical anthropologist leading expeditions into the hidden ways that unconscious cultural narratives shape healthcare practices and patient outcomes.  Armed with this knowledge, I began to learn how to assist a client in exploring their own beliefs around illness, discarding those that inhibit recovery, and surfacing those that aid it!  Frequently, Dr. Conran emerged as a wizened old clinician with decades of experience.  On those nights, he would have us take our turns in the psychotherapist’s chair and observe our counseling approaches to seriously ill people.  I remember the night he gently, but firmly chastened me.  “Tom, you’re trying to do too much here.  Slow down!”  “Let your client guide you.”  Oh, that I would have followed that advice more frequently in the subsequent years of my career!  Dr. Conran died suddenly in March of 2008.  Here’s a posthumous thanks to him, for shaping how I practice my craft!  So many of the things he taught me have come in handy, especially during this pandemic.

Speaking of the Pandemic, our current circumstance with a new-ish variant, and another spike in hospitalizations, has me looking back over my shoulder at our long Pandemic journey together.  Remember that period when the lockdown ended, but the vaccines were still a half-year away?  Then came the vaccines and the deliriously happy belief that many of us nurtured.  I really thought that we had arrived at the beginning of the end of COVID!  Then the Greek letters of the alphabet started showing up, and the next thing you know, I’m passing gifts out of a Christmas morning window to my quarantined, masked up son.  My wife is taking extra shifts at her hospital job because the COVID census is spiking, just as physicians and nurses are sick with it.  Here’s my wife’s take on the new phase of our collective journey together:  “We are moving from a Pandemic mindset to an Endemic mindset.”  My old professor used to utilize a powerful metaphor in thinking about the management of serious illness.  Perhaps it will help in explaining what Lisa meant by “Pandemic to Endemic.”  

Imagine that your life is like an extended road trip.  You pack the car of your life with all of those things you want in it to make the trip pleasant.  But doesn’t it sometimes happen that a stoplight interrupts your life’s journey?  While waiting for the light to change, a thing jumps into the backseat that you can’t get it out of your car.  To make matters worse, that thing brought its own junk food.  And now it’s eating and belching and flatulating, and growing and growing.  Pretty soon it takes up all of the backseat, and threatens to take up the front seat as well.  What are you going to do?  I’ve already stipulated that you can’t get it out of your car.  The question becomes, “How do you put that thing on a diet so that it has only a limited space in the back seat, and no more?”  This is the important question for anyone with a chronic, or serious illness.

In my own practice, I frequently encounter people who limit the space that depression takes up by exercising, connecting with warm friends, focusing upon what is purposive, practicing an engaging hobby, living a life of service, incorporating a meaningful spirituality, and more.  When it comes to this endemic disease (i.e. chronic) that will be living among us for the foreseeable future, where do you look to find out how to limit its physical and psychological space in your life? 

Limiting the Space of COVID

I remember the two times I bought a house and had to sign phone-book sized pile of documents.  I suppose I could have gone to a law and business library to deeply understand what I was signing.  Instead, I found a realtor whose expert knowledge I trusted.  When it comes to COVID, who is your trusted adviser who bases their comments on a deep understanding of biological science and practice?  If you must do a literature review of your own, for the sake of your mental health, I strongly recommend that you limit your sources of medical advice to those rock-solid sites that have proven themselves for over a hundred years, like the Mayo Clinic’s site, or John’s Hopkins.

When it comes to an endemic illness in a culture, keeping in mind the seamless web that connects us all is essential.  The foundation of Judeo-Christian ethics has always involved a focus on the common good.  With that in mind, I came across a meme that I have used a few times when asked about my habit of mask wearing whenever I am in a public indoor space.  I start by sharing the very personal news that I am actually a nudist.  I like to live my life naked.  I then go on to explain that, unfortunately, I have developed a problem with incontinence.  I began to notice that I was accidentally peeing on all of my friends, so I decided to wear pants.  The moral of the story is not hard to divine.  To limit the space of COVID, making decisions based upon the common good is essential, even when that requires setting aside convenience.

I don’t know, but I have been told that somewhere in some obscure county in Ireland, there may exist a medieval monastery with an old and wise inscription that would serve us well in our current circumstances:  “Noli Esse Asinus Foraminis.”  It’s been awhile since I took Latin, but it seems to me that whatever helps to relate to our neighbor with a slow-to-react spirit could go a long way in limiting the space of the emotional-spiritual aspects of this disease.  

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