I’ve been washing my hands a lot this week. Transiting through an airport, a task once done without thought, suddenly seems like tiptoeing through a minefield of COVID-19. Like probably many of you, questions have been running through my worried mind: Who has the virus? Do they even know they have it? Does it even matter? What if I get sick and give it to someone vulnerable? How widespread is this going to be? Are we all going to get this damn thing? Who will live, who will die?
I try to look at this problem through the eyes of the scientist I was trained to be. There, I can find some comfort—it can be a nasty bug, for sure, but for many who become infected, it will probably pass through them with nary a thought. Of course, those with mild cases need to be responsible to avoid passing on the virus to others who may not be as resilient.
There is also comfort to be found in the data—for example, children seem relatively protected from this virus. But then I look at the media and find nothing but fear and panic. It seems as if a comet filled with coronaviruses is on a crash course for the earth and there is no escaping our fate. Missing from this panicked narrative is that we still have choices in how we respond to the crisis.
We’re told that beyond washing our hands well, not touching our faces, and staying home if we’re sick (common sense advice if there ever was any), the next best thing we can do is to engage in “social distancing.” Meetings are happening online. Conferences are being canceled. Flights are leaving half-empty. People eye each other with suspicion over the tops of their (useless) surgical masks. Even a mindless throat-clearing is met with wariness by passersby. The enemy seems to be everywhere, and nowhere, and the enemy is us…or the other guy.
The stoic Roman emperor Marcus Aurelius said “You have power over your mind—not outside events. Realize this, and you will find strength.” To control our minds, we have to be selective about what information we engage with. Moments like this are filled with hysterical and often inaccurate reporting. Speculation runs wild. As health care providers, friends and family will look to us for guidance. Can we be thoughtful, measured, and rational while at the same time realistic?
This event is going to disproportionately impact those of us in health care, particularly nurses and other professionals on the front lines. Not only will we be managing the fears and uncertainties of our patients; we will also be managing our own. Undoubtedly, an underprepared and overtaxed health care system is going to impact us all, directly or indirectly.
While this is an infectious disease crisis, it is also a deeply human crisis, and in moments like this, psychiatry will be essential. We will be needed not only to help our patients and the public manage the anxiety of this uncertainty, but also to guide our colleagues who will undoubtedly bear witness to much fear, grief, and suffering.
One thing is clear. We are the threat and we are the solution. Aurelius implored us 1900 years ago, “The impediment to action advances action. What stands in the way becomes the way.” The impediment to action right now is fear and hysteria. Reason and human decency are the way through. How we navigate this collective threat will be not only a commentary on the strength of our society but will at the same time highlight, in bright outline, all of our shortcomings.
A clarion call for courageous action beckons. How do we answer? How do we find the grit to continue despite our fears, to be our best selves, and to get ourselves through this predicament that we’re all in together? What story will be told of these challenging days?
Let us meet this challenge with clean hands, sharp minds, clear eyes, and open hearts.
Andrew Penn, RN, MS, NP, CNS, APRN-BC was trained as an adult nurse practitioner and psychiatric clinical nurse specialist at the University of California, San Francisco. He is board certified as an adult nurse practitioner and psychiatric nurse practitioner by the American Nurses Credentialing Center. He has completed extensive training in Psychedelic Assisted Psychotherapy at the California Institute for Integral Studies and recently published a book chapter on this modality in The Casebook of Positive Psychiatry, published by American Psychiatric Association Press. Currently, he serves as an Associate Clinical Professor at the University of California-San Francisco School of Nursing, where he teaches psychopharmacology, and is an Attending Nurse Practitioner at the San Francisco Veterans Administration. He has expertise in psychopharmacological treatment for adult patients and specializes in the treatment of affective disorders and PTSD. As a steering committee member for Psych Congress, he has been invited to present internationally on improving medication adherence, cannabis pharmacology, psychedelic assisted psychotherapy, grief psychotherapy, treatment-resistant depression, diagnosis and treatment of bipolar disorder, and the art and science of psychopharmacologic practice.