Warmer weather has arrived for me in Morgantown, WV. I began Neurobiology two weeks ago, and I am really loving it. Due to the current COVID-19 pandemic, my whole course has been moved to online. Lectures have been fairly easy to adjust to with professors answering questions so quickly! I am learning about diseases such as Multiple Sclerosis and Guillain-Barre Syndrome. It is really amazing how everything connects and tiny abnormalities can manifest as huge clinical issues. Labs have also been adapted to an online setting. The hardest part is visualizing the brain as a 3D structure from 2D images and understanding how the blood vessels twist and turn around the gyri. It definitely is not the same as being in the lab, but I can tell that my professors are doing everything they can to make it work.
My daily routine has certainly changed since the start of the West Virginia “Stay at Home” order. When I was still able to go to campus, I would wake up before 6AM to attend an F45 exercise class at the Student Recreation Center. This is something that I miss so much. I miss seeing all of the “regulars” and many of my classmates in that workout class. It was also a good way to my blood pumping for my long day of studying ahead. I would then shower at home, pack my lunch, and head to campus for class. I loved to eat lunch with my friends in the Market and take little walks as study breaks when needed. I typically ended my day in the library at 7PM and headed home for dinner with my sister and roommate. I made sure to go to bed before 10PM, so I would be ready to do it all again the next morning.
Since transitioning my studies to my townhome 6 weeks ago, I made sure to keep myself in some sort of routine. On a typical day, I wake up at 8AM and have some breakfast while I watch the day’s lectures. I take a break around noon for a workout followed by lunch. I spend the rest of the day outlining and reviewing the material from the class. I am fortunate to have my sister living with me to keep me company. We go for walks, have dinner, and watch some TV before bed. I try to hit 10,000 steps on my Fitbit every day. It is not easy to do without consciously trying. I am constantly checking the weather for the best hours of the day to walk or a run in the neighborhood. It is so important to get some fresh air.
2020 thus far has been an unprecedented time. People are losing their lives to a deadly virus. People are losing their jobs, homes, and businesses. Concerts, sporting events, and weddings are being cancelled. It is certainly hard to find any glimmer of hope with so much uncertainty and inability to find things to look forward to. The toll that this pandemic is taking on the mental health of so many people is something that should not be overlooked. Many people who were foreign to the feeling of depression may see it overtaking their lives. Many people who were typically calm and collected find themselves anxious and on-edge as they draw near others in the grocery store. It might be hard for many to find a purpose when sitting at home all day without work. There may be new stress attributed to the new task of homeschooling their kids or being constantly worried about their loved ones in the nursing homes.
In a recent article published in JAMA, Reger et. al (2020) outlines a few factors of this pandemic that may be influencing the mental health changes and suicidal thoughts of people today. These factors include economic stress, social isolation, barriers to Mental Health treatment, suspension of religious gatherings, and 24/7 news coverage. Certainly I can think of how each of these factors has influenced my well-being as a medical student. I think every individual is susceptible to varying degrees of each factor. Everyone is coping with this differently.
This pandemic is taking its tolls on people I would have never imagined. What about those “healthcare heroes”? Last week, one of New York’s top E.R. doctors took her own life. This story particularly resonates with me because she was a young, female physician. According to a New York Times article, she was a lively, outgoing extrovert with close bonds to her sister and mother. She had no history of mental illness. No one expected her to leave the world in this way. However, she was a part of a special population that might have needed support dealing with loss, inability to see family, shortages of personal protective equipment, and stress from long shifts.
So what is there to do about this mental health crisis?
First, we should remember that social isolation means physical isolation. We are fortunate today to have technological advances that allow us to keep in touch with each other. We have FaceTime, Skype, ZOOM, and so much more. And a lot of these media platforms are free to use. So check in on friends and family often. Maybe call that cousin out West that you haven’t talked to in a while. Let them know that they are important and have your support. Reminisce with them. Remind each other that it is okay to not be okay. Someday we will get through this and hug each other once again.
Second, consider reducing the amount of media COVID coverage that you are getting. You should stay informed about the world happenings, but some new outlets are revealing some information that may be too raw for significance. Watching the news all day can lead to conflicting information as it spills in by the minute. I am a big fan of the Nightly News with Lester Holt as a free podcast. There is a “kid’s version” as well where they talk about summer plans and how COVID-19 affects pets. I find it to be very reliable media source. It is a quick 20 minute listen while I am out for a walk or run. It is also important to be up to date on local happenings. I read the daily WVU Medicine emails and guidelines on what is happening in my city.
Third, reach out to professional for emotional help if needed. Please remember that everyone is going through this tough time together. Physical distance shouldn’t keep us apart. Being depressed, lonely, or suicidal at this time does NOT make you weak. It makes you real. You hurt when the world hurts. Those who seem to be the strongest are struggling with this too. So if you’re feeling depressed or down, reach out to your physician. They may recommend a psych consultation, which could be a really good thing! And in the meantime, continue to take your medications as your doctor prescribes, and follow up with your PCP if you are mentally or physically not well. If you cannot attend a scheduled appointment, ask how these appointments can be done remotely. Our healthcare system has many resources to make Telemedicine happen. It is a great option for many. It is up to you, the patient, to seek out the help you need!
Personally, I have school to keep me busy constantly. My purpose remains – to learn about medicine so I can someday be a “healthcare hero”. But there was a week of spring break in April where I felt so unlike myself. I had nothing better to do other than sleep, eat, and watch Netflix. It was an odd feeling of pointlessness. And still three weeks later, I get a little disappointed when I cannot see my family and friends. I cannot give hugs and baked goods to my neighbors. I get my happiness from making other people happy. My ways of sharing this happiness will just have to change.
There are two essential parts of my wellness that I hold onto in my weekly routine. The first is exercise. My dad helped me turn the garage into a workout studio. In our little gym we have dumbbells, yoga mats, ankle weights, and an exercise ball. We took some old carpet and laid it on the floor, and I filled a milk crate with some textbooks to lift. It actually works really nice! I need to get myself moving every day. It helps to pass by the time and is so good for my focus and attention as I study. The second is my faith. I have a core group of girlfriends in medical school who have been such rocks for my spiritual life. Every Sunday we get together over ZOOM to read some bible passages and check in on each other. It is so uplifting to read God’s word and hear God speak words of truth and encouragement through my peers. Click here for a link to a bible study I wrote for this time of the COVID-19 pandemic.
There are moments when I wish I could just fast forward to 2021 because I feel like I just go through the motions every day —sleep, study, eat, repeat. And in all of this I ask myself three questions. How is COVID-19 going to make me a better person? How am I going to figure out what kind of doctor I want to be when I cannot see patients? How am I going to grow through all of this?
I never thought that my future as a physician would put my own life at risk someday. It is like physicians and health care providers are the soldiers going to war. I have a mentality and motivation to learn and observe so that I can become a true help in the future when my medical training is finished. I strongly believe that mental health is topic that should be talked about more often. Not just by celebrities on award shows or in the news when someone famous passes away. It should be talked about in schools and clinics and PTA meetings. Having a good mental health helps us to find purpose in life. It motivates us that we can and will be better. I watched so many loved ones deal with depression and anxiety over the years. And now more than ever, I feel like my calling in life to advocate for mental health patients has become so real.
The article by Reger et. al (2020) closes with a “silver lining” to the COVID-19 pandemic. They write
Suicide rates have declined in the period after past national disasters (eg, the September 11, 2001, terrorist attacks). One hypothesis is the so-called pulling-together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening social connectedness. Recent advancements in technology (eg, video conferencing) might facilitate pulling together. Epidemics and pandemics may also alter one’s views on health and mortality, making life more precious, death more fearsome, and suicide less likely.
I am hopeful that we will all get through this together. I am thankful for those health care heroes who are risking their lives every day to save others. I am thankful for those grocery store workers who stock those shelves and clean those carts so I can be safe and healthy. I try to count my blessings every day, uncertain about what the next day will bring. But by doing my part as a good daughter, student, friend and neighbor, I can help society recover from COVID-19 mentally and physically. Together we can “pull together” and come out of this better people, physicians, neighbors, and Americans.
Reger MA, Stanley IH, Joiner TE. Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm? JAMA Psychiatry. Published online April 10, 2020. doi:10.1001/jamapsychiatry.2020.1060
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