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Reclaiming autonomy

A few weeks ago, I ran into a transplant surgeon friend whom I hadn’t seen since the beginning of the pandemic. We discussed how we really weren’t that psychologically affected by the restrictions until recently; the first six months hadn’t been that much of a hardship in terms of cabin fever. But now, at the six-month mark, we were really missing interactions with friends. Even though, in pre-pandemic times, we might not have accepted every invitation or gone to every event, we now are denied the ability to say yes to any of them. Our options have been removed and our autonomy restricted by a tiny virus over which we have little if any control.

Loss of autonomy. I think that’s the core of the psychological distress that the pandemic has induced in each of us to various degrees. You may have always wanted to go on vacation to Borneo or Russia or Italy or the Galapagos but put it off year after year with the thought “I *could* go, if I really wanted to!” This year, the pandemic has stolen your dream entirely. There’s no chance of that fantasy travel ever becoming a reality in 2020. Your wings have been clipped. You feel trapped, even though in all likelihood you probably wouldn’t have taken that trip anyway this year.

We as physicians have been feeling loss of autonomy in our professional lives for decades now, so we are somewhat used to the feeling (and resultant frustration). While for some that might make the loss of personal autonomy less shocking, many others may feel it more acutely because freedom in one’s personal life and choices make loss of professional autonomy more bearable.

Remember to be grateful and count every blessing. Relatively good health, food on the table, a roof overhead and paying work cannot be taken for granted. Most of us have it much better than the others in the service, restaurant and entertainment industry who have lost their jobs and health insurance and for whom survival is at stake. Let’s try to use whatever autonomy we do have to lift these sectors up.

Weddings have been postponed; proms and graduations have been cancelled or curtailed. College dreams have been altered. Births and birthdays have barely been celebrated, and funerals have been held in obscurity. Nothing is as we expected or wanted, and it’s not only OK but necessary to grieve in order to heal. Just as we need to give ourselves permission to grieve the loss, we also need to give ourselves encouragement to dream, to plan and to look forward to life after the pandemic. This is what will keep our spirits buoyant while we do the hard work and make the sacrifices of today.

How to cope? Reframe the situation. Reclaim your autonomy, even if it’s in small ways. Keep your sense of humor.

  1. Can’t travel? Spend time with your loved ones planning a reunion or trip to be taken (with no set date) after the pandemic has subsided. Research shows that the act of planning a trip often brings more happiness than going on it. Give yourself an adventure to look forward to when things start to normalize.

  2. Have to wear a mask? Of course, we all do in the interest of keeping our fellow humans safe and staying safe ourselves. If you’re female, rejoice in the fact that make-up is no longer necessary or expected and in fact will do nothing but dirty your mask. If you’re male, rejoice in the fact that you can sport a massive five o’clock shadow and no one will ever know. A mask is a great leveler.

  3. Can’t wear formal clothes to work for fear you’ll bring the virus home? Celebrate that it is now acceptable for physicians to wear full-time scrubs or more comfortable and casual clothing which can be easily washed and sanitized. Think of the money you are saving on your dry-cleaning bills! (But do keep dry cleaners in business – send them your household items to clean instead if you can).

  4. Can’t go out to eat? Get takeout from the best places in town and keep them in business so you can enjoy dining in person when the pandemic is over. Have a family “restaurant night” where you attempt fancy dishes yourself. Lady and the Tramp accordion player optional; giant meatballs are your responsibility.

  5. Have to see all your patients via telemedicine instead of in person? Wear a professional shirt with sweatpants and bunny slippers. We won’t tell on you.

  6. Can’t have socially distanced dinner or get-togethers with friends in person as the weather gets colder? Have Zoom dinners. You can even send a menu out in advance or order takeout so everyone has the same dish. Have a movie night: Watch a comedy or action/adventure movie together on an app like Discord where you can all chime in with snarky comments by voice or text.

  7. Craving lots of social contact? Organize a Zoom cocktail party complete with breakout rooms for smaller conversations. Have theme nights, complete with costumes.

  8. Remember, the outdoors isn’t cancelled; many great fall outdoor adventures await you. If nothing else, even a drive in the crisp air to see the autumn colors can be invigorating.

  9. Be active in your community from home via online forums. You can still effect positive change, correct injustices, bring attention to problems that need to be solved, and help others from your home computer. Look for ways to help your fellow living beings whether or not the practice of medicine is involved.

  10. VOTE on Nov. 3. Voting is the ultimate expression of autonomy; no matter which candidates receive your vote, please be thoughtful and exercise your sacred right to have your voice heard. No one can take that away from you. If you are mailing your ballot, follow the directions with care and place it in the secrecy envelope before the external mailing envelope. If you are voting in person, take precautions and wear a mask.

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