day 1 of journaling, day 18ish of since that first campus-wide email: I have a lot of fears. I fear nothing but God, I exclaimed in a spoken word piece in 2016. about my parents dying in a untimely way. about writing. about pandemics. about being ignorant or unloved. I think in loneliness, in the silent solitude that never was deafening than it is now with barren cities and untrodden streets; I turn to words.
Reading and writing, as I have mentioned elsewhere, are conversations I can have with myself when I am in the unfortunate postion of not having a captive audience (i.e., my housemates or my sisters or my friend who made the naive mistake of finding me quietly, moodily brewing). I think I teeter between extroverism and introverism, only halfway comfortable with seculsion.
Good writing is probably not this reactionary behavior. but if you’re here (Come as you are) reading these thoughts of mine, may be you’ll be amenable to it’s lo-fi reverberance. The rules, standards, and expectations of society have changed, and by all means, will i be experimental, reckless with this piece of my day that doesn’t necessitate a commitment to ritual. wash your hands for 20 seconds. I have done quite well to follow routines, and new years resolutions, but this evening, as you find me, thinking of Rhett Butler’s unpalatable character but mic-dropping, noire film line: I don’t give a damn (about proper sentence structure).
I do care about a lot right now: my community, solidarity, the fate of our world, and existential thoughts that keep me up, thinking of what one ought to do with life.
a few weeks ago: I saw the headlines change: The outbreak in Wuhan got the designation of the pangolin/bat-hybrid coronavirus which revealed itself as COVID-19 and then slowly and all of a sudden a pandemic. I read the news often and knew there was infectious mischief pervading the Eastern hemisphere. Though, China seemed to have it under control. In January, I asked my friend whose family remains in China how they were, whether if her partner would be back post-Chinese New Year. I told her I was sorry about the xenophobia, the racism that was spreading. Some time later, I remember sitting in a room full of medical students, learning about pulmonary function tests, when in a dull moment, I remembered the morning headlines. I exclaimed how suprisingly fast the virus has spread and no one wanted to talk about it but her. I read articles about college students being quarantined after international trips, and discussed the ethics of quarantine with friends, whether it was a just public health measure or an insult to their autonomy. We talked about if colleges were doing enough to combat the racism Asian students were facing. I remember thinking that it, like other viruses, wouldn’t advance as far as it has. And later, sitting at a dinner with academics and physicians, post-lecture on the COVID-19, I learned that it was simply a matter of when schools would be shut down, our economy would take a hit, and life would be different. My dad texted me about a community WhatsApp chain, testifying to growing anxieties. I stayed up until 3 am reading about ethical responses to COVID-19 on a Friday. That night a patient with coronavirus attended a graduate student party, and the medical school students gathered in mass for our annual Skits Night.
Perhaps, it’s hard to absorb the impending doom when you’re drinking from a fire hydrant that is medical school, but I think I believed and still believe that we can persevere. Accepting doom somehow meant giving up on hope. I thought if it affected one country so much, it wouldn’t affect others as much —not because we were any better, but because we would have the privilege of learning from example, of having the gift of time.
an aside: Intro to Ethical Responses to COVID-19
Emergency public health responses raise some of the thorniest ethical questions, converging issues like that of autonomy, transparency and justice in the context of heightened global stress and limited information. In reading and attending lectures (s/o to Larry Gostin), I’ve summarized a few ethical issues (the list of ethical issues is much longer: disease containment, balancing human rights and public health, etc.)
- Navigating the cordon sanitaire (like the one implemented in Wuhan/Hubei): Cordon sanitaire refers to the restriction of movement and mass isolation within a defined geographic area, while quarantine is similar but more limited to groups. Quarantines must be (1) proportional, (2) reciprocal, and (3) effective. (1) The principle of proportionality holds that interventions should be necessary and proportionate to the threat posed, meaning the public would not be protected by a less invasive measure. (2) The principle of reciprocity requires society to provide necessities, from medical and psychological care to humane housing. A just quarantine is also one equitably applied to everyone (@celebrities). (3) Any quarantine must also be effective in achieving its aims. Broader and less targeted, cordon sanitaires require higher logistical burdens and, in my opinion, should be more strongly scrutinized against these ethical requirements.
- Allocating scarce resources: Several companies, countries, and institutions have redirected efforts to create a vaccine for COVID-19. If a COVID-19 vaccine is developed, who should get one? Ideally, everyone, but catastrophes are plagued by scarcity. Ultimately, resource allocation should alleviate human suffering and prevent death. The ethics of allocation is varied in its interpretation of how to best do that. Some may consider random allocation: first-come, first-served. In public health ethics, distributive justice is more popular. It holds that resources should be expended equitably with particular attention to the most vulnerable. Historically, resources are usually allocated by need. Those with the greatest need have been those most likely to die or those who provide critical services, such as health care workers. On a global level, the fair and equitable distribution, as described in the Pandemic Influenza Preparedness Framework, requires that resources also be distributed in low- and middle-income countries that may not be well-positioned to acquire or create those resources themselves.
- Autonomy & the Right to Be Informed: Governments are obligated to their citizens via the social contract that requires the state to protect the interests and security of their citizens. The state has the responsibility to keep its residents reasonably informed of the danger and progression of an outbreak. In the widespread misinformation plaguing our lives today, this may be of the more difficult responsibilities to fulfill. Before an outbreak, championing autonomy requires planning to minimize social, economic, and political consequences, while also fostering trust and transparency through community participation. During an outbreak, citizens deserve to know how they can protect themselves. The government should be transparent, so people can make an informed decision that will affect themselves. Vulnerable populations deserve particular protection, as they are the most likely to suffer when civil liberties are compromised for the public’s benefit.
a week ago: Colleges are shutting down. My English professor from College wrote a beautiful eulogy for the campus narrative. America should be shutting down. I am in finals week, studying interrupted by progressively urgent emails from the college, urging us to wash our hands, stay home at sick, limit groups to 150 then to 50 then to socially distance. Six feet apart and all I want is a hug. I read an article that discussed respiratory failure in patients with coronavirus as a study-break from studying for for respiratory exam. Fibrosis, shortness of breath, air hunger, a lonely death. Overwhelmed by the chaos of what feels like a slow demise, a slide into dystopia, I veered towards optimism and wrote, rarely have I since the last Presidential election, on Facebook, trying to urge my friends to not feel like victims to this calamity that would deny others more than what we’ve lost.
Social distancing ≠ isolation.
You can still be social in small groups*, your housemates & family…in fact, you can pick up the phone!Things are being canceled to save lives. This upheaval is alarming, inconvenient, and confusing. It’s a tough and unprecedented time. But we can adapt, be kind and altruistic. We can look out for one another and help each other in more ways than we know. We can see this through.
Do the small things
*a clarification: please of course limit your contact with people and use common sense. Stay at home. Transmission among family members and close contacts will be high. Keep a physical distance from elderly folks and those who are at higher risk (or people in general since you probably can’t tell who is at high risk) but check in on them (via phone, etc.). Limit unnecessary travel. Wash your hands!
the day of cardiology and respiratory finals: A couple of days ago, we as students, having already decided, waited on the adminstration to make the decision to cancel our spring break, service trip to the Native American reservations in Northern Minnesota. We had planned mutiny if we were encouraged to go. Aside from considering a historical undertone of small pox blankets, the math was simple. We would be receiving all the benefit of learning, and the people on the reserve would be accruing all the risk (i.e., the risk that we could bring the virus to areas otherwise insulated). Th dean entered the room and informed us that we would not be going. And at that moment, I felt loss in accepting the right decision. Many of my classmates canceled their trips to warmer climates; others packed their bags. Exhausted by four hours of exams, I had lunch at home, a coffee, called a few old friends, and drove down I-93 home to return to my family. I listened to music that worried about things I used to find inundating but now, in comparison, find relaxing.
the past few days: A friend and I have spent our 9ams, chatting over coffee, on the phone, feeling helpless with our lives moved online and our spring semesters that promised so much dissolve. We predict chaos on Zoom and wonder about the next time we’ll be in the same place. We’re working on community organzing:
We developed a Google form to collect information from people who are in need OR people who can support others through ways that minimize contact (e.g., dropping off groceries/mail, or providing friendly phone calls to isolated community members). The goal of the database is to connect people who are in need with people who are willing to help in the area.
Please feel free to share this information if you would like:
Public Facebook group link (where future updates and the directory will be posted): https://www.facebook.com/groups/213069193241618/
Google Form (for expressing the ability to support others or any need): https://forms.gle/MLJvFRVHewo2DebG6
We’re wondering if you could let us know if we could help or individuals that we can reach out to in supporting or engaging via this community effort. We are energized, passionate, and motivated to give back to and help this community in any way that we can. We welcome all feedback and advice!an email excerpt
Over my spring break, I’ve sat in on medical school Zoom meetings and undergraduate efforts to create new educations. I’ve read the efforts of many to provide for their communities, to move the science forward, and do their part. I am so grateful for all those who have adapted, risen to the challenge, and put the needs of others before their own. I am so grateful for what are exceptions but should be the norm. I am in awe of humanity, so much that my heart and body aches in its expected loss.
today: since I’ve been home, I’ve learned once again social media is draining, but also that people’s responses to the virus are varied from self-redeeming vacations to powerful calls to stay at home / from buying toilet paper in bulk to reaching out to isolated communities to offer help. I have not hugged my parents or sat close to them, out of the insidious fear that I may be an asymptomatic carrier of the virus, that I may have inadvertently picked up from a campus that now has cases, so gently harbored in the warmth of my body and so carefully hid behind general well-being. I shouldn’t have come home. I listen to my family’s coughs and sneezes suspiciously, and perhaps have washed my hands to fault of rough, breaking skin. How do I reckon with this fear of the unknown? I listen to my father, on the phone, urging people to stay away from congregation, to keep home and worship, people who are desperate for community, people who do not know how much their fear will cost. Now, I am praying, meditating more to ease tension headaches and to know of, sit with all of those fears. And I am writing: writing out of my own need to express myself, my own desire to connect through this shared experience.
my bedroom ceiling is bare now, the white canvas, it was painted so thickly that the brush strokes still testify to the painter’s sweeping motion a decade and a half ago. for some time, it was covered in glow-green stars, carelessly placed, but still reminiscing the galaxy a few floors above. there’s a bird house that replaced a tropical Santa clause harlequin that competed for attention with the glass ballerinas, which danced a different show with each gust of summer air. and there were dreams I saw on the ceiling, the thoughts I had projected in mirages and mosaics that reminded me of the fields of Monet. my gaze is soft, but my mind unaccustomed to meditation, I find peace in the constant background of my bedroom ceiling, despite the distractions, as I lay in bed wondering as I always have of what tomorrow will bring. 03/17/2020 - unedited
tomorrow: I pray that my loved ones do not fall ill or to an untimely death. I pray that we all stay healthy and loved and of common sense. I think of those people who I do not know, who are struggling and unseen. I worry for healthcare providers like my father, and what to do with all this data. I do not fear for myself, but I am overwhelmed by the possibility that I cannot care for others, that I cannot protect them from something so small, so strong that it has changed life as I knew it. I hope we can learn and rebuild, and that the worst case scenarios I talk about with my friends are nightmares at most, realities unrealized. InshAllah.