A New Kind of World War, And the Soldiers We Must Support

“After this is over, we are going to have a lot of doctors with PTSD.”  My friend made this statement toward the end of one of our video conferences.  The group of roughly 20 men that I meet with to discuss faith and life, has been discussing the coronavirus and how we are managing our lives on this new frontier.  About half of the participants are physicians, many of them on the front lines of this war against an illusive enemy.  We heard the stories from China and Italy, then New York and California.  The virus has advanced its front line to Chicago.  Some of these physicians are amongst the best people I know, and after a few very frank conversations, a couple things became very clear.  First, they are very scared.  And second, this virus will change their lives much more than it will change for most. 

Legitimate and Necessary Fear
They are literally heading to the front lines, sometimes on a daily basis and very frustrated with people who don’t take this virus seriously. They are scared for themselves, and scared of bringing this virus back to their families. If they infected their spouse or parents, they know the reality that could ensue and the tremendous amount of guilt they would have.  Many don’t have the choice of working from home.  Just like times of war, despite all the technology, we have to have “boots on the ground” to do the necessary work to win this thing, or at least minimize the casualties.  Having a healthy amount of fear can be very effective in maximizing our alertness, energy, and attention to detail.  All of these are necessary in the trenches. No matter how much faith one has in God, in government, or in the healthcare system, if the coronavirus touches your life, you may lose faith in one of them.  

The Immediate Effects

Exposure to trauma can bring about negative thoughts about oneself or the world, which could include blaming others or rejection of previously held values.  This is common in post traumatic stress disorder.  For all those on the front lines, including all other healthcare professionals and hospital workers, they and their families are reflecting on their mortality on a daily basis.  This actually isn’t that much of a surprise, given that many doctors have come out and shared their stories on the internet from around the world. So, why is being a healthcare worker in a pandemic so unique?  

The Vietnam War And Its Unique Trauma
As my friend said, I do fear that many healthcare professionals will struggle with at least some symptoms of PTSD, if not a formal diagnosis.  As I thought about his statement, I remembered a book I read in graduate school.  Achilles In Vietnam, by Jonathan Shay was assigned reading when studying PTSD.  In the book, the author discusses why Vietnam was so particularly difficult for veterans.  Along with the usual trauma of war, Vietnam had some unique characteristics. In his book, he talks about how many Vietnam veterans had the unique experience of feeling betrayed by their government due to insufficient support of military backup and/or supplies.  Also, it was a unique war because they often were unsure who the enemy was, and they were fighting in unfamiliar terrain.   And when our soldiers returned, they were ridiculed and spit on. 

The Parallel Experience of the COVID-19 Healthcare Worker
So far, every one of these scenarios has been parallelled in this war against COVID-19.  We heard our president call it a “hoax” and tell people it would “magically disappear.”  We have had equipment shortages around the world.  Hospitals are fighting an invisible enemy, one that science hasn’t fully grasped.  They are having to make difficult decisions, like cancel elective surgeries, and decide who gets the ventilator, only to be critized by patients and their families.  They are watching patients die alone, without families, because they are trying to protect the survivors from contracting the virus, only to be chastized by those same people for not calling them to the bedside soon enough.  Whether you are losing lives because of poorly built M-16s or insufficient N-95s, the effect on the front lines can be the same; lost lives and feelings of abandonment. 

The Shift Ends, But the Effects Do Not
Then they drive home only to see and hear stories of people continuing to gather in large groups, ignoring shelter-in-place orders, putting them and their families at further risk.  Just like so many stories of war veterans, they go home and isolate themselves from their families, partially out of fear of infecting them, and partially because they need the time to physically and emotionally recover...because tomorrow they will have to do it again.  It would be wise for us to remember that the number of times we send them to the front lines will depend on our ability to stay home as much as possible.  If you are a spouse or a family member of a healthcare worker, please educate yourself on the symptoms of PTSD, and encourage our heroes to seek help as needed.  

Shaken Faith and Doing Our Part

Seeing good people die can shake your faith.  We see this with many soldiers after they go to war.  They see friends and innocent people dying, and it challenges their sense of a merciful and compassionate God.  Sometimes it results in a loss of faith.  However, the loss of God at a time of pain and healing, can lead to heightened feelings of loneliness and hopelessness. This time will test your faith, your patience, and your compassion. This has been a lonely time for many.  Indeed, many of my clients are expressing strong feelings of sadness, anxiety and boredom as they work from home, or take online classes.  We are in a new kind of war.  I salute veterans who have fought for our country in past wars, and I salute those who are on the front lines fighting this war against COVID-19.  Just as our citizens have supported our troops in the factories and natural resources industries, we need to support our healthcare workers and all who support them.  Stay in your home. Be vigilant about how you are interacting with people. Tell your friends and family to stay home. Thank them, and other "essential" workers.  Of course, wash your hands often.  And when this is all over, and we no longer need to be socially distant, let's have a parade for them.  

Darkness Is the Absence of Light.

     Paralysis. That's what it feels like. As a clinician, I sometimes wonder if our whole nation is suffering from Post Traumatic Stress Disorder (PTSD).  I wonder if all these articles and images that we are exposed to are causing secondary trauma. No. I don't wonder. I'm sure of it.  It's a feeling of sadness, fear, anger, hyper-awareness, the desire to isolate yourself, or poor memory. I couldn't get myself to watch the video of Laquan McDonald getting shot.  It filled up my newsfeed, but I was scared how it would affect me. I didn't need to see it.  I believed what I read. I believe that there are some police officers out there who abuse their power and do unspeakable things especially to the least empowered in our society.  And I also believe that there are people in our world who are religious and political extremists, and commit crimes against innocent people.  These are facts. But the most important fact is that most people of faith, most politically involved individuals, and most police officers put their shoes on in the morning just like the rest of us. They are pursuing their dreams and goals, desiring to live peacefully, and are making positive contributions to our society.  And many of them are on the front lines of preserving our health and safety. But with the constant bombardment of videos and political rhetoric, we can have the impulse toward isolation and protection of our own, which entrenches us further into the feelings of sadness and helplessness that comes with trauma. Even worse, it can result in anger.  This doesn't help you or your society.  

      I'd like to suggest that there is a solution.  Get off of social media. Connect.  Start with this weekend.  Make time to talk with your families. Spend time connecting, loving, holding, smiling with each other.  Next weekend, invite your neighbors over for tea and dessert.  The next weekend, reach out to your a local church, mosque, temple, police station, fire department, etc.  Perform an act of kindness. Say, "Thank you" for their contribution to your community, to keeping you safe, or just to smile and laugh together.  They need it.  You need it. Your psychological and physical health depend on it, and the health of this nation will be better for it.  Therapists are trained to be aware of, and to appropriately handle vicarious trauma.  After hearing the stories of many people who are struggling emotionally, or who have been affected by their own personally traumas, it can have a psychological effect on the therapist.  Most people are unaware of the creeping effects of vicarious trauma that all the negative videos and articles are having on them. Some faith based, and community based organizations are already organizing interfaith events with the goal of building bridges and peacebuilding.  Please don't wait for them.  Good people of the world, we are not helpless bystanders in this horror movie that has been occurring.  History has proven that one person, or one small group of people can indeed make a change that alters history.  We can keep asking the questions, "What is happening to this world?" or "What is wrong with people?"  These questions tend to push us away from the table. Let's instead take a firm seat at the table and spread the good that we have within us.  
     My third grade teacher, Sister Shirley, taught me in a song, that "Love is something if you give it away. If you give it away, you end up having more.  It's just like a magic penny; hold it tight and you won't have any. But lend it, spend it, and you'll have so many, they'll roll all over the floor."   Now is not the time to be misers with our acts of kindness, empathy, and compassion.  It is time to let the light shine in and the light flow out.  Now, would you like coffee or tea?  

A Love Letter

I’m not sure how to say this perfectly, so please just listen.  

This year has been a tough one.  We have been together now for a long time, and I thought you had changed.  I remember, several years ago, you were very cold; so cold, you’d take my breath away.  You would become cold, and stay cold for months. And you just looked a mess.  I was young then, so I didn’t mind, because I knew you would come around.   Actually, I rather enjoyed the change of pace, and the challenge of weathering the storm.  I knew that eventually, you would be showing me the best side of yourself; the warm, welcoming, radiant side.  I thought that our relationship had matured.  I admit that I would explain to the younger generation, that they didn't know you like I do, and that they don’t know what commitment is because they leave as soon as they have any turbulence in their life.  A small part deep inside of me very much appreciated your changes.  Regardless of the cause, I mistakenly thought you had grown to understand that such extremes are dangerous to any relationship.  In fact, just last year, I was telling everyone how good you were to me, with much less severe reactions to this changing world.   Now, I understand that every relationship will have its setbacks.  But this year!  This year was brutal!   This was a year that cannot be explained with the classic defenses of moodiness, hormones, the economy, work stress, or even old age.  You were relentless in your series of storms followed by bitter cold, followed by more storms, followed by long stretches of even more frigidity.  I started to feel as though we would never be warm again.  I started to feel as though you forgot HOW to be warm.   I have talked with many people, who tell me I should just leave you.  They all say that I deserve better.  They say that I could just pack my things, and start a new life somewhere else.   It was unanimous.  I eventually started to agree that my life would be better without you.   And then it hit me, in an ever so subtle way.  As I got out of bed one morning and made a grunting sound because my back was tight, and my knee ached, I realized that perhaps you haven’t changed.  As my son looked outside with excitement on a snowy April day, I realize that perhaps I've become weaker and less forgiving.  Perhaps I have changed.  Perhaps, you were just being true to yourself.  Am I really that noncommittal that I can’t take one bad season in 30 years? Surely, I haven’t always valued you as much as I should.  All those summers have passed that I didn't visit you even once.   I could have taken a romantic walk on the lake, or spent some money downtown to show how much I appreciate you.  I apologize for those times I woke up cursing you because I was going to have to shovel snow before going to work.  I apologize for talking so badly about you to all my friends.  I apologize for thinking I can do so much better than you.  But most importantly Chicago, I apologize for thinking that this miserable winter was entirely your fault.  Surely, I have changed over the years as well, and I should be aware of my own shortcomings and how my own weaknesses have contributed to my unhappiness.  I look forward to the next six months together, with the hope of spring flowers, summer sunshine, and fall colors.  After all, Chicago, you were just being your unpredictable, ever-changing self.   But honestly, if next winter is anything like this one, YOU MAY NEVER SEE ME AGAIN! 

His Name Was Perfecto

  His name was Perfecto Ochoa.  He was born  in Woodward, Texas on June 13th, 1924. The town doesn't actually exist anymore.  From what I understand, Woodward's population dwindled in the 1930's and declined to ten residents by the year 2000.  My grandfather's family had at least two ranches in the area.  He would often tell us the story of how his parents would go to one ranch and leave him with a rifle, a horse, and  a bag of frijoles.  He would hunt animals for meat, like birds and rabbits, but he would remind us that he was only around nine years old and he would spend many nights alone and crying. During the great depression, his family traveled the U.S. looking for farm work.  They went from California to Michigan.  Somewhere in there, like many Mexicans who owned land in Texas, they lost their land to the government due to some tax or law they didn't know about.
    Let me be very clear about something.  My grandfather's first language was Spanish.  However, as far as he was concerned, he was Tejano.  He never referred to himself as Mexican.  He states that his grandfather was born in Texas.  So, even though Texas was once part of Mexico, like all other Texans, he was proud of being from Texas.  Although he was proud, he said that his family often had to keep a low profile because the white Texans would actually hunt African-Americans, and the Spanish-speaking Texans dare not get involved.  He never went to school, nor did he learn how to read, but he taught me quite a bit.
   As a young adult, he tried a brief stint as a coyote, or someone who sneaks Mexicans across the border.  He said that he got caught the first time he tried, and almost went to jail.  One of his relatives worked in law enforcement so he made a deal with him that if he enlisted in the army, he would not have to serve any time.
So Perfecto tried to join the army, but they didn't accept him because he had flat feet.  I'm not sure what that was all about, but that's what he said.   Eventually he moved to the Chicago area like many did during industrial times, and married a Dutch woman named Hilda, which was very controversial in those times.  He worked for, and retired from the railroad.  I remember when I was little I just assumed he drove the trains and thought about how cool his job must've been.
   My grandfather was never a very religious man, and he never belonged to a church.  However, when he was diagnosed with cancer last February, and the doctors told him he had about three months to live, he swore that he was going to shock the doctors. He almost made it a year.  But what I admired most during this time was his very matter of fact attitude about death.  Whenever I visited and asked him how he was feeling, he would say, "Good, for now."  Then he would point upward and say, "Until He decides its time."  It wasn't until his last few days that, as he struggled through the discomfort, a slight impatience set in and he would beg God at night to take him.  As a Muslim, I am taught that sickness before death can bring about God's forgiveness for mistakes you have made.  I envied him for having that time, but most of all, I admired his courage and total submission to God's will in the last year of his life.
   I visited him two days ago.  It was the first day that he stopped speaking.  As I was about to leave I had the blessing of a very bitter sweet memory.  My aunts were about to clean him up a bit, and I asked how I could help.  So they asked me to lift and tilt him on his side.  As I leaned down and tilted him toward me, his hands were up on his chest and his face was right in front of mine.  He whimpered a bit, very much like a child who his sick or half asleep.  It was very sad seeing my grandfather like that, but I must not forget that he once saw me like that.  And at one time in my life he may have held my whimpering face close to his when I was a baby, his second grandson, who happened to look a lot like him.  So, as I looked at him and saw my old age, I also saw my grandfather returning to his Lord in the helpless, weak state in which we are born into this world.
  In the last few hours of his life, my grandpa began to struggle to breathe.  All of his children that were in town, where called to his house and stood around his bed to say a prayer led by a local clergyman.  As his wife and children finished the prayer, they said "Amen" and my grandpa took his last breath and passed away. Grandpa, we fished together, fixed pipes together, worked together, painted together, when junking together, and danced together.  My high school friends used to tease me and say I'm going to look just like you when I get old.  I just hope that I can face death with as much courage and submission to God's will as you did, knowing that from God we come and to Him we all return.  Vaya con Dios.

A Not So Welcome Home

    This Summer, I was blessed to be able to spend 5 weeks in Egypt with my family.  We were excited before going because, as most of the world knows, the Egyptian people were able to overthrow their dictator, through peaceful demonstrations and determination.  I have to admit that I was a bit nervous, because I had heard that the police only recently began to appear on the streets and the new government had very little real power.  Essentially, Egypt was just starting to crawl toward its dream of freedom and democracy, which moving forward, could mean some instability.  To keep it simple, my family fell in love with the Egyptian people.  We were met with smiles everywhere.  Despite the poverty and bureaucratic challenges, the Egyptian people have hope in their eyes.  It was a beautiful thing to see.  I wish the same for the people of Syria.
     As Muslim Americans, we are often a bit of an enigma to Muslims around the world.  The meet us and we tell them we are Muslim, but its almost as if they don't believe it, because we're SO American.  It wasn't until our taxi driver Mohammad, saw us praying in the mosque that it finally clicked.  He became especially gracious to us, recognizing that it can be difficult to preserve your faith as a minority in America.   Although we enjoyed our stay, the heat and the pollution of Cairo can be a challenge, and our departure was bitter sweet.  We were looking forward to coming home.
     We are in the last ten days of Ramadan, which are considered to be especially blessed.  So, as I did in Cairo, I broke my fast with my family, prayed with my family, drank tea, and freshened up to head to the mosque for prayers.  I was very much looking forward to the taraweeh (night prayer) tonight because it was the first one I would be able to attend in Chicago, after battling with jet lag the last two nights. I parked my car and walked up to the mosque to notice that someone was holding the door open.  My first thought was that this was very kind of him, but then I quickly noticed that it was a security guard.  I took a deep breath and greeted him and walked in to get in line for prayer.  As I stood there with a knot in my throat, I was confused at what I should feel.  I have to admit that anger was the first feeling.  You see, I'm assuming the mosque had to hire this security guard because of the recent acts of terrorism against mosques in the Chicago area.  One mosque had some sort of acid bomb thrown at it, and another was shot at.  So this was my welcome home... watch your back, because if you look like a Muslim, you might be in danger.  It doesn't matter if three of my four grandparents were born here.  It doesn't matter if I played football and baseball growing up, or that I make a living trying to mend families and marriages, and trying keep teenagers off drugs.  It doesn't matter, because the people who have hate in their hearts only act based upon what they see externally.
     I expect better from you America.  As I and many of my Muslim friends continue to work toward the realization of a dream of our forefathers;  life, liberty, and the pursuit of happiness, I pray that we continue to strive for these pursuits rather than the pursuit of each other, regardless of the political climate.  And as I finished my prayer, I realized the sad truth that although Egypt needs my prayers for its future, America needs my prayers as well.  

Capturing the Moment

I will often tell clients to journal because sometimes when you are feeling something or thinking something, it is very valuable to capture that thought and moment of inspiration.  Once it passes, you may never get it back.  Most of the greatest minds in history kept some sort of journal, to capture their ideas and develop them. 

It often happens in silence.  When all the kids have gone to bed, the phone isn't buzzing and the television isn't on, your mind can actually get a chance to really reflect.  This is where growth can actually happen... if you let it.   So as person who believes with all his heart that prayers are answered, I face life's challenges with full conviction that there is power in prayer and that prayer can indeed change our lives.  So when an event happens, and I know that there are many people (many very good people) praying for the same thing, it only makes sense that things would swing in the positive direction.  And when it doesn't, I get frustrated and scared, and question, "why?" 

Then I answer myself with the fact that things are happening exactly how they were intended to and, just like we sometimes tell our children, "you don't need to know why" because they wouldn't understand, I need to just keep praying... and maybe I'll never understand "why?"   After all, why not?  Who am I to say how life is "supposed to" go?  After all it is happening exactly how it should, just not according to my definition.  I don't like it.  God give us patience. 

Why Are You Watching Me?

"It is freezing out here."  I thought, staring down at the yellow and red leaves at my feet.  I was trying to keep warm, but also trying to keep my face dry.  It was a cold, wet, fall day and as I'm looking down at the wet leaves covering the grass.  My brother, who's standing next to me says, "this is stupid."  "I know,"  I say.  "We aren't even doing anything." 

About 20 minutes ago, my father yelled upstairs to us to get dressed because he "needed our help outside."  We got dressed and came outside.  He led us into the garage and lifted this old wooden ladder off the two homemade pegs on the garage wall.  That ladder always looked so darn heavy. It must have been a 32 foot ladder, and probably at least 32 years old.  "Watch it.  This thing is heavy." he'd say as he carried it around the back of the house and stood it up on the grass.  I just kept wondering why he chose such an ugly fall day to do this.  What I realize now, is that he probably wasn't too excited about it either, but he had to do it on one of the only days he had off of work.  Then he attached a yellow, nylon rope to a 5 gallon bucket by making some kind of funny knot on the handle.  We just stood there watching, "doing nothing." 

Then he'd lean the ladder up against the gutter and after a quick tutorial about how to properly use a ladder and how to hold the ladder for another person, he'd start his ascent, bucket in tow.  We then would assume the position, right next to each other, with our feet by the feet of the ladder and our hands holding the ladder up against the house.  We would alternate looking up to see what he's doing, then back down because the rain was falling on our face.  Just as we start to day dream, watching the water drip off our hoods onto our matching, Venture brand gym shoes, he'd interupt us. "Watch it," he'd say, as he lowered the bucket.  We'd look inside and see black decaying leaves, often smelling of wet, rotting yard waste.  We would empty it into the garbage can and he'd hoist it back up again. 

Then, at the moment when we were most bored and most mad at my dad for dragging an 8 and 10 year old out in the cold rain, he'd yell from the top of the ladder, "why are you watching me?"  And we would yell back up with that phrase that we knew he was waiting for, "So that we know how to do it when we get older!" 

Then he would continue to do his thing, raising and lowering the bucket, and every 20 minutes, repeating our dialogue with him.   "Why are you guys watching me?"   "So we know how to do it when we get older." 

"This is stupid,"  I'd whisper.  "Tell me about it,"  says my brother.