Seismic Shifts

Seismic Shifts

Seven years ago, I lived in a large Brazilian city, where I measured distance in minutes stuck in traffic. Five years ago, I moved to a tiny village in Northern California, where I reveled in the beautiful views and learned, in retrospect, the value of big city anonymity. Two years ago, I moved again: to a town small enough to avoid traffic jams, but big enough to allow for visits to coffee shops where I usually don’t run into people I know.

When you move to a different place or culture, you adapt. Every move requires re-learning where you keep your silverware, where you can find the best produce, and how long it usually takes you to get to work – or play. Each new place has its own social norms, ideas, and unwritten rules and expectations that are invisible to visitors and taken for granted by locals. Each new job – or, in my case, career shift – involves work codes, vocabulary, flow of hierarchy, power dynamic, and collective culture. One learns to pay attention and listen; misconceptions lead to missteps. 

There’s something therapeutic about moving. We learn about ourselves.

Even the physical act of moving is packed with symbolism. We are forced to confront what we own. What we’ve kept. What we have become. Forgotten treasures are unearthed from the depths of unvisited drawers and we vow to integrate them meaningfully into our new house. We finally get around to donating or discarding things that should have been purged long ago. We flip through old pictures, books, and love letters… and remember days long gone. In packing, the essentials are the last ones boxed and the first things we unpack in the new house.

The new house has elements of the old. We, after all, are still somehow ourselves. But it’s not the same.

Early in 2020, before we called it a pandemic, my husband would check in almost daily with a former student who was living in China. This is how I learned of the new virus. We talked about how hard it must be to live in a small apartment and have rules for who goes grocery shopping and whether, presented with the same choice as his student, we would have returned to a virus-free Brazil, or stayed where we were. 

As a pediatric medical doctor, the concepts of lockdowns, masks, and contact tracing made perfect epidemiological sense, but I was lulled into a false sense of security by past experiences. HIV was – is – devastating, but comparatively slower to manifest and kill, and Ebola and H1N1 didn’t evolve into worst case scenario predictions. In fact, my entire medical career had a confirmation bias of good outcomes. Over twenty years ago, I sat in a huge lecture hall while the virology professor pontificated on the fact that epidemics and pandemics would come and ours was a generation of doctors that would face untreatable and devastating germs. But medical school is full of dire potential outcomes and we learn to celebrate the tiny victories and close calls and better-than-it-could-have-beens. I thought it would be bad. Very bad. But I thought it would be, as it had been for most my life, not as bad as it could have been. 

I underestimated.

As the international media spotlight shifted from China to Italy, we began to check in with friends in Europe. The personal reports were far more harrowing than anything we read in the media. Not because our friends were more affected or worse off than some – even most, but because what we read in the news was so unfathomable that the comparatively small sacrifices and hardships of loved ones hit closer to home. 

Unfathomable, but not countless. The whole world was counting. We counted deaths, infections, infection rates. We sought to make sense of the numbers in a way that measured risk and helped create personal guidelines. I couldn’t help but compare the reports of overwhelmed and overflowing hospitals with my own worst shifts and I knew that my imagination came woefully short. 

I had a trip planned to Brazil. When I canceled the trip in late February, I was apologetic. It felt like an overreaction. A little over a week later, New York was reeling under the impact of the pandemic, borders were closing, and the thought of being trapped overseas away from home and splitting our family unit felt unsettling. Friends and family in Brazil, now watching the news from New York with increasing dread, reached out in renewed support of our decision.

I was restless. The canary in the mine shaft had stopped singing, but life went forth as usual in California. Conventions, workshops, university lectures, and my son’s school: full speed ahead and little conversation about how to deal with the virus that would inevitably reach us. Or, as we would come to find out, was already here.

In March, when I was supposed to be boarding a plane to Brazil, I would wake from dreams of sweltering in PPE and intubating people on a conveyer belt. The irony is that, as a primary care pediatrician who worked in private care and neonatology, the last time I intubated a grownup on my own was never. I am not only not certified to practice medicine in California, but I am unqualified to do what we need most: nursing.

I didn’t really want to be in a hospital facing the unprecedented. But it felt like something to do. Action. I felt powerless and helpless and, for the first time since we moved to California, isolated. We were new in town and our support system was spread across the country and the world. We had grown used to thinking of the world as small and any loved one was just a plane-ticket away. The pandemic expanded distances and suddenly I felt very alone. If my husband and I got sick, who would take care of my son? On the nights I wasn’t dreaming of intubating, I lay awake making plans for what to do if any of us got severely sick.

For much of my life I’ve been known as the person who can find silver linings. In medical emergencies, we’re taught to act one step at a time, but we arrive prepared for the worst. I default to the same logic in my personal life. I don’t expect the rain, but I’ll take the umbrella just in case. If it rains, I’m prepared. Until it does, I’ll enjoy the sunshine. 

There was a storm brewing, though, and the wide-spread wishful thinking made me increasingly nervous.  Experiment and change and novelty had become my comfort zone. I wanted to plan six months and a year ahead. I wanted to discuss worst case scenarios and strategize for those. Needless to say, my perspective was unwelcome. I felt like the oracle of doom.

As the viral revolution took over the world, I compared it to my recent moves. Packing. Unpacking. Bringing to the surface and unearthing treasures. Changes in modes of transportation and routes. Morphing family dynamics, blurred work-home boundaries, and parents trying to figure out how to navigate a whole new layer of parenting and coping. The ubiquity of humor. The relentlessness of grief. The cycles of agriculture and production, trade, and consumption. The little pleasures that emerged as essentials: walking, sunlight, baking, reading, planting, and reaching out to people and places that felt like emotional home. 

The COVID pandemic world was, in some ways, a new culture. Inasmuch as expertise existed, it lay with those who were used to code switching and letting go of rules that are arbitrary to all but the communities that subscribe to them. It felt easy at times. Too easy. A grand adventure. It felt impossible sometimes. There was no consensus. We were making this up as we went along, and nobody knew the socially acceptable norms.

I dreamt of a changed world. I’d been equating this with moving, with shifting cultures, with learning new norms. But this was not the same.

An intentional move to a new house, a new city, a new country, and a new life involves packing methodically and taking the time to reminisce, assess, and plan for the future. The pandemic was a natural disaster: the kind where you don’t have time to pack, you grab what you can – if you can – and, when you return to your house, it’s upended, partially destroyed, and what can be salvaged isn’t always what you’d have chosen to keep.

Fear and confusion can be paralyzing. The magnitude of the pandemic – and the social and economic difficulties it triggered or magnified – was beyond what most of us have experienced in our lifetime. I intentionally tried to listen. If I couldn’t change the world, I could still learn from it. I grudgingly accepted that humanity does not change in leaps and bounds; on the contrary, change is incremental and largely unintentional. 

The world will not be new. There are no blank slates and do-overs. But it will be altered.

Very little lies within our control. I can still hope for silver linings and that we find agency in who we become when we emerge from all of this. We still have some control over how we unpack what’s left and how we incorporate it into what comes next. 

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