Monday, July 27, 2020

Disruption

Many events have occured in the past that have had major impact on human life and have brought about cataclysmic changes in the way we have lived. To site a few in the living memory, the invention of automobile and air travel in the beginning of the last century. This put paid to the horse dependent transport and revolutionised travel.What was considered as distant became closer, intra continental and inter continental travel, which took days and months became days and hours. The laid back life in small communities gave way to big towns and cities and industrialisation galloped. This period also saw the beginning of increasing consumption of natural resources which only accelerated and we now have entered the dangerous anthropocene era which may be signalling the end of humans.

Next arrived the spanish flu of 1911-12. With no native immunity and in the absence of vaccine technology this virus killed millions and made human race realise the importance and the power of micro organisms. This also led the way to major changes in the life style and personal hygiene and public health assumed major roles in matters of health. A whole sea of change occurred and led to major advances in the fields of vaccine technology and discovery of antibiotics

World wars 1 and 2 again were major disruptive influences. Rabid nationalism and racial discrimination led human race to the brink of disaster. These aslo revolutionalised human thought and brought in women into the mainstream of life. Needless to say these wars also saw increased consumption and destruction of nature.

Next to arrive is the era of Computers. These have greatly eased the way businesses are done and the way we live. Precise and fast calculations, storage of massive data became possible. In the bargain every aspect of our lives has been touched by these machines and the so called privacy appears gone for ever. These machines have led to artificial intelligence which is threatening human brain. There is justifiable fear that a day may come when this AI will subjugate humans.

Now we are in the midst of another crisis. The emergence of a novel virus which is making disruptive rounds around the world. This virus known as Covid though not as lethal as the Spanish flu virus has caused enough turmoil partly due to its rapid spread and the fear of death and disability. Though the death rate is 3% in the young and 6% in the elderly with impaired immunity, nonetheless, for a population which has believed for every illness there is a cure, this illness for which there is no known cure as yet has come as a virtual death sentence. The embargo on social interaction,advice on facial mask and hand washing has made hitherto taken for granted life, that much difficult. The universal exposure of the populence to the electronic and print media which have a tendency to give importance to gory news have only added to the fear. What will happen to me if I get infected seems to be on the mind of most persons

In addition, this disease has caused major disruption in the economic and social activities and we appear to have entered into an era of severe economic, socio psychological depression.The frenetic efforts at the making of vaccine, which may take another year appears to be the only answer in the long run. In the mean time human kind needs to change its behaviour [social distancing, mask wearing and hand washing] to keep the virus at bay and the constant need for the comforting thought that even if get infected, I am likely to belong to the 96% who recover from the illness.

Anything good that one sees in this pandemic? Yes, the realisation that one needs to live a symbiotic life with nature seems to have been realised. The relative stop to consumption may have slowed the process of racing into the Anthropocene era.
Anxiety

anxiety is a state of mind where in there is a constant run of negative thoughts that does not allow the person to perform and live his routine life. I experienced this in the past few months. Several events contributed to this. One is the announcement of lockdown. This prevented the normal social interaction at all levels. For a person, who lived outdoor life 4 to 5 half days a week and enjoyed playing and being with friends, this was like a jail sentence. Worse, the benumbed mind did not allow me to do any constructive thinking and do any writing. There was a constant feeling of restlessness and mild tension.Though the medical practice was only part time and numerically small, the enjoyment of interacting with patients,many of them, my friends, left me quite frustrated. Tele,video consults are no replacement for face to face interviews.

Then occurred another event 4 weeks ago which compounded the ongoing simmering anxiety. My 86 yea old sister in law who has progressive dementia, living alone with a helper,worsened and became unmanageable. We had to wind up her apartment in a hurry and shift her to our home. Then we had to do some frantic search and luckily were able to admit her to a dedicated home.All this took three weeks of intense tension for both of us.Since the past one week I [we] are able to unwind a bit. though the ongoing anxiety,though much less, remains.

What were the signs and symptoms that I experienced during this hard time? The one constant was the feeling of mild sinking in the pit of stomach.This would occasionally become worse, some times associated with nausea but no vomiting. Next was episodes of sweating which worsened when ever there was a phone call or when thoughts of what is going to happen next came up. Third was a mild head ache located at the temples. Sleep was hard to come by and when it did it was disturbed and that too only in the wee hours of morning.All these were classical signs and symptoms of anxiety state but not the dry coughing bouts. On some days when action was involved like shifting her to that home or bringing her to our home, it would be there all the time. On other days it was only for some time in the mornings. In fact if some one heard me coughing like i did they would presume that I had covid infection! Surprisingly,my pulse rate remained normal.

when once she got admitted the first symptom to to go was the sinking feeling, followed by attacks of sweating and the coughing bouts though the early morning ones remained. Sleep too improved. Since the last ten days my tele consults and seeing an occasional patient and friends in person has helped to calm me down and the prospect of restarting my out door activity too has helped to ease up

One can imagine the logistics night mare that we had to go through with restriction on vehicle movement, with the dementia patient living 20 kms away and the dementia home 30 kms away. This was the kind of situation when one realises how important to have close friends. Many helped us to see us through these tough months.

You might wonder, why then the anxiety still on.

Very, mild bearable, mostly due to worry regarding the relative settling in that home and to some extent, thinking about the plight of millions of the socioeconomically disadvantaged country men and women

We are a resilient people and hopefully,in the coming months we will be able to successfully weather this storm.