Winter is Here.
By: Simi Rahman
Tags: Burnout, Covid-19, Healthcare, California, Third Wave

As a pediatrician it’s impossible not to think about the onslaught of human suffering as we head into the 3rd and worst wave of COVID-19.

We are drowning and all we can do is try to keep our heads above water. Many of us will not make it, either due to COVID or due to mental and physical breakdown. We have been riding these waves for months, and it’s taking a toll on our psyche. On our ability to have a healthcare force that can withstand this 3rd wave.

A 4 month old with burns and a 9 month old with cocaine in its system. Strung out and stressed out parents. Drunk drivers and diabetics unable to get their insulin, gun shot wounds and head traumas. This is Pediatrics in a big city hospital. And it’s getting worse every day.

Since the start of the pandemic pediatricians have been witness to the erasure of childhood norms and sometimes of childhood itself: the normalizing of screentime for schooling, the isolation and loneliness of children unable to find their footing and losing multiple rungs on their development ladder. The stress of evictions and food insecurity, the loss of school meals, the drop in dental and eye screening, the gaps in immunization and the preventable illnesses and deaths that follow. The lack of exercise and the climbing BMIs. The crying of stressed out children on Zoom.

Now imagine this was your childhood I was talking about. Realize this is the childhood faced by millions of children in the richest country in the world. And millions upon millions more all around the world who rely on our leadership, outreach and funding in order to survive to adulthood.

So much pain has been normalized and now seems to cause no comment because the atrocities no matter how huge, are always outdone by a fresh load, everyday.

However, the death of childhood is an especially heinous crime, one that resonates through a damaged life for its entire existence, trauma living inside bodies and minds. Human trafficking, child marriage, child pornography and the commercial sexual exploitation of children (CSEC) are all on the uptick as a result of this. The world has a few uses for broken children, and there are those who would grow the size of that economy on the backs of such trauma.

It shouldn’t be this bone crushingly difficult to do the right thing. But it is. And I’ve stopped asking why anymore. I know why. It’s not some grand revelation. It’s quite simple really. This is who we are. Last week, in a city north of here, two children were found in a home where their two teenage siblings had been decapitated. This is who we are now. Maybe this is who we’ve always been, the thin veneer of law and order wearing thinner every day of this benighted year only to reveal our true faces.

I may be in pain, but I cannot complain because not only is everyone else in the same boat, but hundreds of thousands more are worse off than I am, so I keep my suffering under wraps. Crying in the middle of the day. Giving up on routines and norms because nothing feels meaningful anymore. Because I feel like a psychopath for even trying to be normal. Because I can’t ignore it or compartmentalize it or try to pretend there’s any recovery that’s possible, the truth has sunk into the lines on my face, the aches in my body. This is now who I am.

Years of needless suffering lie ahead of us because we as a society couldn’t follow basic rules. Because we as a society have become so poisoned, that those who have been convinced to act against their own best interests, even now, insist on their right to harm everyone else. They’re so convinced of their superiority that there is nothing that can be done to change their minds. 70 million is a chilling number of people who voted for the guy who drove us into destruction, made us forget that we could have done better.

An even more chilling thought: had it not been for the mishandling of the pandemic, we would still be in Trump’s America for 4 more years, and America as we knew it would have ended. She has still not pushed back against this current existential threat, and I don’t believe she can. Too many have joined the cult, trapped by fear and loathing in their own funhouse horror show, unable to find the exit. And an entire network of criminal kleptocrats get away with this while the people of the United States face a healthcare catastrophe and breakdown of society on a scale that is unimaginable.

Four more years and we would have descended into civil war. There are those that make the point of irreconcilable differences between red and blue states, of no longer remaining the United States. Maybe it’s time to go our separate ways, just to keep the peace.

Because guess what? This is not even the biggest threat coming our way in the next decade. Human-driven climate change melted the ice caps this year, a prophecy fulfilled, and the die cast. Irreversible climate change already in play because there is no amount of political willpower that can right the ship in time. None.

So add to this humanitarian catastrophe the ever increasing disasters caused by climate change, and we are in the end times already. Time to accept that fact and act accordingly, I tell myself.

When a few cities over, the Sheriff comes out against enforcing stay at home orders, on the upswing of the 3rd wave, you know you’re about to endure a lot more pain.

You have to, you have no choice anymore in the matter as part of this epically dysfunctional healthcare system.

The years of schooling, the training and learning, the sleepless nights and busy days, applying yourself to the minutiae of caring, were for nought. The sense of failure is worse this time. Because the first wave caught you unawares. The second wave was still bearable. But the 3rd wave is a battering ram of failure. Every public health effort laid waste, the ability to care in the face of callousness is waning.

My anger is spent, my rage has gone deep and settled somewhere deep inside me.

In its place is a deadly despair. A realization that there is no measure of mitigation that’s effective against nihilism. A paralyzing despair, that calls into question every single decision I’ve ever made.

And all our best laid plans have been laid to waste. A year of dance recitals and family time, socializing and adventure, college visits and prom has evaporated. And not only that, I feel like a fool for ever believing those things had meaning.

In their place is an uphill climb with a massive rock that rolls down the hill every night. Every morning begins the same way, a nightmare where reality and fantasy have started to blend, where hours and days have lost their meaning. Where relationships have stagnated or gone off track. Where sleep has become an escape from the racing thoughts. Yoga and meditation, exercise and eating healthy all seem like laughable pastimes afforded by those with the luxury of denial.

So yes, I’m showing up. But I’m not here at all. And it’s not fear or exasperation like it was the first few months, but instead a complete loss of faith in my own species and our right to inhabit this planet we are so intent on destroying.

Some may read this and wonder if I’m depressed. I do fit the criteria, but no, I’m not depressed because I continue to have insight into my own mental state. What I am is something else entirely. Fed up with caring, and relieved in some ways to let myself off the hook.

The planet will be fine.

Life will go on without us.

And that’s a cheerful thought indeed.