Why I'm Not Panicking

My Post-Election Long COVID Rundown: November 2024

How to Respond to an Emergency

As an anesthesiology resident at Stanford, I learned to respond to Code Blues. The overhead announcement meant a patient was in cardiac arrest and, in response, a multidisciplinary team arrived bedside, ready to employ Advanced Cardiac Life Support. We then worked together to save the patient’s life. Codes, as we often refer to them, are the ultimate emergency. They’re dramatic, stressful events that have often been recreated on television. The TV scenes typically show a crowd of people barking orders, eyes wide and hair unraveling. Background music pulsates and medical equipment clangs.

It’s all for show.

In reality, the best-run codes are quiet, synchronized, and methodical.  I remember an attending (what we call our clinical professors) advising me to slow down and walk when he saw me running full speed to respond to a code early in my training. We need to show up calm and focused, he said, not harried and shaking. The lesson has been reinforced in the thousands of emergencies I’ve rescued since: Effective work takes poise, stamina, and perspective. To that end, panic helps no one - especially in an emergency. 

I’m seeing a lot of panic around me this month. The US election results have understandably triggered strong emotions and a fair amount of doomsaying. And while I’m certainly concerned about the possibility of our scientific institutions led by inexperienced and brazenly unscientific opportunists, I’m not panicking.

Neither should you.

Calm and Focus

Instead, I focus on the work at hand. I use what I have. I continue to search methodically for additional resources, and I implement new strategies safely and steadily. I’m kind to myself. I track my progress. I reach out to like-minded people.

None of this would make for good TV. And yet, this is how I respond to an emergency. 

My health has certainly constituted an emergency. In 2021, I spent my days bed-bound in a dark room, unable to think or speak clearly. I was dizzy, confused, winded by the slightest effort, and in pain, unable to participate in a meaningful life. Today, I see my kids off to school most mornings, nag them about their messy rooms, speak and write with leaders in Long COVID research, and with you. It’s certainly not easy. I limit my physical activity, and I’m learning to speak, read, and move better with rehabilitation specialists. I am not yet at my baseline, but my life is fruitful once again.

My recovery methods would fail to make a Gray’s Anatomy storyline. I don’t have access to magic medicines or experimental treatments hidden to the public - I’m not that influential. Instead, I’ve used a slow and steady approach. My doctors, especially early on, knew very little about Long COVID, myalgic encephalomyelitis, or any other infection-associated chronic condition. We collaborated, not by diving into obscure research, but by evaluating my symptoms systematically, the way physicians are classically trained to do. Slowly and surely I was able to identify patterns within the complexity, and one by one I found treatments that improved my symptoms.

Managing Uncertainty

The path to curing Long COVID is a long and imperfect one. We’re in this for a while, and the ride will be bumpy. It feels particularly bumpy right now. Waiting for a definitive cure, and using trial-and-error methods in the meantime, requires emotional fortitude itself. Adding to that stress, we’re faced with the possibility that research funding for Long COVID may be interrupted by the next presidential administration. How exactly the new administration’s policies will impact research and access to healthcare is yet to be seen, but it’s enough to leave us feeling vulnerable and overwhelmed.

For many, the election news feels like we’re facing a code blue without adequate training. What’s going to happen? What should I do? How will I navigate the unknown dangers ahead? What we’re really asking are questions about courage and resilience.

Because the internet swarms us with sensationalized opinions, it’s easy to believe that we are alone in our fear. Nobody’s faced the magnitude of danger that we’re currently facing….have they?

Of course they have. Reflecting within the United States alone, generations of Americans have lived under oppression and lived marginalized, their physical safety and civil liberties threatened. Please refer to the histories of Black, physically disabled, and/or queer Americans. While many people have tragically fallen victim to unjust institutional structures, groups have also resisted and influenced change. How?

How to Survive Turmoil

Thriving during periods of turmoil is an extraordinary phenomenon often attributed to a combination of psychological, social, and situational factors. Research on resilience, post-traumatic growth, and adaptive behavior sheds light on methods of surviving and thriving in a time of intense stress. In the early days of my training, I didn’t know I was practicing these principles of resilience to manage medical emergencies, but that’s precisely what I was doing.

1. Strong Sense of Purpose  

A clear purpose provides motivation and resilience during adversity, helping you transform challenges into meaningful action.  

As an anesthesiologist, my purpose was crystal clear: saving lives. Whether managing cardiac arrest on the hospital ward or stabilizing a trauma patient in the operating room, that purpose guided every decision.  

Since developing Long COVID, my purpose has shifted to saving my own life. I draw motivation from my family—I want to fully engage with my husband and children. Through Long Covid, MD, I’ve also found purpose in empowering others to regain health and function. I’m motivated by being a doctor again, too, even if it’s in a different form than my previous career.

These purposes drive me to explore new treatments and stick to routines that help me recover. When I take my medications or do a (tedious) stretching routine, I remind myself, “I’m doing this to play with my children and, one day, their children.” When I track medication side effects or practice (frustrating) reading skills to understand and explain research, I think of you, my audience: “I’m doing this to empower others who are suffering as I do.”  

I encourage you to find your purpose.

What motivates your commitment to your health, and can you find motivation from current events? Perhaps it’s public education, health equity, or art. Maybe it’s fame, fortune, or simply living well for the people you love.  

There is no greater tool in your resistance kit than your health. Take care of your body so it can serve a cause greater than yourself.

Ask yourself:  

- What group or movement do I want to support?  

- What cause needs my voice, my energy, my unique talents?  

- Which one inspires me to stick to a bedtime or set up that appointment I’ve been avoiding, so I can contribute effectively?  

Say its name aloud. Let it be your focus as you put down your phone, stop doomscrolling, and get the rest you need. Care for your body so it can sustain the fight for what matters most to you.  

2. Emotional Regulation Skills

Channel your grief, don’t let it consume you.  

Emotional stressors can trigger Post-Exertional Malaise (PEM), potentially making it worse, and it’s challenging to help others when you’re bedbound. It’s completely understandable to feel sadness, but it’s also okay to set boundaries around it.  

By limiting your exposure to upsetting content, like compulsively reading the news, doomscrolling, or engaging in conversations with others who are upset, you conserve your energy for more productive actions. Remember, setting boundaries on what you consume doesn’t mean you care less about an issue. There’s a point where more news only adds stress, not value. Recognize when you’ve reached that point, and allow yourself to step away. This is certainly not easy, because grief is not a linear process and grief is definitely part of the reaction to events in the US and abroad. Processing grief is different, however, than re-traumatizing oneself by seeking out painful news, videos and images. A mental health professional can be a helpful partner in this journey.  

Regulating emotions (which is different from ignoring or suppressing them) helps engage your frontal cortex and executive functioning. Intense emotions activate the limbic system, putting us in a fear-based, fight-or-flight state. This interrupts our ability to think clearly, perform delicate tasks, and problem-solve—skills that are essential in managing emergencies, and also essential processing those intense emotions.

3. Community and Social Support

Remember when I said interdisciplinary teams work together in a code? ACLS protocols emphasize that patient outcomes improve when teams work in coordination. Members play varied roles, from decision-making and leadership, to skilled proceduralists and support staff. A very important part of the code team is the runner, someone who typically stands at the door and is designated to run for supplies or additional help. Our skill sets and responsibilities are different, some would call them ‘big’ roles and ‘smaller’ roles, but that’s not quite right. Every team member makes an important contribution, and we remain after the code ends, regardless of outcome, to debrief our experience and identify successes and areas needing improvement.

Debriefing sessions are not meant to assign blame, they’re really intended to bolster our group resilience by providing an opportunity to process a traumatic event and assess ways we can respond next time. (Note: there is always a next time.) We benefit from group connections in all important social realms. Connection with others benefits us psychologically and practically. Emotional support reduces feelings of isolation, and mutual aid networks offer resources and protection. Story-telling and communal activities, like debriefing sessions and even online Twitter Space chats, are rituals that strengthen our bonds and thereby strengthen our resilience.

In the hospital, we don’t traditionally debrief after high-risk surgery; they can be just as stressful as codes but we perform them every day that they literally become routine. We still benefit from processing the events, however. For me, the quickest way of de-stressing after an especially challenging case was sitting with colleagues in the break room, sharing lumpia or a bag of chips. It gave us an opportunity to release our fear and find comfort in company. We would never admit that’s what we were doing. No way, we were too tough! But that’s what we were doing. We were healing each other through companionship, and by bearing witness to a shared experience.

Who is bearing witness to your story? Connect with them, maybe debrief with them. Perhaps you feel no one is, yet, but it doesn’t mean you’re alone. Write to me. Tell me your story.

I encourage you to seek out others who understand your journey—whether they are living with Long COVID or have faced similar struggles. Who’s on your feed you want to know? Reach out. Make acquaintances. Make friends. Share. Virtual connections can be real and fulfilling, and they are also effective tools of social and political movement.

Look For the Helpers

Lastly, I recommend we pay attention to those who are already sharing their stories and bringing light to issues that impact the Long COVID community. On Substack and beyond, I recommend Kelly the Disabled Ginger, Ezra Spier, Alice Wong (her memoir Year of the Tiger changed my perspective on health, medicine, and the meaning of life), Katelyn Jetalina, Eric Topol, Noha Aboelata, Alba Azola, Amy the Tonic, Zed Zha and Harry Leeming. Move away from those who detract from the conversation, who troll, who rile you up intentionally, and move toward your community….which I hope includes me!

In these turbulent times, the most powerful thing you can do for yourself is to remain focused on your recovery and emotional well-being, and contribute to others from that center. As your health builds, and your endurance grows, offer more as you see fit. How can you contribute to your team without detrimentally impacting your health? Are you a runner in this scenario? If so, maybe you have the ability to send an email or post a productive message online. Does your health allow you to be closer to the proverbial bed? Maybe you can contribute to brainstorming sessions or fundraisers for a cause that’s meaningful. If physically protesting is important to you, ask yourself if that is safe for you and if that is the most effective role you can play on the team. Move with intention and sincerity.

A lesson I learned a little late in my medical career is that my service to others hinges on my own well-being. Today, I care for myself in service of others. Of course, my health, and the impact I have on issues I care about, are not all in my control, but I try my best in areas in which I have agency. Regulating your emotions, leaning on your community, and embracing your inner resilience will help you navigate uncertainties with grace and purpose. Don’t panic. Don’t run at every alarm. Rather, move forward, one day at a time, with the understanding that your well-being is the most important tool in facing whatever comes next.