Sunday, April 26, 2020

Keep Throw Change

Many years ago I was talking to a physician colleague who is also in solo practice. I asked her how she made it, as she only worked in the office, and didn’t do hospital rounds. Her response has stayed with me and I dredge it up when the going gets tough. She said: my needs are not that many.

I coined the KTD acronym and Marie Kondo became the millionaire. Decades ago yielding to my near-OCD clutter-phobia, I created a method to deal with organizing rooms. It is simple and works well: you start from one corner of the room and for each item ask the question of whether you should keep, throw or donate it. Marie Kondo has the exotic Japanese twist to basically the same premise. And I certainly don’t identify with the rolling up of clothes instead of regularly folding them that she does. 

With the Covid-19 crisis we can extrapolate the KTD practice to what has suddenly become a massive individual, national and global issue. And the KTD can become KTC, keep, throw, change.

Individual
I want to keep the breakfasts with my mother with no background pressure of things to do. Also the drives with my family in which the conversations are deeper and more spiritual as the content has shriveled, being that interaction with friends has gone down, and mundane stuff has exited. 

Health and time
Prophet Muhammad (peace be upon him) said that the two most valuable things we have are health and time. And I want to treasure these. I had a schedule before Ramadan and now that fasting is here, the schedule has to change a bit but productivity, contentment and joy lie in creating another schedule and then dutifully following it. Being near-OCD, multitasking, female and physician have been assets to me. And though time now does not run away from me like it used to, I want to keep valuing it and harnessing it, and keep it front and center, as life slowly returns to normal. 

Rushing around
We’ve got to get rid of the rushing around. A lot of us realize that all we were doing was jogging on the spot. We’ll need to choose how we will fill our day. A conscious, perhaps a written plan, is vital to reintroducing items in our schedule. Life has this bad habit of descending into automatic chaos unless you rein it in, train it. Whether it is office or house work, it is essentially endless and can swallow you whole if you’re not careful. We must be controllers of our time, not let it control us. Which reminds me of another Mahjabeenism: if you don’t lead life, it tends to lead you. 

My needs are not that many
Many years ago I was talking to a physician colleague who is also in solo practice. We were discussing the challenges of practice and not wanting to be bought out by hospitals and dealing with practice finances. I asked her how she made it, as she only worked in the office, and didn’t do hospital rounds. Her response has stayed with me and I dredge it up when the going gets tough. She said: my needs are not that many. Cloistered at home we realize that our needs are really not that many, and as we return to normalcy, not immediately expanding our needs is paramount. 

Life trajectory
All this time has afforded us a unique, albeit forced, opportunity to assess the trajectory of our lives. Professionally and personally we can assess and decide what combination of keep, throw, change we should use. 

Quran immersion
For years I have wanted to reach a point of understanding the Quran when it is recited or read. Even before the Covid-19 crisis, I’ve been working with the Quranic app and it is amazing in the way that it teaches Quranic Arabic. The current cloistering situation lends another unique opportunity for Quran immersion. Previously in Ramadan iftar parties and taraweeh prayer really ate into the already chopped up day. I’ve discovered another great book that takes each Quranic Arabic word and places the English meaning below it The Glorious Quran Word to Word translation. Hopefully when Ramadan ends I will continue to have a daily relationship with the Quran. 

National
Daily condolences
Pre-Covid I would write a condolence message once a month or maximally every two weeks. Muslims write the Quranic text of “to God we belong and to Him is our return”. Last week I had pasted it in Arabic calligraphy to someone. This week I have sent condolences twice each day. It first started with deaths narrated on television, then of relatives of friends, then distant relatives. I dread how it is closing in. This has to stop. 

Social inequity
The tales are harrowing. “I used to earn $250,000 a year and now it is zero” said a radio interviewee. “Thank you for donating to our fitness club” is gratitude from a business owner who needs donations to get through this crisis. Seeing the miles-long car lines in Texas to get donated food is difficult to process in our minds. Is this America? A Mercedes in the line gets its turn. The owner can get his car payment deferred for a month or two but has clearly run out of money for groceries. It seems people have become paupers overnight. The factors that have led to the tremendous inequality in our society need to be redressed. 

Stampede through the eye of a needle
The CARES Act 2020 through the Paycheck Protection Program was intended to help small businesses across America. But appears that no safeguards were put in place and the stampede through the eye of the needle got sharks across America, with slick lawyers and smooth relationships with bankers, to run it dry within a week. 71 publicly traded companies received $300 million of the $346 billion that was allocated to help small businesses leaving many small businesses out in the cold. Even though payroll documentation has to be provided, and the assistance was meant for companies with less than 500 employees, the loophole that Shake Shack used was of having less than 500 employees in one location. Due to public condemnation, Shake Shack has returned  the $10 million assistance it got, but the other billionaires are enjoying the money. This ever-widening gap between rich and poor also needs to be addressed urgently, and quickly become a thing of the past. 

The great equalizer
Covid-19 takes the rich, famous, regular and poor, and its humiliation of America is hard to process. Regression to the status of a developing country, and the dubious distinction of being the world’s Covid hotspot is ignominious. Americans deserve better than the performance of the federal government having essentially no stockpile of ventilators and personal protective equipment and the lack of an integrated federal and state response to tackle the pandemic. Our disaster response needs urgent and intense overhaul. 

Medicare for all
The first domino has fallen. More than 16 million Americans have filed for unemployment which terminates their health insurance. Our health care system was already very flawed, leaving large segments of the population uninsured due to the ridiculously high monthly insurance premiums. That flaw is now going to involve a large swath of the population. Medicare for all is the only way that the sequelae of Covid-19 can be addressed. 

Trump’s tyranny
If a person in any organization had suggested that disinfectant be inhaled, ingested and injected, they would have been fired on the spot. There is a rise in emergency department visits of people that have done exactly what Trump suggested three days ago and the number of calls to Poison Control have skyrocketed. Perhaps there should be a class-action lawsuit against Trump for aggravated assault or attempted murder. Whether we use the T for throw or the C for change, Americans must act in November to remove the embodiment of lies, the spectacle of stupidity and the epitome of incompetence that Trump is. We should try to retain a smidgeon of respect in the world community. Four more years is akin to a death sentence especially after our Covid suffering. 

Tariq Jameel too
Tariq Jameel is a Pakistani preacher a’la Billy Graham. He is charismatic and has a large following in Pakistan. His lectures have been attempts at humor, with superficial and distorted religious teachings. The fake-crying really gets me. As does the fact that seemingly educated people, including Prime Minister Imran Khan and former Prime Minister Nawaz Sharif,  just love him. His latest edict is that the Covid-19 pandemic occurred because women are shameless and not properly clothed. Religion in Pakistan, as elsewhere, is a multimillion-dollar industry and especially in Ramadan, the money really flows. Revolutionary poet Habib Jalib has a beautiful verse: 

Muflis jo agar tan ki qaba baich raha hai
Waiz bhi to minbar pey dua baich raha hai
Doanoan ko hai darpaish sawaal apney shikam ka
Ik apni khudi, aik khuda baich raha hai


The poverty stricken is selling his clothes
And the preacher sells prayers at the altar
Both are faced with the question of hunger
One is selling his self-respect, the other is selling God. 

There is no priesthood or confession in Islam; it is entirely deeds based. On the Day of Judgement we will be presented with a pictorial representation of our worldly life and our accounting will be individual, with no parents or preachers intervening. The accounting of religious clerics however will be a notch, or many, above the simple individual accounting that we will endure, because they have the ability to guide or misguide large groups of people. Previously the flock was restricted to the mosque and its surroundings; with the advent of technology, it now is millions at a time worldwide. It behooves the likes of Tariq Jameel to remember that frank misguidance of millions of people will be an insurmountable obstacle on the Day of Judgement. Pakistanis would be well served to listen to the calm, logical, scientific and current-day applicable lectures and interpretations of Javed Ahmad Ghamdi

Global
Climate change
The videos and photos of the skyline of cities around the world since the Covid-19 quarantine are quite stunning. The clarity of the air and the chirping of the birds is such a balm in these troubling times. As the pandemic subsides the world must actively decide on what industries it will re-allow and the massive polluters it should not. Passivity in this regard should be avoided. We have damaged the planet enough; it is now a time of introspection and revision. 

Cooperation
Cooperation among world health bodies such as the World Health Organization, the United Nations, The World Bank etc. are vital so that we truly work together as we are all in this together. Trump’s bullying and threats first to the United Nations and then to the World Health Organization should cease. If it is one thing that Covid-19 has demonstrated is that it will attack nations of all stripes and the best response is a concerted and not divided one. 

We are taught that after fasting in the month of Ramadan, or after Hajj the Muslim pilgrimage, one should work toward and notice a change in ourselves. Similarly we should keep the valuable, discard the unnecessary, and change some issues/people as we emerge from our Covid-19 quarantines. And as documented in world history and known individually, if we don’t learn from our mistakes, we are made to repeat them. The price next time might be incalculable. 

Thursday, April 9, 2020

COVID-19 Cloistered Syndrome

Even though we are cloistered in luxury, it feels like incarceration. The human mind takes a while to process trauma but knowing this does not seem to reduce its impact. My mind goes through these cycles of dread.


I am terrified of, and at the same time fascinated with, blindness and imprisonment. Only because I know I couldn’t handle either. Thus 48 Hours, Forensic Files and 20/20 are my favorite shows. The point when the murderer is sentenced has a particular impact on me because of the essential impossibility, in my mind, of spending 30 years or life in prison without the possibility of parole. 

The cycles of dread
Even though we are cloistered in luxury, it feels like incarceration. The human mind takes a while to process trauma but knowing this does not seem to reduce its impact. My mind goes through these cycles of dread. Starts with the morning when the bed is a magnet and I am steel. Email’s been checked, Whatsapp’s been checked, articles have been read. And then the mental persuasions begin: “come on get out of bed, it’s gonna be ok” and variations of the same. 

Each day is more onerous than the last, because the case-rate and fatalities are so much higher. On March 1st 2020 there were 89 Coronavirus cases in the US. By March 7th there were 446, by March 14th 2,776, by March 21st there were 23,432 and by March 31st 186,258 people were infected! And as of April 2nd there were 243,134 cases in the US and 5,864 deaths, and on April 8th 427,824 cases and 14,721 deaths. We used to casually use the word exponential, now we see it every day.

So one option is not to watch or read anything related to the COVID-19 pandemic. But that doesn’t work for me. And this week it is people we know who are in the ICU; statistics are so different from when a disease hits home like that. And as the days go on, those episodes of paralyzing dread become sickeningly familiar. 

Sunlight the savior
Even a twenty-minute walk does wonders. “I can do this” and “this too shall pass” become fulfillable mantras. Just the pre-walk is like a one-hour vacillation of the fight between the “go” and “don’t go” voices in my head. And the sinking realization that it has come to this; an activity and numerous others that were automatic in the past are actual projects now. 

Bankruptcy
A physician colleague just posted something hilarious and horrid: “if this saga continues, I will have something in common with Donald Trump, Chapter 11”. And speaking of Trump there is first the specter of small businesses going out of business and then suffering Trump’s press briefings and manifest incompetence. 

Small businesses are seeing a 70-80% reduction in activity. And this applies to a large swath of businesses from manufacturing to medicine. A bipartisan CARES Act 2020 was passed but has run into all kinds of snafus, and the immediate provision of $10,000 to small businesses and the Payroll Protection Program seem like they may not materialize or will arrive when irretrievable damage has been done. The consequences of this are not just small businesses filing bankruptcy, but millions of people losing their health insurance. Which in turn make a recession a definite, and the Second Great Depression a probability. Scaling back, pre-retirement or retirement plans are so much more palatable when they are done on our time; having them shoved in your face just worsens that cycle of dread. 

Tyrannical Trump
Never fails that when I am trapped in the kitchen cooking dinner, Trump’s press briefings are on and all channels carry them. Piled on top of the cloistered blues is the tyranny of Trump. It is hard to comprehend that the President of the United States would bully reporters, call the World Health Organization names, peddle hydroxychloroquine repeatedly, lie blatantly, fight with all things Democrat, alter facts whimsically and be altogether rude, grandiose and delusional. With the reverberant theme of “it is this way because I say it is”. And the citizenry has no recourse. “The  CDC recommends face masks but I won’t be wearing them” is Trump’s typical of “do as I say and not as I do”. The cycles of dread are fueled with the sickening realization that a petulant teenager has the lives of millions on his narcissistic little hands. 

All this time
Time was that vacations and staycations were just so awesome. Now time hangs heavy and the voices that propel to action feel shrill. I used to dream of a sabbatical when I would write my book. That the day is filled with telemedicine, cleaning, napping, cooking, the news and bed makes my self-worth tank. And I re-read those self-affirming memes that soothingly forgive you for essentially becoming a lump of lard. 

Fat on the other side
I’m very fat-phobic and my children accuse me of wanting to commit fat-icide. My mother and aunts were fabulous cooks; and round and rolly to prove it. And it was so plain that most, if not all, famous chefs are obese. So I figured I would dislike cooking and that would take care of any roundness that might threaten me. One of the memorable things of this cloistering will be that I discovered the joys of cooking. The family appreciating the meal every evening, is truly one of the greatest joys I have ever felt. Fortunately for me, I don’t have a sweet tooth and am not a stress eater; quite the South Beach lo-carb diet queen. That I have never been skin-and-bones is all my mesomorphic build, genes and metabolism-as rationalized by all overweight folks. Used to weigh myself once a week, now it is every day. The cycles of dread, my molasses like inertia, the specter of a financial fall, the disgust of governmental corruption and incompetence, the sadness of the national and global death toll and the fury of how this pandemic could have been handled differently will all be there. But at least I won’t be fat on the other side.