Hit the snooze button. What body doesn’t love a good eight hours? Give yourself the gift of delicious sleep now—because everything looks and feels better after a full night’s rest. For more on how to sleep more soundly in our new normal, turn to chapter 6.
Stop, stretch, and roll. Stretching can release tension, relax your body, and help you feel more mindful. Not into stretching? Try foam-rolling, which is, in my opinion, the cheapest and easiest form of muscle massage.
Drink water. This is like remembering to water household plants—it’s easy to forget on a regular basis, but it can make all the colors of the world look brighter.
2. Nourish your mind. While many people think of self-care as something you do, what you think and how you feel are just as important—and can be just as restorative. Here are some ways to nourish your mind:
Engage in a hobby that makes you happy. It sounds simple, but few actually take the time to pursue hobbies when they’re hurt, sad, lonely, or anxious. Allow yourself the time and energy to do what you enjoy, whether it’s painting, playing an instrument, or gardening.
Challenge your mind. Nothing may be better than a good cognitive game to help distract your mind and enable your brain to see your problems in a new light. Try learning a new language, doing a crossword or jigsaw puzzle, or reading a good book.
Take a minute (or ten) to meditate. Meditation is one of the most effective ways to help treat depression and anxiety, with studies showing the practice works as well as antidepressants for some mood disorders. Look online for tips on how to meditate and make it part of your new daily routine.
Write it all down. Journaling is like venting for the soul, except you don’t need anyone around to do it. Write down anything you want: what bothers you, what you’re grateful for, what you’ve been through, what you hope to accomplish. Your journal is your space, and there’s no write (ha!) or wrong way to use it.
Stop with the screens already. With so many of us working from home, it’s easy to stay glued to our screens 24/7. But easy doesn’t mean healthy. Taking a tech break whenever possible can help refresh your mind and mood.
Laugh, giggle, chuckle, or guffaw. You’ve probably heard it before: Laughter is the best medicine. There’s medical research to support this maxim, with studies showing a good guffaw can help cut stress, boost happiness, and even improve the body’s immune system. I think everyone should laugh every day, whether it’s by watching a favorite comedy show or being silly with friends or family. One of the biggest lessons I learned during my year of self-care in The Self-Care Solution was how to laugh at myself—and that’s truly a gift that keeps on giving!
3. Nourish together. We often think of self-care as a solitary activity, but there’s no reason why you have to go it alone all the time. As long as you’re emphasizing the “self” in self-care and not doing what someone else wants or thinks you should do, there’s no harm in engaging in activities with others. In fact, there may be some serious benefits to communal self-care, including creating feelings of community and connectedness—two things we all need right now. Here are some ways to practice communal self-care:
Take an online or outdoor yoga class. Or any type of group fitness. This way, you nourish your body and mind while connecting with others.
Watch a movie, stream a ballet or Broadway show, or visit a virtual museum together. There’s nothing like savoring great art with someone else. Share the experience in whatever way you can and take the time to discuss your experience together afterward.
Connect with your inner circle. Get your family or live-in household together for a special night of cooking, playing board games, watching (or re-watching) a big sports match, or otherwise doing a group activity you wouldn’t normally do on just any night.
Throughout this chapter, I’ve given you a number of strategies that can help you find greater mental health, happiness, and resiliency in our new normal. You may need to experiment to find the exact combination that helps you, but I have full faith you can do it. Despite all the losses we’ve suffered, the human spirit can prevail, especially if you believe it will. Throughout history, we’ve survived extraordinary hardships before—the Holocaust, 9/11, two world wars—and we’ve always come out on the other side with a sense of fortitude and optimism. We will do so again. You will do so again.
On a personal level, you may have already lived through times of extreme emotional adversity. In every instance, you weathered the storm—after all, you are here reading this book right now. Remember this and believe that you can weather the storm again, even if you have to walk through a lot of rain to get to the rainbow on the other side.
Chapter 3
Healthcare
In early April 2020, the U.S. surgeon general went on national television and told the American people that the coming week would be one of the hardest and saddest in the country’s history—“our Pearl Harbor moment, our 9/11 moment.”1 At the time, New York City felt and looked like a war zone, the United States’ infection curve rate had shot up over the preceding month. The surgeon general was now worried that the fallout moment had come for the country’s death count to catch up.
That same week, I was home with my children, Alex and Chloe, getting ready for bed when I suddenly started to itch. Moments later, while brushing my teeth, I felt incredibly dizzy. I wasn’t overly concerned, at least not at first: I’m allergic to a few ingredients found in some foods and skincare products, and I figured it was something I had eaten or used on my face. I took a Benadryl and tried not to think about it.
Fifteen minutes later, I was so light-headed that I had to lie down. I crawled into bed and called my boyfriend, who is also a doctor. Before I could tell him, he asked me what was wrong, saying I didn’t sound right. I checked my Apple Watch: My pulse was in the 130s. I was now tachycardic—medical speak for having an abnormally high heart rate. Often, when our heart rate is high, it’s to compensate for a very low blood pressure, right before loss of consciousness occurs.
Suddenly, my heart rate dropped below 70. My boyfriend told me to call 911.
I yelled for Alex and Chloe to come into my bedroom and asked them to call an ambulance. For the first time in my life, I was having someone else do for me what I had recommended a dozen times before. Instead of being the one to respond and help, I was now the one who needed help, and it was frightening.
Moments later, the paramedics were in my apartment. They checked my heart rate, oxygen, and blood pressure, both while I was standing up and lying down. After I learned my vitals had returned to normal, I told them I was a doctor. They asked if I wanted to go to the emergency room.
My answer? “Are you kidding? Absolutely not. I’m fine.”
Here I was, possibly having a medical emergency at the height of the pandemic, and I was unwilling to go to the ER. In retrospect, I probably had had an anxiety attack or weird reaction to expired Benadryl—I’ll never know for sure. Fortunately, it turned out to be nothing serious. But I was willing to take the chance that whatever I had was better than going to the ER in the middle of a pandemic.
As a doctor, I was able to make that decision—and it turned out to be the right decision. But if you’re not a doctor, avoiding the ER in the exact same situation would not have been the right decision: If you’re about to lose consciousness and it’s bad enough to ask someone else to call 911, it’s probably bad enough to go to the hospital.
Does this mean that you should go to the ER every time you feel unwell? Absolutely not. But it shows us how complicated decisions have become, even for doctors, about when, where, and why we seek medical attention.
In short, the coronavirus has changed healthcare and how we all think about preventative medicine, along with why and how often we go to the emergency room and the doctor’s office. While some of these changes are great—the rise of telemedicine, for example, can benefit a lot of people, as I’ll explain later in this chapter—other common developments we’re seeing like avoiding doctor appointme
nts and emergency room visits when necessary and not keeping children up-to-date on vaccines can be detrimental, if not life-threatening.
These choices aren’t necessarily born out of negligence or ignorance, but what is now the new normal for us all: risk. In pandemic times, we have to assess risk on a regular basis and determine whether it’s safe to do certain activities, which includes going to the doctor and the ER. These decisions aren’t easy to make, but you don’t have to be a doctor to learn how to assess risk about your own healthcare—you just need to learn how to think like one.
In this chapter, I’ll tell you what I know and have learned about when to go to the emergency room in a pandemic—and when an urgent-care clinic or family physician may be the better choice. I’ll also share with you my experience with telemedicine and what you need to know about using the virtual service that’s replaced a lot of traditional care. I’ll also tell you which medical supplies I think everyone should have at home during a pandemic.
Moreover, I’ll explain why learning more about how to manage your health and in what ways can help empower you, even in the seeming chaos of a pandemic. The goal of this chapter is not to become your own physician or healthcare provider—even doctors have doctors! But I want to help you make more deliberate decisions and actions for your health and to learn how to be in the driver’s seat.
The Problem with the ER Is Not the ER
The stories started making headlines in the first few weeks of the pandemic: An otherwise healthy woman in New York City who didn’t go the emergency room because she was worried about the coronavirus—the next day she had a stroke.2
Or a Washington state woman in her mid-fifties who waited a week to go to the hospital for the worst headache of her life due to fears over the virus—her headache turned out to be a cerebral hemorrhage (aka brain bleed) that doctors couldn’t treat.3
Or the thirty-eight-year-old Pennsylvania man who delayed going to the hospital for chest pains because of COVID-19 concerns—he suffered a fatal heart attack in his home.4
These are terrible and tragic stories that represent the extreme, not the norm. But they do help illustrate a pervasive trend that experts say may take years to reverse: People are scared to go to the hospital. And that’s not a good thing.
According to a CDC report, emergency room visits fell by 42 percent in the weeks after the onset of the outbreak.5 Around the same time, a study published in The Journal of the American Medical Association showed a big jump in the number of deaths due to diabetes, heart disease, Alzheimer’s disease, and other common causes of hospital visits in states with the most COVID-19 fatalities.6 The spike was not insignificant either, with New York City seeing a 398 percent jump in heart disease deaths and a 356 percent jump in diabetes deaths compared to years past.7 Researchers attributed the uptick to the fact that people were afraid to go to the hospital due to the coronavirus outbreak.
Fears over COVID-19 contagion and the ER are understandable—I had them, too. But they’re fears, not facts. So let’s look at the facts.
Fact #1: Medical Emergencies Don’t Stop Because There’s a Pandemic
While everything else might come grinding to a halt when there’s a viral outbreak, medical emergencies don’t go on vacation just because there’s a new pathogen working overtime. Appendicitis still happens during an outbreak, as do heart attacks, strokes, car accidents, and all the other reasons why people can end up in the ER. Don’t get tunnel vision and think that the only threat to your health is COVID-19 (or the latest high-impact pathogen): Every ailment that was a risk before the pandemic is still a risk now—and to the same degree.
Fact #2: The Hospital Is Likely the Safest Place We Have When It Comes to COVID-19
The major breeding grounds for coronavirus that we’ve seen so far are cruise ships, prisons, nursing homes, and households. I want you to notice that nowhere on that list are hospitals or emergency rooms, despite the fact that we know COVID-19 exists in both places in a higher concentration than is likely in other places. That’s important to remember because it’s a fact, not a perception or an opinion.
Fact #3: This Isn’t Your Local Emergency Room’s First Rodeo
Hospitals have been dealing with patients with highly communicable diseases for years. They are well schooled in infection control practices and have entire in-house teams dedicated to rapid response measures. Hospitals are also equipped with personal protective gear, negative pressure rooms to prevent airborne transmission, and other tools and technology to help reduce the risk of other patients getting sick. In other words, hospitals can practically do COVID-19 control in their sleep.
Fact #4: The Measles Is More Contagious Than COVID-19, But No One Freaked Out About Going to the Hospital During the 2019 Outbreak
Measles is the most contagious and transmissible respiratory infection in the world, much more so than COVID-19. If you walked into a room where a person with measles had coughed hours earlier and you weren’t vaccinated, there’s a 90 percent chance you’d come down with the potentially deadly disease. In 2019, there was a major outbreak of measles in the United States, centered around the greater New York City metro area. But you didn’t hear about people avoiding hospitals en masse, even though many measles cases were treated in area wards.
Fact #5: If Hospitals Can Handle Ebola, They Can Deal with COVID-19
Remember when the first Ebola case came to the United States in 2014? Americans erupted in fear after a man was hospitalized in Dallas, Texas, with the disease. The virus, which includes symptoms like fever, diarrhea, vomiting, and bleeding, is fatal in approximately half of all patients who become infected. After the Dallas case came out in the news, Ebola was the leading headline of every major media outlet for weeks. America’s fear became so severe that then-president Barak Obama urged the public not to “give in to hysteria,”8 in part because the hysteria was largely unfounded. With four designated Ebola treatment centers across the country at the time, the United States was trained, drilled, rehearsed, and ready to contain the infection. (By 2020, the United States had more than thirty designated treatment centers.) That’s one reason we saw only eleven confirmed cases in the States of the highly contagious disease during the 2014–2016 outbreak.
Fact #6: Hospitals Aren’t Waiting for the Missing Link in COVID-19 Care
Yes, the coronavirus is a new disease, and yes, we’re continually learning more about the virus every day. But that doesn’t mean doctors are sitting around the ER waiting for a missing piece of information in order to limit exposure to anyone who dares step inside a hospital. Infection control and patient care in the United States is based on the most up-to-date, evidence-based science—it’s not based on hypotheses or expectations of a more comprehensive protocol to come. You should feel comfortable and confident that you are getting the best available care anytime you go to the hospital, even when we are dealing with a new virus.
When to Go to the Emergency Room
While emergency rooms are safe places and experienced in containing infectious illnesses, no hospital is 100 percent safe for 100 percent of patients 100 percent of the time. In other words, the spread of COVID-19 can, will, and has occurred within hospital walls. Hospitals attract sick people, after all, and while doctors and nurses are trained to deal with illness, it’s not always possible to ensure that every single patient or staff member knows or follows the rules all the time.
That’s why it’s not necessarily surprising that one study found that as many as one in five coronavirus patients in the United Kingdom caught the virus while being treated for other illnesses at area hospitals.9 In other words, while your risk of COVID-19 exposure at a hospital is low, it’s not zero.
You also have a minimal chance of catching a host of other communicable illnesses at a hospital—which has always been true, long before the first coronavirus case was ever recorded. While the world may be COVID-centric now, hospitals see patients all the time with highly contagious illnesses like influenza, noroviru
s, and tuberculosis. What’s more, unlike COVID-19, many patients with these types of infectious illnesses don’t always know or take steps to help prevent others from also becoming infected until after they’re diagnosed.
There’s another persistent reason not to run to the ER every time you have a fever, feel pain, or suffer a stomachache. The ER is for emergencies—hence the name, emergency room. Going to the hospital for non-urgent issues takes away resources from those who need them, like all the people who have heart attacks, strokes, serious accidents, and other life- or limb-threatening events. Unnecessary hospital visits also waste money, costing up to $8.3 billion in preventable expenses every year.10
While some may think it’s obvious the ER is for emergencies only, not everyone shares or can share this perception: Up to 30 percent of all emergency room visits are for non-critical issues that could easily be treated by an urgent-care clinic or primary-care doctor.11 Unfortunately, however, many Americans don’t have a regular healthcare provider or can’t afford health insurance, relying on the ER for basic medical care. Either way, it’s important that those with healthcare resources not add to the strain, especially during a pandemic when so many hospitals are already overburdened.
These are just some of the reasons to think twice about taking a trip to the ER during a pandemic. At the same time, there are plenty of reasons to rush to the hospital and prevent yourself or a loved one from joining the recent string of tragic stories about people who didn’t go to the ER out of fear of catching the coronavirus. But how on earth do you make that decision? Or when do the benefits of going to the ER outweigh the possible risks, including exposure to COVID-19?
Before we get to these answers, I want to clear something up: I’m not suggesting that anyone try to manage his or her own healthcare in lieu of speaking with a doctor or healthcare professional. We don’t live on the moon, after all, which means most of us have access to a clinic or a healthcare provider whom we can call or see at all hours, even at night and over the weekend (because, P.S., almost all doctors have an after-hours service).
The New Normal Page 6