Editor’s Corner: Caring For Ourselves and Each Other in an Unprecedented Time

Elizabeth Brém, MD
Assistant professor of medicine at University of California Irvine Medical Center in Orange, CA

During the COVID-19 quarantine, my grandfather, the well-loved patriarch of our large family, passed away. It is difficult to process loss and grief over Zoom, thousands of miles from where you want to be, and it is hard to feel closure after watching a funeral via live stream. It was also painful to think that Grandpa Jack – a man with 8 children, 10 grandchildren, 8 great-grandchildren, and many good friends – spent his final days in the hospital without any of those friends or family members at his side, due to visitor restrictions.

In Meditations, Roman emperor and Stoic philosopher Marcus Aurelius wrote that our operating principle should be, “Do the right thing. The rest doesn’t matter.” During this stressful time in world history, we would all do well to keep our feet firmly on that foundation. About half of Grandpa Jack’s children and grandchildren are nurses or doctors and were busy doing their part in the pandemic, so I take some comfort in thinking that he would be proud that his progeny could not be with him because they were “doing the right thing”: caring for their communities.

The last weekend in May 2020 was an emotional rollercoaster for many of us. On Saturday, May 30, we watched NASA astronauts take off from U.S. soil for the first time in almost a decade, on a commercial rocket for the first time in human history. As they successfully propelled to the International Space Station, the astronauts revealed that they had named their shuttle Endeavor. The launch was a testament to what humanity can achieve when we work and endeavor together.

As the weekend unfolded, demonstrations of frustration and anger in response to the death of George Floyd in Minneapolis spread across the country, shattering any illusion of unity.

When it comes to equality, we must again strive to do the right thing. This can be difficult in health care, where there are often hurdles to getting patients equal access to appropriate care. We frequently encounter patients who lack good insurance and have limited transportation options, insufficient coverage for important diagnostic tests and treatments, and astronomical copayments. These problems are so common and seemingly insurmountable that it is easy to feel overwhelmed.

Mindfulness is one practice that can help us gain clarity and energy for the work we must do. A key tenet of mindfulness is to focus on what needs to be done now. Taking a moment to collect our thoughts and come back into ourselves is an investment in time that will pay us back in dividends. Like Stoicism, mindfulness practice helps us “triage” and recognize what we can control and learn to let the rest take care of itself. We can control our reactions to events and ideas. This can help us avoid getting caught up in the unreliable energy of grief and rage. (Editor’s note: Read Dr. Brem’s July 2019 editorial on Stoicism.)

One way to take action is to support organizations that support diversity. If you are in a position to help, there are many organizations and causes worthy of your time and money. The American Society of Hematology (ASH) has shown a sustained commitment to diversity in hematology, including through its minority award programs for students, researchers, and clinicians at all stages of development and training. In addition, ASH supports patients from diverse backgrounds throughout the world through its programs to promote research, access to care, and improved management of sickle cell disease (SCD) and creation of the ASH Research Collaborative’s SCD Clinical Trials Network. One can choose to donate to the ASH Foundation specifically to support these programs.

In these anxious and frightening times, please take care of yourselves and each other. If we are distressed and scattered, we are of little use to those who depend on us. Marcus Aurelius also wrote, “All things are mutually woven together and therefore have an affinity for each other—for one thing follows after another according to their tension of movement, their sympathetic stirrings, and the unity of all substance.” I believe we can take the time to listen to and support those who are hurting and embrace this moment to become a stronger, more supportive hematology community, country, and world.