Enduring the Edge State of COVID-19

We certainly are living through interesting times.

The level of despair and anguish being experienced is like nothing that has happened in decades. For most of us, not in our lifetimes. Urban hospitals all over the world are being converted into mass casualty triage tents previously only used in active combat zones. There is so much uncertainty, anxiety and stress everywhere. It can feel completely overwhelming.

For the past 20 years, I have helped people going through cancer treatment and their loved ones navigate the strange new landscape of uncertainty a life challenging diagnosis can bring. This process is now repeating itself on a planetary scale. The entire world-- billions of people-- have been very quickly taken from the familiar into the unknown. The economic toll is just beginning to be felt, but the human toll is already rippling out all over the world.

It was from Roshi Joan Halifax that I first learned the term "Edge State". This refers to the boundary between the known and the unknown. For all of us, the world we knew is gone. The world that we will make out of this is still to be determined. We are in the in-between-- the Edge. What Tibetan Buddhists call a "bardo".

Edge States are not easy. There are some tips and coping skills that are helpful. But I don't know if they can "solve" the Edge. The Edge is something we have to be at home in, like living in a hut on the lip of a smoldering volcano.

I don't think it's an exaggeration to say that for many of us, certainly all of us in health care, this is a traumatic time. It's a slow motion, serialized trauma that will unfold for weeks, probably months. There is only so much one can do to be ready. Of course, in our happiness based society, the goal is already targeted to be "resilience", but that may be more for economic wishful thinking than for emotional health.

I believe that before we speak of resilience, we have to experience what is happening with the best available tools in our toolkit. What we are experiencing is grief for the world we knew, the people we love who will not survive this experience, perhaps already for so many who have succumbed. We are also grieving the lives we thought we were going to live. We all had plans and roles that have disappeared, crumbled and changed.

How do we experience this in as healthy a way as possible?

My work with people going through cancer treatment, when life becomes a prolonged Edge State, has  taught me a few things:

1) Accept that this is happening. You don't have to be immersed in the news all the time, but stay informed just enough to guide your daily decision making and daily choices.

2) Structure your time. If you are now working from home, or not able to work, set up a schedule. Most humans find safety in routines, even if they are annoying routines. Wake up and go to sleep at the same time. Eat meals at the same time. Exercise if you are able to.

3) Find your breath. Mindfulness has become increasingly popular, but with its popularity have also come a bunch of unfounded claims. I believe that mindfulness is a mind-body technique to improve the human stress response through breath awareness. This may be helfpul to watch. Practice breath awareness as often as you can, especially after watching the news.

4) Try and keep a clear mind. Avoid alcohol and other intoxicants. If you smoke anything, quit. There is growing concern that inhaled smoke in any form makes people more susceptible to increased complications and death from COVID-19.

5) Do the best you can. This is a global pandemic. The world is grieving what it knew. The horrors of this time will be told for years to come. This doesn't need to be the most productive time in your life. You may not make the best decisions every day. The goal is this: be a loving friend to yourself. Treat yourself and others with kindness. That is surprisingly difficult for most of us in a slow moving trauma like we are all experiencing. Do the best you can. That may be hard enough.