Three years, nearly to the month of the start of the COVID-19 pandemic, I contracted COVID. I had managed to avoid it during the period when no vaccination was available. But now the pandemic was waning, and I was fully boosted. I had been ready to join the bustling academic environment of the Pediatric Academic Societies (PAS) 2023 Meeting in Washington, DC my registration, plane ticket, hotel, and dinner ticket to the American Pediatric Society Howland Award Dinner, were all ready. Then I got symptoms, thought they were due to allergies, but with an abundance of caution (and a new 2-month-old grandbaby in the house), I tested myself and that pink line showed up quickly and unequivocally. Plans changed. I started antiviral medication and an inhaler, and the next 2 days watched carefully to see if symptoms would worsen.
I spent the first day furiously writing an article that had been percolating in my head and sent it off. My thoughts raced. I contacted a zillion folks apologized for likely having to miss the meeting but not excluding the possibility of attending. Using the Centers for Disease Control and Prevention (CDC) calculator on isolation, I figured I could discontinue isolation in 5 days as per the guidance, put a mask on, and take off to the meeting.
On the third day of isolation, in a large room upstairs in my home that accommodated all I needed except for food (that need, my husband kindly left outside the door), I began to feel the need for calm. I realized that the thought of going to the PAS and attending the planned sessions especially those that would deal with anti-racism efforts was triggering for me. It made me think of my successes and failures. It made me think of what I had not achieved. I am outspoken, so had I offended anyone in expressing my views on bias, leadership failures, and the need for advocacy? My mood in the past few years had been uncharacteristically negative perhaps due to ongoing leadership struggles. My thoughts raced at night, especially in trying to decipher what I could do to address the number of issues that I felt passionately about including the epidemic of gun violence and Black maternal mortality and the whole question of health disparities and inequities, the themes that had permeated throughout my professional career. Now in my sixth decade, I began to question whether my contributions had been at all impactful, the current metric applied to academicians. Was my life worthwhile? That thought came since when young, I believed that all things were possible. The passage of time, the experiences of my life, the third stage of my life that shines a bright light on what has not been accomplished, and the re-emergence of the same problems that we had confronted 3 decades ago brought a humbling realism to my thoughts.
I kept busy with already scheduled appointments and the necessity, even in my currently pessimistic mood, to stay focused optimistically, or perhaps seeking the ever-needed validation that my thoughts mattered. The week or so before, I had served on the panel held virtually by the Columbia University Division of Ethics, commenting on the movie Aftershock. The link was now available and I listened to the data eloquently outlined by my colleagues, Drs. Sandra Soo-Jin Lee, Lisa Nathan, Dana-Ain Davis, and Colleen P. Campbell, and noted that my comments, while backed up by the data that demonstrated unprecedented increases in Black maternal mortality rates in 2021 (69.9/100,000 live births), the highest in the United States and far exceeding that of other high-income countries, needed to connect with the message of the movie, which is that of human loss. I regained a sense of purpose in my isolation in the work of the National Institutes of Health (NIH) Steering Committee on Community Level Interventions of Firearm and Violence Prevention which due to a recent Congressional appropriation of $25 million to the NIH and CDC would begin to fund research on this public health crisis. The work of this committee would not change the ecosystem of the United States that has allowed the proliferation of ever more lethal guns, would require navigating around the contentious debate of gun control but perhaps would provide some hope of curbing the epidemic. I would serve as an unbiased guide to this research effort. The continuous reports of mass shootings and daily firearm-related deaths and injuries counterbalanced this feeling of optimism. Nevertheless, I was acutely aware that these researchers are genuine and their science rigorous.
I began reading nonmedical book, always a sign that my mind is slowing and calming. Yes, it included Michelle Obama’s second book entitled The Light We Carry. While still reading it, it was clear that the running theme was the acknowledgment that the world is indeed a dangerous place and that we are the sum of our childhood experiences, the social and political environment of our country, the need to justify all our actions, the impact of personal attacks especially when holding leadership positions, and our personal relationships with all the failings and flaws of the human existence. Another book which caught my attention was that of Malcolm Gladwell, Talking to Strangers. The various examples he gives are insightful of how the sinister intents of individuals are often well camouflaged, revealing that we are at risk for misjudging situations, defaulting to assuming what is presented is the truth, especially when dealing with individuals that we do not really know. In my musings on the purpose of the PAS to help us network in our academic pursuits, Gladwell’s discourse touched a chord. Have we as academic leaders charged with making purposeful decisions about trainees, faculty, staff, and patients focused sufficiently on guileless engagement at the service of the overarching vision for child health? I reflected on my conversations with colleagues on the Board of the Haiti Cardiac Alliance as we struggled through deciding what is still attainable in efforts to have Haitian children with congenital or acquired heart disease access medical and surgical interventions given the dire political and economic situation in Haiti. The bravery of Owen Robinson, the executive director of Haiti Cardiac Alliance, has been resounding evidence of the power of hard work and optimism. I was interrupted a few times by my daughter to videoconference with the grandchildren who I now could not see in person, and my daughter resumed calling me during her hour-long ride from her surgical residency. Yes, she is the mother of those 3 babies.
So, almost a week into my isolation, I recount all of this to share that while my anxieties have not gone away nor the various traumas of my life, time for reflection and thought has given me the brief gift of holding on tight to optimism. Forced isolation gave me permission to slow my constant thoughts, reminiscent of the rare time I missed a month of school due to chickenpox, giving me a reprieve from the need for a perfect attendance record. The problems that we face locally, nationally, and as a world have not gone away. The polarization that exists in our country and in our daily encounters is real. Trusting is difficult and often needs to be tested to determine if it is deserving. The need for us to continue to strive to connect, listen and talk to each other is evident. Our science and activism are ever more necessary. I have reflected on how important my family and friends are, those who know my failings but stick with me rain or shine. In the context of having to slow down because of a relatively minor infection with COVID (I am grateful for this), it is the words of a 2-year-old that teach me yet again the meaning of life. With that incredible smile, her words “grandma hold my hand, grandma sit with me” resonate—it is after all, really all worthwhile. I did not attend the PAS, I am getting better, and I began to quiet my mind.
Declaration of Competing Interest
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This work has not been published previously and is not in consideration for publication elsewhere. I am the sole author of the publication, and if accepted the article will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright holder. I am the corresponding author.
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I have no disclosures or conflicts of interest.