Cautiously Reentering the World

Jill Gilbert, MD

We now find ourselves in a world in which doors are opening once again, allowing slivers of light to reach into our new reality. We blink in the brightness as we take cautious steps toward a new normal, recognizing that it is still an evolving destination. We are confronted with the fact that the COVID-19 pandemic is not over—it may never be “over”—but our spirits must somehow be filled with the richness of living to survive.

In my case, when the pandemic first hit, the “busyness of just doing” provided a buff er and a distraction for what I would otherwise be feeling. In the middle of a crisis, I find that keeping busy can be protective. I could concentrate on the task in front of me and not on the horrors I was seeing.

I found comfort in a structured medical center response that always told me where to go, what to do, and how to serve. In fact, I quickly found that, to create more structure for myself, I needed to go into the offi ce every day rather than work from home. The structure itself was soothing.

When the first call for volunteers went out, I witnessed providers saying, “Sign me up for everything.” I candidly asked them how they were thinking about this lifechanging event. I was often told, “If I don’t keep moving, I will cry.”

My grieving was relegated to quiet times at home. But if I did not allow myself to grieve, my feelings of anger, sorrow, and fear would then pop out sideways at unexpected times, manifesting as irritability, depression, and a lack of concentration.

Moreover, my usual coping mechanisms—like eating out with a great group of friends and hanging out with my husband, an emergency department doctor—suddenly disappeared.

Like so many others throughout 2020, I learned to create distant social opportunities with friends such as Zoom cocktails, virtual movie nights, and wine parties in the driveway. These events were never as good as they would have been in person, you can’t hug through a computer monitor, but necessity compels.

I also tried to “lean in” to the solitude and find the peace of my own company. I realized that the busyness of my usual life—going out multiple nights per week, traveling for work several times per month, attending large professional meetings held in hotels or convention centers—was something that did not always support a personal sense of peace.

I am an extrovert. I am the extrovert. I am the poster child for extroverts. Throughout my life, I was the social organizer, the life of the party. But I found as the pandemic wore on that I could recharge by being alone and by doing quiet things. This was an important discovery when the world seemed to be on fire from every front. I wondered what would happen to me when the world opened up again? Would I be ready for reentry? What have I learned and what can I do diff erently to maintain serenity in a world that is unpredictable, unforgiving, and frightening?

So here I am, on the precipice of reentry. I suspect this is similar in some ways to what a fellow experiences at graduation upon starting a fi rst job. A fellow is used to working within limits set by Accreditation Council for Graduate Medical Education rules and regulations, but limits such as “caps” or duty hours do not exist in the real world. Moving into a limitless environment can be scary and unsettling. In my case, I had to learn how to incorporate the lessons I learned about myself during this “quiet period” and apply them to my reengagement with life. The forced process of reevaluation and refl ection during these quiet periods has been a gift and I will apply the lessons learned to this new world.

A few things I have learned:

1. Self-compassion and giving oneself grace are key to weathering critical events. They are underutilized and underrated forms of resilience.
2. Work travel is exhausting. A great deal of activation energy is required to attend every meeting around the country or world. It is OK to decline some in-person meetings or to attend some events virtually.
3. It is OK to cautiously enter previously “unsafe zones.” For example, I am now triple vaccinated but live in an area with a relatively low vaccination rate. I began avoiding restaurants, one of my pleasures in life, when the pandemic started. Recently, though, I went to a restaurant with a few friends, and it felt like a slice of heaven, a bit of normalcy. I asked to sit in a less-crowded area of the restaurant and although I did not feel 100% safe, I realized that the risk-benefi t ratio at this point favored the need to feed my soul by embracing these relationships. I recognize that I will always have some fear, but that life must go on and I have the agency to choose how to proceed.
4. I share some qualities with introverts. I now realize that I do not always “charge” by being with large groups. It is a mix. Sometimes, I charge by reading a great book on my back porch. I will seek balance in how I recharge.
5. I do not need to be in constant motion.
6. Fear will be with me for the foreseeable future. I accept that fear without shame. I aspire to not let the fear prevent me from living. I also give myself the grace to opt out of activities that seem too risky.
7. A little self-refl ection and a lot of self-compassion go a long way in a world of immense change.

Jill Gilbert, MD, is a Professor of Medicine and Vice Chair for Professional Development in the Department of Medicine of the Division of Hematology-Oncology at Vanderbilt University School of Medicine in Nashville, TN.