Life in a time of covid-19 - part 3: fear and gratitude

First - no I didn't: have to don PPE at work yesterday (... see the Life in a time of covid-19 - part 2 blog if you're confused). This was a huge relief. But I have vastly more than huge respect for all those who did. As GPs ... I've never admitted to being one here before but hey ho times change ... we are usually on the frontline but right now the frontline has washed into the A&E departments and we are left with phone calls; lots of them. We're doing what is called telephone triage which basically involves speaking to many worried well; issuing too many prescriptions for antibiotics to sore throats and earaches; and trying to diagnose rashes from descriptions of how red or sticky they are. Video calls are coming but what looked like plain sailing last week has veered off into choppy waters with messages not sending properly or sending twice or the process freezing on screen almost like its afraid of something; maybe its moment of being the rabbit in the headlights will pass and we'll be able to see those rashes next week. I have a sinking feeling, however, that the tide is about to turn and this is a discombobulating pause before a storm hits us with the force of a hurricane. I think general practice will again become the frontline - the gatekeeper for the rest of the NHS. It will be a darker and more treacherous frontline than we have ever faced before. If I'm honest - and I think we all should be honest about this - I dread what lies ahead. But ... and there's always, incredibly, and if we can be positive, positively - a but ...

As Benjamin Disraeli said "Fear makes us feel our humanity." 

I am amazed, every day, by the kindness of friends. And of strangers. Friends who say they'll keep an eye on - or rather, in these days of isolation, lend an ear to my far flung children. The supermarket that delivered biscuits to our surgery yesterday morning. The flowers given free to NHS workers on Sunday. To feel appreciated is a true pleasure. It is humbling but at the same time invigorating. I think as a society, we are quietly relearning how to say thank you. Much of my distress at work in recent years - and yes, I considered quitting many times but didn't - was caused by a feeling that no-one really cared when we stayed late, or spent hours waiting for a reply from a specialist, or committed our own time to managing their complex needs working on our days off or at weekends, unless they thought we had done something wrong, or made a mistake; then they cared a lot. And really let us know how much they cared! The fear of making a mistake was terrible - did I miss something; should I have managed that differently; what if they get worse? And it was so rare to be thanked. So rare that rather than it being the norm, I found myself noticing every word of thanks. Perhaps, these strange times will rekindle our collective gratitude. I see messages of support everywhere now, I heard them on the phone to our patients yesterday, and I think that rekindling has begun.

So what is gratitude?

Gratitude - definition: expressing gratefulness or being thankful. From the Latin gratus meaning pleasing.

Essentially gratitude is both acknowledging that something good has happened and then showing appreciation for whatever that thing was. It might be anything big or small - from thanking your nephew for organising a remote family quiz last night with teams communicating by text and everyone laughing at their different backgrounds and light-hearted bickering over answers; to a shared joke popping up on your phone, or a message saying 'Hi! How are you?' from someone you haven't seen for months; to finding that the dishes have been washed ... I can dream!

Expressing gratitude is good for emotional wellbeing.

I'm grateful every day for this pair of faithful friends

I'm grateful that I have this space that is mine

And I'm grateful that it's Spring

I'm grateful that I saw a shooting star two nights ago. And yes, I made a wish. And no, I don't know if it will come true. But in the making of my wish and the seeing of that speck of flaming dust, I felt hope. And I appreciated that.

Paolo Coelho wrote, "Don't give in to your fears. If you do, you won't be able to talk to your heart.'

I know I'm at risk of getting a bit preachy here but as the great Miranda Hart would say 'Bear with ...'

... to talk to our hearts we need to combat our fear and I think daily practising of gratitude could help. Here's how to do it -

At the end of every day, just after the light has gone out and you're lying in bed waiting for sleep, tell yourself 'ten gratitudes - one for each finger (in case your sleepy brain forgets how to count). These should be ten things you encountered during the day that you feel grateful for. It might be the sunlight on a daffodil; the laugh of a child; the words in a book that made you smile; the lyrics of a song that you had forgotten but heard today for the first time in years; the feel of your freshly washed socks; that for the first time in a week you didn't burn the toast; that your spouse hasn't noticed - yet - that you ate the last chocolate; that your neighbour had a tear in her eye when you gave her a spare loo roll. It can be anything; nothing is too small. If you noticed it and it made you thankful then it counts.
If you do the 'ten gratitudes' exercise every night, it will help your mental health. By forcing you to focus on positive things, it is mindful, improves happiness and does reduce fear and anxiety. *

Finally, in my opinion, no-one sums up fear and courage better than these two - I wonder if they have ever been grouped together like this before -

'I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear'

Nelson Mandela

'You're braver than you believe and stronger and smarter than you think'

Winnie the Pooh to Piglet, AA Milne

Let's all try to be Piglet.




*As long as your ten gratitudes aren't these -

1. I didn't kill my husband
2. I didn't kill my husband 
3. I didn't kill my husband
4. I didn't kill my husband
5. I didn't kill my husband
6. I didn't kill my husband
7. I didn't kill my husband
8. I didn't kill my husband
9. I didn't kill my husband
10. Yet

!!