This essay was originally published on the Center for Dying & Living‘s newsletter and reprinted here with permission. Dr. BJ Miller is a hospice and palliative care specialist, public speaker, and connector. His new book with Shoshana Berger, A Beginner’s Guide to the End, is a practical, compassionate, and comprehensive guide to dying—and living fully until you do.
By Dr. BJ Miller
Much has happened for all of us since my last email, either directly or vicariously. Personally, I’ve felt mixed about whether to reach out more often. On the one hand, we’re all in need of sound information and support and contact; and on the other, it seems to me that we also need to put the computer down and let this time affect us and change how we operate one day to the next.
And there is the big point I’m feeling right now: the need to be changed. We are moving from an acute crisis to something more chronic. This is one of the medical conventions that is actually very helpful and decidedly true. Acute vs. chronic. The rhetorical difference is time, and the medical distinction has to do with time’s physiological impact. Acute vs. chronic issues summon different parts of the nervous system and brain, have different effects on the immune system, and impact our sense of reality and identity differently.
In an acute crisis, something unusual or foreign is happening to you. You might be able to grit your teeth, hold your breath, and get through to the other side of the moment where the world as you knew will be waiting. But if the source of crisis doesn’t get “fixed” or leave you in relatively short order, you and that body of yours come to a crossroads: either keep trying to kick the source of trauma out of your field of view, or accommodate it. By accommodate, I don’t necessarily mean to hug or feed the trauma, but I do mean to change your view of reality so that the thing is a part of the picture, not some thing crashing the picture.
This is the serious side of the tiresome phrase, the new normal. Less a statement of fact, this phrase is really more of an aspiration. How do I wrap my head around this thing so it doesn’t feel so shocking or intrusive or awful? Feeling you’re being robbed or cheated every minute of the day is caustic to the mood and spirit.
Those who’ve spent time with grief know this vital transition. Grief is what metabolizes this process. Somewhere along the arc, you start to see beyond what is lost to what still is. There’s a transformation of vantage point. Your sense of longing isn’t solely pointed to the rear view. While you can still howl for all that is lost, you don’t have to hate reality for what it isn’t. And, with that, you get to feel whole again.
The COVID-19 virus is a simple little bundle of proteins, dumbly doing what it does and without choice. Really not much of an enemy; the much more formidable foe is the dissonance that comes from holding a world view that doesn’t jive with reality.
So, maybe we can start to listen for the call of time. Maybe we can let ourselves be changed — be affected — so that we can love life again for what it actually is now, and work with it instead of be worked by it.