Monday, April 13, 2020

Boundaries in the age of COVID: Part 2

I appreciate WHO, and the struggle they are having trying to care for the health of humans, not just in one municipality, one city, one state or province, not just in one country, but everywhere all at once. It's clear that their tool is data as they struggle to collect as much of it as they can, dealing with all the multiple intersecting verbs of existence, gears that affect other gears, different political systems that have differing ideas about what constitutes relevance or truth, trying as clearly as possible to present recommendations without being dictatorial about it. 
I have found it useful to consider boundaries.
Boundaries as containment systems. 

Boundaries as limits. 
The old boundaries vanished and new ones are in place. 

Physical boundaries:
Face masks contain breath moisture. They are a deliberate boundary between exhalations of discrete persons. This simple fact spins me off in many different directions of thought. Way long ago, before COVID, viral concerns were a real concern, mainly in Asia; I remember visiting Taiwan just two short years ago and noticing the immigration official at the airport who interviewed me at entry to her country wore a mask. It was a novelty to me.
Most of the rest of the folks I saw there, in streets, restaurants, milling around tourist attractions, in museums, did not, but some did. I asked my hosts about it. They explained that it was fairly common when people were concerned about either having an illness and not wanting to pass it on, or didn't want to catch one from someone else. My attitude at the time was that they perhaps had a touch of paranoia. I still (naively, in retrospect) trusted my own immune system to be able to deal with whatever life might throw at it. 

Travel boundaries:
In mid-February I attended the annual San Diego Pain Summit, 6th year in a row, no restrictions yet on travel between Canada and the US. Life as usual. It seems like a distant memory even though it was only two months ago, because so much has happened since.
I had to get up hideously early on Feb 17 to catch a cab at 4am to get to the airport to come home. The (Asian) cab driver was sick, and was wearing a mask. A very sturdy looking mask. He didn't make any conversation or eye contact. It crossed my mind that I had heard there was a virus killing people far away, but hadn't heard anything about it being local, so I assumed all was probably well in North America. 

He did touch my bag (in and out of the trunk), and he did hand me a receipt.  
I like to imagine he may have been sanitizing his hands like crazy out of my view. And he certainly took great pains to not breathe on me.
I came home feeling fine, have had no symptoms for the past two months. I hope I'm not a typhoid Mary for COVID, one of those asymptomatic people who sheds live virus. 

I did treat a few people after I came home, just a few, as my practice was slow as molasses anyway, a good thing in retrospect: I have always made a big deal about "washing" my hands with a Clorox wipe before touching anyone, even in pre-COVID days. This was before masks were an acceptable thing for asymptomatic people.
I have tried to not breathe on anyone anyway since all this came to pass. I haven't treated anyone since mid-March. 

The grey zone. 
I was in it and still am.
No way to be tested if you are or were asymptomatic. 
You had to have traveled AND have symptoms. The quarantine rule if you had recently come back from somewhere else came up a lot later where I live, mid-March I think.
I think I'm clear. I mean, I gave my 96-year-old mother a ride to and from the hairdresser mid-March and she's fine as far as I know. (Unless she's another possible asymptomatic Typhoid Mary... perish the thought.)

The hairdresser was already sanitizing surfaces and having customers wash their hands. Hair salons are currently closed by provincial request. 

Financial boundaries:
Shortly after I came home mid-Feb from San Diego, future travel plans went totally sideways with the cancellation of all my workshops. Air Canada fully refunded my plane ticket to Asia for teaching workshops in Japan and Singapore, because I had booked the flight in December. So now I have nice fat credit applied to my credit card. That should keep me in groceries for several months; cash transactions are now forbidden. 
Just to be on the safe side I applied for CERB. CERB is the Canada Emergency Response Benefit. I qualify, because I earned more than $5000 last year and this year I will earn zip. Nada. Nothing. 

I do get an old-age pension, and they may clawback some, but it won't be for another year or two. Suddenly the government is made out of money and they are firehosing it out onto everybody. Two thousand dollars a month for 4 months.
That's a good thing. Even though it feels totally weird,  a very very flipped boundary in the citizen-government relationship. 

Cultural boundaries:
It was an unfamilar cultural boundary I was experiencing when I was in Taiwan and saw mask-wearers walking around, a cultural boundary which I now consider to have been blown right out of the water, because it's being encouraged here in Canada now.
My own Prime Minister, in the course of asking people to please start wearing homemade masks, made a verbal gaffe while addressing the nation on TV about not wanting people to "speak moistly" which, right after he said it, he commented that he had not put it very well. His very rare verbal gaffe has been made into a comic video. Which brings me to...

Personal boundaries:
He has not publicly commented on this video - it's likely that he has seen it and has decided to "grey rock" it. Grey rocking is when you either let something sit there, as completely inert and unremarkable as a grey rock, or else be a grey rock, and have the same attitude as one might expect a grey rock to have. Either way, not putting any emotional or reactive energy into a phenomenon, especially if you are a public figure the way he is, is to possess excellent personal boundaries that will serve you well in your role as PM, channeling yourself into what is important for the good of the congregate you have been elected to serve, rather than into personal issues or proclivities publicly displayed which serve no one.
He not only exhibits good personal boundaries, but also smart political boundaries. Which brings me to...

Political boundaries:
He has some.
I've been thinking about him a lot, comparing his political boundaries to those of Cuomo and Trump, both of whom I also watch every day. Well, not Trump every day, because he doesn't provide any food for thought, but I've watched him bloviate more than I usually do. And I am prompted to contemplate stark contrasts, how they arise. 
Contrasts between political systems, the ones of Canada and the US even though we are all on a continent with a virus that doesn't give a shit about political boundaries. 
Contrasts in political parties in the US, Cuomo inhabiting one and Trump the other, how Cuomo seems to have a value system in his innermost self and how Trump seems to have none whatsoever and how each of them line up rather well with their respective parties, although I confess: I have massive bias against anything that smells the least bit rightwingy. There is so much here. Maybe later.
Back to Trudeau - he was raised by a statesman and has become a statesman. He's not of the party I usually vote for, but I like his style. 
The party I vote for, where my loyalty was born and has always thrived, is to the left of his. It is the party that was led by Tommy Douglas when I was a child. But I still can admire Trudeau's style without losing any loyalty to my own set of political values.
My party is an outsider party, a leftoid party, sees itself as a party of some distant better future, has a history of reform, religiosity even (Douglas was a Baptist minister), views itself as a pro-social conscience of the nation. I like these values. I feel I somewhat embody them. I've always been a walking contradiction in some ways, pro-social even as I never was interested in reproducing more humans or committing to having anyone else living in my domicile but me, inhabiting a profession with which I disagreed vehemently about certain things, loving some things it stood for and thinking other things it stood for were conveniences more than they lent inherent value to it. I feel quite comfortable agitating from the outside. 

Physio boundaries:
Although I never married, never wanted to, I ended up married to my profession for better or worse. I have put a lot of emotional and professional energy into fomenting change within it which took many decades to clarify to myself first (no easy task) then implement in the form of a book and workshop format.
A lot of physios seem to end up becoming administrators when and if they realize they aren't suited to treating of people. I've never been one of those. I've always been more interested in individuals and their pain problems, never in systems, or meetings, or in general in being part of something bigger than myself. Myself has been more than enough to try to figure out over a life span. Also, whenever I've toyed with being part of something bigger than myself, socially, part of a system or a group, even a progressive group, I have either felt submerged and made to feel invisible to myself, a cog in a machine, or I've become competitive and strove for excellence and realized that if you do that you get promoted to your level of incompetence and have to endure stress about that. And that kind of stress was always enough to make me break out in skin rashes. So I've always been more comfortable as a human, being a lone tumbleweed rolling around by myself, bumping into fences, walls, and so on sometimes and coming to a halt for a while, then having lots of time to think.

I retired today, for real.
Up to now, I was thinking it over, sometimes out loud. I had been thinking about it for months and months and months. The plan was, keep my practice up until March 2021 at which time my provincial license was due again. Huh. I guess according to the boundaries of my legislated organization I'll be on the books until then anyway. Whether I pay rent and keep a door open is a different thing. I can still do one (be on the books until the current license is up) without having to do the other (physically maintain a practice).  

I had to reorganize my own inner boundary about all that. 
It was hard work. 
It was emotional work. 
It was like divorce. Instead of staying married and celebrating a fifty-year anniversary, it was more like, ok, we've been at this 50 years so now we can quit this marriage and liberate each other from it.
Come May 1, I'll have to deal with my treatment room and its contents and I won't be paying rent anymore.
Today I went in and left a "goodbye everybody, I'm retiring" message on the phone. 

It felt poignant, and even right now it feels a bit like the skin on the front of my chest has been sandpapered. 
But I also feel a burst of energy now that the deciding is finally done. 

The virus and the boundaries it has imposed:
Here we all are, all of us now a big bunch of human tumbleweeds all trapped, blown up against a fence, trying to find paths forward, trying to see the bends in the future and what direction they might go. 
Somewhere I read that the symbol in Chinese for "chaos" is the same as the one for "opportunity."
I don't know if that's actually true. Maybe I should check with Asian friends.
In any event, it seems that the virus has handed us a fabulous opportunity to reevaluate, maybe even re-invent ourselves, our existence on the planet as connected to nature, each other, our social worlds, able to examine all the boundaries and containment systems that grew as though by themselves and later generations adapted to but maybe, just maybe, we don't really need some of them, can move others, can change a few things in society in order for there to be less horribleness to each other, as humans, still being. 


Bronnie Lennox Thompson said...

Diane, you were one of the very first people I encountered as I started blogging in 2007. YOU are inspiring as a person, as a woman, as a physiotherapist, as an author and most of all as an educator and clinician.
I am so proud to have been able to spend time with you, have your autographed book and some of the most amazing hugs in the world from you!

Diane Jacobs said...

Thank you so much for those kind words Bronnie.
Please take care of your precious self and thank you for everything you do.

nagak said...

Diane, I often think how long ago the SD Pain Summit feels now, although it was only in January. The sun, the brain tickles, the conviviality and in retrospect, the opportunities to sit and talk with one another. So much has, as you say, turned sideways since then. Your experience as a physio and an educator has most certainly been life-changing for many (patient/clients and others in physio). As a clinician, I voluntarily left my job last November due to a software problem that our IT department couldn't fix. It was infuriating, and I wonder now when I will be back in a clinical setting. There is still so much that is fascinating about the human body--but as you write with such eloquence, it is about so much more than just the body. Please know that "retirement" for one with your skills is really not that, for you have so much to teach us all yet. --Kiri Schultz

Diane Jacobs said...

Thank you Kiri, maybe we'll meet again. All the best.

Suzanne Thorson said...

You may retire, but you will always be teaching. It's who you are. I will be coming to see you the next time I'm in SK. We can pick apart woo and nonsense over a bowl of soup!
I hope you are still planning on attending San Diego! I sure hope to be there next year!
See you soon!

Diane Jacobs said...

Great! I look forward to seeing you either here in Sk or there at the summit. :)