In the Year of COVID, Echoes from the Past

The new, deadly infection was tearing through communities even though the methods of transmission — and the practices people would need to adopt to avoid infection — became clear fairly quickly.

Yet there was resistance to change. Some rejected unambiguous evidence of how the infection was spread presented by respected epidemiologists. It was created in a government lab, they objected. It came from another country, others protested. Some proclaimed that it didn’t even exist and that the story and the restrictions that were recommended by experts like Dr. Anthony Fauci of the National Institutes of Health were only put out there to infringe on their hard-won rights. And even though so many people were getting sick and dying, the President of the United States seemed to be ignoring it. As a result of fear and anger and wishful thinking, a lot of people went about their business as they always had, and many of them died.

I was frustrated and sad, infuriated even, when I heard of people I knew who seemingly embraced the contradictory concepts of this plague being both a fiction and a government conspiracy to wipe out undesirables simultaneously, people who continued living their lives as if nothing had changed. As a doctor and often as a friend, I talked to and sometimes pleaded with people to do what we knew would prevent the spread of this deadly infection. My colleagues and I did this in hospitals and on the street and in community meetings and in bars. Over time — precious time — most listened and changed their behaviors to protect themselves and those they loved. Tragically, for some, that change came too late.

And when people did die, in the early days at least, there was a need to deny that this was the reason, especially by those who were most in denial about the facts around this infection and about the behaviors of those who succumbed. They died of a heart attack, leukemia, anything but THAT.

— — — —

Welcome to my recollections of nearly four decades past, of being a young gay pediatric resident in New York City in the early 1980s witnessing the horrors of the early days of the AIDS epidemic.

During 2020 I have experienced many chilling echoes of those terrifying days when what would come to be called Acquired Immune Deficiency Syndrome (AIDS) still had no name. Or rather many names: Gay Lung Disease, Gay-Related Immune Deficiency (GRID), and many others. I remember that, as the modes of transmission of what was presumed to be a virus were elucidated — sexual contact and blood-borne transmission generally through needle-sharing by IV drug users or transfusion of blood products before a test was available to screen for what would be called Human Immunodeficiency Virus (HIV) — the demographic groups most likely to be affected were called derisively “The 4-H Club” for Homosexuals, Heroin addicts, Hemophiliacs, Haitians. (While persons of Haitian descent were among many of the earlier diagnosed cases of AIDS, this was later found to be a statistical anomaly, yet the early inclusion, even informally, of this ethnic group speaks to a deeply-ingrained racism in my profession.)

The most haunting echo, of course, is the denialism of so many who are so at risk.

Social media did not exist in the early 1980s, but social silos did. Even though people could not post opinions or videos about the issues of the day, there were places where they could freely express them to a receptive and supportive crowd. For gay men in the early 80s that was usually a bar. (Of course, this was true for pretty much any group. After all, one of the most highly-rated TV shows of that decade was “Cheers.”) This is where I usually heard incompatible conspiracy theories that:

1) AIDS was a hoax to keep us from being fully sexual beings, and

2) AIDS is a government plot to get rid of all of us.

Though directly contradictory to one another, I was amazed at how many gay men I knew believed both of them. The upshot was that a lot of men I knew and loved resisted — sometimes fatally — sound medical advice to use condoms while having sex.

— — — —

Recalling this history, then, I have been completely unsurprised that so many people in this country have similarly adhered to contradictory conspiracy theories about COVID:

1) COVID is a hoax to take away our freedoms, and

2) COVID was manufactured by China to destroy the American way of life.

With this mindset, wearing a mask and giving up family gatherings is both unnecessary and a way of rejecting a life lived in fear.

The thing is, whether you “believe” in COVID or not — just as whether so many gay men in the 80s “believed” in AIDS or not — everyone in the world is stressed right now. Worldwide, the stress hormone cortisol is being released into our bodies at levels and with a constancy previously unimagined. We tend to think of the Stress Response as being either Fight or Flight. But there is a third “F”: Freeze.

I’ve lived in my house for thirty years now. Before that, I either lived with my parents or I rented. If there was something wrong with my place, there was always someone else I could talk to about fixing it.

However, once I was living in my own house, if I was in bed trying to get to sleep and I heard a funny noise, it was now my problem. Was it an acorn hitting the roof? A raccoon in the rafters? A kink in the radiator? My most frequent response was: Maybe if I ignore it, it will go away.

So when we human beings are faced with an existential threat that demands a core re-alignment of our priorities and behaviors, a significant number of us are going to resist it, especially when we have leaders who are incapable of thinking beyond their own perceived self-interest and who discourage healthy and life-saving behavior change.

This is the tragedy of being human. Whether we admit it or not, we act primarily out of fear, often fear born out of love for those close to us and an often-flawed notion of what is best for us. We instinctively value emotional truth over intellectual truth because we identify with those we believe and believe in. And I am certainly no exception to that. It’s just that, over many years, I’ve accepted that, as scary as it might be, I will eventually have to figure out what that funny noise in the middle of the night is.

So when I do encounter people who tell me they “don’t believe in COVID,” I will admit that I feel angry and scared and frustrated. But I take a deep breath, and I don’t ridicule them or insult them or tell them that they are going to kill people because I’ve been through all this before.

And then I ask them to tell me what they know, and I listen, and I NEVER try to shame them because shaming NEVER works to bring about change, not in kids, not in adults. If anything, it makes people dig in even deeper to truth-free and dangerous and deadly notions.

So I listen, and I find something in their words that I can agree with. Because human beings always have more in common than we have that separates us. This is the basis of pioneering psychologist Carl Rogers Client-Centered Therapy: finding something to like or to love about the person across from you. This is also the basis for Improvisational Theater: the “Yes and…” response — agreeing with the premise set up by your scene partner and adding to it.

For me, that agreement usually comes from acknowledging that fear and love. Even if there is no factual basis for someone’s fear — there is no actual conspiracy — the emotion that stems from it is real. If I can start my response with:

“Yeah, that is very scary. I can see why you’d be angry about that and feel the need to do what you’re doing. May I share with you some of the things that scare me?”

that generally leads to a much more productive discussion than:

“Look, you idiot! The science is clear on this. You’re going to kill yourself and your family if you keep doing this, you worthless piece of crap!”

— — — —

One of the things I remember most deeply about my many years of Catholic education was the dictum:

“Hate the sin. Love the sinner.”

And whether it was behavior around the spread of AIDS in the 1980s or COVID in the 2020s, I have found that dehumanizing the person across from me who is engaging in unhealthy behaviors shuts down communication, destroys empathy, and hurts me as much, if not more, than it hurts them.

I also have to accept that I have power only over my own behaviors and my own responses to others’ behaviors, and my response will never be persuasive in the way I might like if it is petty and demeaning.

If I learned anything about saving lives during the AIDS crisis nearly forty years ago, it was to spend less time criticizing others for their behavior and to spend more time looking at the wounds within myself, so that I will not feel the need to lash out but rather to call others to a common ethos of healing.