I haven’t written for a couple of weeks – there are different reasons, ranging from decorating work in the little room where I like to sit and, my aspiration of trying to find something else to discuss that is not Covid.
As you can see, I have not succeeded.
What to do?
Well, in many ways it is hard to find something else when my world has become so narrowed – sure, I interact with lots of different people (although less so lately for reasons I will explain) and, yet, the changes of scene, environment, landscape have all drawn-in.
In many respects I am lucky, there are nearby places for me to walk, countryside to explore (although I feel I have got to know it too well recently), yet, the old world of coming and going, driving to see patients in their homes, visiting different care homes, chatting with staff and relatives, all that has reduced or shifted.
What about my brain?
When Covid began I was participating in all sorts of different online meetings – even before the realisation that face to face wasn’t the most sensible approach I had dug-in and logged-on to Zoom, Microsoft Teams or, at the very start, BT Connect – a phone conferencing system.
There were multiple daily briefings, situation reports – Sit-reps as they say, gold, silver and other tarnished command meetings were rattling around the system. Often I would contribute, my sense of things; at times it was fun, to be in the thick of it, yet, it was wearing.
Those meetings have all reduced in frequency – or, at least, the ones I am invited to.
Yet, the wearing continues.
What I mean by this is the physical and mental exhaustion of sitting staring at a computer screen; navigating online meetings and discussions, waiting for frames to un-freeze, for audio to catch-up and multi-tasking (checking emails, WhatsApps and wandering into Google) during a meeting that in the old world would have been considered rude; nowadays, no one is sitting next to me to tut-tut at the content of my browser;
I am sure some people are doing their shopping when I am going-on.
This multitasking places a strain on our brains; despite what people say, we can only do one thing at a time. Jumping semi-simultaneously from Amazon to family WhatsApp to Google News and back to patient results whilst someone drones-on about infection control can only happen in series (we can’t parallel process like computers) – we do one thing, then another then another. (OK some of us can pat our heads and rub our tummies).
Serial processing; switching backwards and forwards from concentrating on Word to Outlook to Chrome uses mental energy;
Most of us are doing the switching, that itself contributes to part of the wearing.
The biggest thing however is the move to video-consultation and meetings.
We are not evolved to function this way.
In the old world, if you had four or five meetings (called ‘back-to-backs’ by managers) you would possibly have five, ten or twenty minutes of downtime as you walk or drive from venue A to B.
In Cyberspace you click the buttons and you are instantly re-routed; no down-time.
Also, the effort of adapting our listening, sensing, perceiving styles to online meetings is draining.
In an old-style get-together you might have looked at the person speaking; made episodic eye-contact, that kind of thing – with video-conferencing you are faced with multiple faces and their different expressions, their micro-gestures, smiles, frowns, sulks;
All of this information can be overwhelming.
And it is this, the new way of interacting that I can feel is changing my brain.
It used to be thought that our brains were, not necessarily static, but just lots and lots of electric messages buzzing between one another, like an old-fashioned telephone exchange. We now know that it is lots more complicated, the way we think, more like waves of rolling energy, which is organic, constantly changing, growing, re-shaping and adapting to experience.
If I watch a movie, my brain is changed following the experience; in part through the creation of new memories, but also because of the concepts or ideas laid-down from watching (It maybe depends on the film in question).
There is the philosophical notion of the world being my idea, i.e. what I perceive is made-up by me, my mental representation; this works the other way too, I am the world’s experience; I see a flower because my brain generates the image on my visual cortex – the flower in tandem with my perception changes my brain.
A dynamic tête-à-tête;
And so too the new world.
Sitting, reviewing, assessing and connecting with patients on video is changing the way I practice medicine; it is changing the way I understand illness and disease, it is altering me.
I have been developing new skills, new strategies to improve communication, to allow the patient or the nurse or colleague a better chance of understanding my questions, and me, theirs; I have had to learn new ways of assessment that requires the intermediary of cyberspace.
And it is this that is draining; exhausting.
Our brains are the most energy hungry organ in our bodies; like gravelly 1950 Mustangs, voracious oil-guzzlers.
Coping with this change requires nutrition – an explanation for the odd chocolate craving and rest; sleep.
Since Covid began my sleep pattern has never been better; indeed, I need more sleep that ever before (except, perhaps when I was a baby or toddler).
My brain is changing.
As to whether I want or like this change, I don’t know; there isn’t really an alternative.
When this is over, or rather, when the old is forgotten and we are living in the new normal it might be difficult for me to return to my old ways.
My kids used to ask me what sort of doctor I am.
My usual explanation would be, the ‘touchy-feely kind’.
I work by listening and sensing patient’s expressions and emotions, tuning-in to their posture, rate of breathing, eye movements, skin tone, complexion, the rate of conversation, choice of words or language; I never found this tiring – it was natural. I would often hold a patient’s hand, maintain eye contact, laugh or smile at their jokes or anecdotes.
All of that seems to be behind me. Washed away by technology and Covid.
I miss it and the replacement is a pathetic substitute.
It is changing me in ways I didn’t anticipate or even desire, yet, the plasticity of my neurones is rising to the challenge.
What else is there to do?