2020年3月18日 星期三

What I Learned About Self-Quarantine From Nine Months of Chemotherapy


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“I’ve been quarantining for three hours, and I am already so bored!” – Friend

“Oh my God, how am I going to do this for another week, if not more?” – Another friend

“This self-quarantine is crazy. I am losing my mind. Did I tell you about my date last night, Ps. He was so weird. I’ll call you right back, I am going to walk my dog.” – Yet another friend

“Of course, I am going to her birthday dinner. Our age group is not at risk.” – Again, another Friend

It would appear that my 30-something-year-old contemporaries have varying views on what self-quarantining means, and to whom it applies. Who can blame them when it’s not required (yet, at least) here in New York where we live, and the media information about COVID-19 is so rampantly multiplying with murky, contradictory, and misleading statistics and recommendations?

I’d like to help. Having recently emerged from my own unrelated, 10-month-long self-imposed quarantine, I can offer you the following advice: Listen to the actual health authorities—i.e. Anthony Fauci, not Mike Pence—and when it comes to following their recommendations, err on the stricter side.

In 2018, I was living in Italy, attending business school in Milan. In late May, I was spending the week in Rome, interning at the Valentino flagship store on Piazza di Spagna. It should have been just as romantic as it sounds. But after months of feeling unwell, and seeing various specialists in Milan to no avail, newer symptoms of a cough and an aching pain in my side became so severe I ended up at a walk-in clinic in Rome. When the blood results came back four days later, I received a call telling me to go to the hospital immediately. At Campus Bio-Medio Hospital just outside of Rome, the doctors performed a bone marrow biopsy (a nasty little procedure), and I was formally diagnosed with Acute Lymphoblastic Leukemia—a mouthful affectionately called by its acronym A.L.L.

Arrivederci, Italia. Thirty-six hours later, I was stateside again. My parents picked me up from J.F.K. and drove me directly to M.S.K., or Memorial Sloan Kettering Cancer Center in Manhattan. I would remain there for five weeks, attached the entire time to an intravenous line pumping me with chemotherapy drugs, blood transfusions, antibacterial medicines—you name it.

I left the hospital in remission on July 5th,  2018. However, I still had nine months of intensive chemotherapy in front of me, followed by three years of maintenance chemotherapy to ensure the cancer cells were completely obliterated. (I have just finished my first year of maintenance. Quite a time for my quarantine re-entrée.)

It was these initial nine months of intensive chemo that necessitated my self-quarantine. My white blood cells and neutrophils, also known as the immune system, were compromised by the constant attack of the chemo, whose job it is to kill said blood cells. I spent every day in my parents’ home. I could not go to crowded spaces. I often wore gloves outside. Visits to the doctor’s office, my main social activity, required a mask and constant hand-sanitizing. I spent half my days disinfecting my hands, whether through hand washing or sanitizing, paranoid that I would become ill. My daily walk outside was my one break from quarantine, the purpose of which was to minimize my risk of forming a blood clot (which, of course, I developed anyway). You get the point—I’ve done this before.

So, this week, when friends started complaining of boredom and disruption after mere hours of social distancing—in some cases, while recounting to me the date they went on the night before, or describing the birthday party they were about to attend—I did not feel much sympathy. That is, until I remembered how frustrated I felt way back when I’d first returned home from the hospital in 2018 and realized that I would be stuck there for nine more months. Until I remembered that, in fact, I had complained a lot. Unlike my peers, who at that point were doing everything as usual except maybe not going to parades, my own isolation was accompanied by almost-daily doses of poison that left me feeling hungover for basically an entire year, without the drunken benefits of a night out.

Regardless, I get it. Self-quarantining sucks. Especially since there is currently no clear end in sight. In my case, it was not hard to convince me that isolation was the best option when the carrot dangling in front of me was extending my lifespan. Beyond battling cancer, which could kill me, I was at risk of getting pneumonia and other illnesses that my body, its immune system weakened by the cancer treatment, couldn’t properly fend off. In fact, despite my stringent precautions I still contracted a virus that led to a very dangerous bout of acute myopericarditis, requiring a heart biopsy and a weeklong stay in the cardiac ICU at New York Presbyterian.

So, for everyone who currently has a healthy immune system, think about all the people who are currently in the situation that I was in last year, i.e. cancer patients undergoing the worst year or years of their lives, with no immune system. Think about how real the threat of COVID-19, a disease we know incredibly little about, is for them. Think about those with other autoimmune disorders, chronic conditions like heart or lung disease, or the elderly. Think about the people who fall into several of these categories. Do you want to make them sick? Just because you are asymptomatic or might not be at the most risk of dying from coronavirus, do you think it is okay to contribute to the spread of the disease and increase the chances of these people getting fatally ill?

It can take a while to find your groove in isolation; it did for me. Please keep in mind that I was not able to work in this period, given the state of my health, so I cannot offer tips on “WFH,” a term we are all now too familiar with. I am currently eight days into my self-imposed coronavirus quarantine and happy to report that I am yet to lose my marbles. Practice makes perfect. Some tips to dealing with the cabin fever are as follows:

1.    Your life will begin to feel like Groundhog’s Day. Be prepared.

2.   Glass half full, people. Remind yourself how lucky you are to be alive. It makes the self-quarantining seem like less of a big deal.

3.    Watch those movies and read those books on that ever-growing list in the notes section of your phone.

4.    Take advantage of the extra time with your family and loved ones, if you are not sick yourself.

5.    Explore journaling and meditation to deal with increased anxiety.

6.   Most importantly, take it seriously. Follow the CDC and other health experts’ advice.

I don’t mean to sound glib. I know this is not going to be one long, lazy vacation. I cannot speak for working parents who are now juggling doing their jobs and taking care of their children all under one roof. I cannot imagine how hard this will be for them. I cannot speak for people who rely on schools to help feed their children. I cannot speak for the people worrying about keeping a job and making rent while being told to stay home, without paid sick leave. Or for those who have already lost their jobs due to the catastrophic toll this virus is taking on the global economy. I come from a place of privilege, and I’m acutely aware of that. I also know that, unlike my cancer-quarantine, a pandemic incites extreme behaviors and panic on a global scale, not just for the individual. I know that people are not simply watching movies at home with a bag of popcorn, but are also on Amazon trying to find food for their family and toilet paper for their nether regions.

I recently called my doctor’s office and asked, “Am I more at risk? Why have I not heard anything from you all? Am I going to die if I get coronavirus?” The response engendered both optimism and concern. They said that while my latest blood counts are within normal range, which means I should not be particularly more at risk currently, they recommend that I follow what the CDC’s guidelines, because that is all the information they have as well. Eerie.

So, what I ask is this: That the government assist people in this trying time, that health officials become clearer with their messaging and recommendations as their understanding of the coronavirus develops, that the media try its best not to add to the confusion, and most of all, that people properly self-isolate and understand their role in the spread. Let us all come together in this moment of uncertainty and embrace the quarantine.

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