The Covid-19 pandemic has brought into stark relief one of the great certainties of life: death. As news reports relate the daily death toll — which, when aggregated, exceeds that of 9/11, the Vietnam War and even World War II combined — the reality of our mortality has pierced the consciousness of our society. With vaccines available, there is now hope that the end is in sight for the pandemic. But as we begin to look forward, we carry with us a heightened awareness that we remain mortal.
As a practicing psychologist, I deal with patients who at times must address mortality directly, usually when struggling with a medical diagnosis or the death of a loved one. More often though, references are made indirectly through unconscious and superstitious behavior (the wooden windowsill in my office is rapped frequently as people discuss deep-seated fears). But the pandemic made mortality an explicit theme in most of my sessions for the past year. And that’s a good thing.
Accepting our mortality can be positive because it allows us to consider what really matters in life and motivates us to act on our values. A common denominator has been my patients’ overwhelming desire for deeper connections. They’ve had less interest in having 1,000 Facebook friends and more interest in feeling known by a few select people. That was informed by a recognition that time is limited and not to be wasted — an awareness that needs to outlast the pandemic if we want to maintain some of the gains we’ve made.
Family bonds in particular were a type of relationship that was often strengthened as people formed pods during lockdowns. “I was working so hard to stay alive. I don’t want to go back to the pace I was going at before. I actually look forward to family dinners now,” said a mother of young children in my practice. She added, “I will never waste my time commuting two hours a day again.”
Other relationships ended, which were difficult, but ultimately for the best when there was a mismatch and moving on was necessary. And many friendships were renewed, as the awareness of the fragility of life took hold and people had more time to communicate with one another — albeit virtually.
This desire for quality rather than quantity in relationships required flexibility and a change in behavior. A patient who’s a grandparent became computer savvy to stay in touch with his grandson. Another patient, an executive who has a son with Down Syndrome, began reading to him every night before bed. They have had a difficult relationship, and my patient acknowledged that he had never spent as much time with this son as with his other children. Now in his 60s, with his son in his 20s, he said, “Better late than never. I want to make this right before either of us die.”
Revelations about the importance of relationships can also help us figure out the bigger-picture vision we have for our lives. Some younger patients questioned the idea of keeping all their options open as the best path to a meaningful life. A graduate student in his 20s said to me, “I suddenly feel this urgency to settle down and get married, ASAP. If I can’t go out to bars and travel, I want someone to come home to.” He is no longer putting off commitments to some future time, and although this represents a loss of freedom, it also helps him feel in charge of his own life rather than merely a victim in a pandemic.
Covid-19 also held a mirror up to the ways we avoid our mortality. One patient, a woman in her 60s who lives alone, told me, “I’ve always been alone, but I never felt lonely before.” While that sensation might not be a pleasant one, the isolation of lockdown and the rules against visitors in hospitals have led her to think about changes she can make to mitigate her new-found fear of dying alone; she came to terms with the fact that her 60s were the time to take the necessary steps to age in place safely.
For some, this exercise took the form of practical but needed measures to “get their house in order.” I routinely ask patients if they have a will, a health proxy and someone to fulfill their final wishes. These questions are typically met with resistance, but during the pandemic, people have been more open to engaging in these conversations. Though this resistance is rooted in fear, ironically, knowing that one is prepared for these circumstances can help alleviate anxiety about dying. Finding ways to take action at a time when people have largely felt powerless has also been helpful. I hope that people will continue to see the value in these directives even after the acuity of the threat is gone.
A few of my patients started out being more than just resistant to the reality of dying but in complete denial about their mortality, downplaying the prevalence or severity of the pandemic. Determined not to stop leading the life they had planned and believed they deserved, they traveled, went to large social gatherings and wore masks grudgingly. Their sense of invincibility made them a risk to themselves and potentially endangered those near them.
For others, denial was the only way they could continue to function at jobs that were essential to their livelihood. “You can’t be a butcher from home,” said one patient. A few of my patients who work in hospitals began the pandemic with a rush of adrenaline bordering on excitement and suppressed the knowledge of being in harm’s way. A few months into the surge, however, the stress of being in denial took its toll, and these patients started to experience depression, disrupted sleep, even panic attacks. Once they renounced the role of heroes and accepted the dangers they faced, they could turn their energy to fighting for proper personal protective equipment and accurate information about vaccines.
An awareness of mortality, and the fear that comes with it, also allowed many of the people I treat to find effective coping strategies that will benefit them far into the future. “When Covid hit, I had a looming sense of death, which scared the crap out of me. But I found being in nature, seeing the change in seasons, learning about birds, all brought a new calm to me,” one of my patients told me. “I don’t want to die, but I have an easier time now accepting that there are forces greater than me at play.”
As we emerge from lockdowns and cross the threshold into resuming life in the wider world, we may be tempted to stifle our heightened sense of mortality. It’s imperative that we not throw caution to the wind and take unnecessary chances that put us at risk of dying prematurely. At the same time, staying fearful and clipping our wings is not a healthy way to cope with our fear of dying.
Because we have seen the ravages of death, we ought to live our fullest lives mindful of our mortality. Such is the best medicine for our mental health, but equally important, it is a way to pay homage to all those who lost their lives from Covid-19.
Other essays from our project on what we should keep post-pandemic:
- Covid masks save American lives. They still can (and should) post-pandemic, by Dr. Megan Ranney
- Social distancing during Covid means no hugs. My personal space finally feels respected, by Christina Wyman
- Covid 'essential' workers were always important. Don't abandon them post-pandemic, by Kim Kelly
- Covid's remote parties allowed us to celebrate with all of our dearest, not just our nearest, by Rachel Pomerance Berl
- Even post-Covid, outdoor dining should keep going. Our staid restaurant culture has to evolve, by Deanna Fox
- I moved back home during the Covid pandemic. Here's what I gained by giving up my solo life, by Samhita Mukhopadhyay
- Covid walks kept this angry caffeine addict sane. And I'm going to keep walking, by Meredith Bennett-Smith