The Person’s error wasn’t about my sexual preferences; it was that they thought I go to nightclubs!†
What impression do you have of The Person?
Would your impression change if The Person is:
a man?
a woman?
the teenage child of a friend?
a stranger over the age of 70?
a white person? a non-white person?
a straight person? a queer person?
my boss?
As much as we try, we can never really get away from ourselves. We all think we view the world through relatively impartial lenses. Then we encounter people and situations that trigger our mental habits.
Like viewing the world and the people in it through the lens of sexual preferences.
Or believing that blog posts are only worthwhile if they resemble articles.
† Long-time readers know my opinions about dancing.
To become a doctor, one learns how to prevent disease and death. To do this, one first must become acquainted with them: What happens? What does disease and death look like? sound like? smell like? What are their textures and patterns? What shifts over time, until the patient has no more time left?
As medical students learn what disease and death look like, they witness human suffering. Many students are unprepared for this. The tears that physicians in training shed are not from recognition of the mechanisms of disease and death. They cry because of the human suffering that surrounds them, that submerges them.
We don’t cry because we recognize that the proteins in the coagulation cascade aren’t reacting fast enough. We weep because there is so much blood everywhere. We see how pale their skin is, hear their rapid heartbeat on the monitor, and feel the coolness of their skin.
We see the contortions of their loved one’s face. We hear them scream, their sobs escaping their throats.
If we cry when we witness the suffering of one or two human beings, won’t we still cry when this happens to multiple human beings who are infected with a pandemic illness?
What if the cause of death isn’t a disease, but is instead a person? How do we then react?
Some psychiatrists recently shared the mental model of projection to explain why people kill others. Briefly: Projection is an unconscious process. People generally don’t think of themselves doing “bad” things:
I would never hate people because of their religion.
I would never treat people differently because they are poor.
I would never deny someone a place to live.
… even though they may have fleeting thoughts or impulses that align with these.
In projection, someone will “project” negative thoughts and impulses onto someone else and deny that they themselves ever have them:
I’ve done the work and I don’t have implicit biases. That guy, though, hates anyone who belongs to that religion.
I’m open-minded and understand that people who are poor are still people. That person, though, thinks poor people are all lazy and stupid. Just a bunch of moochers.
Of course everyone deserves a place to live. That guy, though, thinks some people deserve to be homeless. He thinks they’re all criminals and deserve to die.
In projection, we (unconsciously) don the gown of righteousness. We can do no wrong. Our intentions and motives are pure. In projection, we (unconsciously) coat The Other Person in the rags of depravity. They are evil. They only want to do bad things.
We are nothing like them. We could never be like them. They could never be like us. Anything we do glows with virtue. Anything They do is wrong.
We crush cockroaches underfoot because we are nothing like them and could never be like them.
How different are They from cockroaches?
We can’t test for projection. This is supposed to be an entirely unconscious process. (If we were conscious that this were happening, we would (should?) be horrified. We could not tolerate this and would take steps to stop it.)
I don’t discount the idea of projection for killing, but because there is no way to validate it, this is not the first explanation I go to. There are also a lot of steps: I’m a good person, you’re a bad person, you’re so bad that I don’t think you’re a person anymore, so killing you isn’t actually killing a person.
The dehumanization that comes from neglect is more compelling to me than the dehumanization that comes from projection. Indifference can cause more harm. It can be a conscious choice.
It’s not that I think you’re subhuman or an animal. I just don’t think about you at all. Torturing and killing an animal, even a cockroach, means that I at least thought of you as something that can react. If I don’t think about you at all, then you already don’t exist. And what sort of reaction could you possibly have if you don’t exist?
What harm could torture, rape, and murder have on nothing? If you don’t exist, then I’m not killing anyone in hospitals and schools. There are no children. I’m just flattening buildings.
You don’t matter. You have no matter.
People, like you and me, weep around the world.
A man cries for his son who will not live to start school because of the cancer in his brain. A son cries for his mother who died in an accidental plane crash. Someone cries for a friend of 60 years because their heart stopped beating.
Death from disease and the random events of life already causes suffering. Do not cause more suffering by killing other people. You will not only destroy others, but you will also destroy yourself.
The reason behind my recent silence here is I am attending to a beloved family member whose health continues to deteriorate. Surely other medical professionals have written about the difficulties of our roles and responsibilities: We are not (and should not be!) doctors or nurses for the ones we love, though it is difficult to push the professional knowledge out of our minds. Sometimes (often?) it doesn’t feel like love is enough, even as we realize that our professional knowledge isn’t enough, either.
I have spent most of my career working with people experiencing homelessness. I don’t recall newspapers and other media writing about this topic as much as they do now:
Homelessness is a federal problem. Was there ever a time when the feds tried to solve the problem of people having no place to live? What is the history of homelessness in the US?
Well, there’s actually a FREE, short paper (it’s an appendix!) from a long report about permanent supportive housing with the title “The History of Homelessness in the United States“. That article led me to the book Down and Out, On the Road: The Homeless in American History. I’m about 80 pages in and, so far, it’s not encouraging. The arguments and opinions about homelessness from 100 and 200 years ago are similar to what we hear now in 2023 (deserving vs. undeserving poor, work tests, etc.). I’m hoping the author will describe the intersections of homelessness (“vagrancy”) and health, including substance use (alcohol? opium?) and mental illness.
If this problem were easy to solve, we would have already solved it… right?
The inimitable Ed Yong is leaving The Atlantic! His stellar writing about Covid over the past three years were invaluable to me: Not only did he provide meaningful analysis about how Covid was affecting individuals and populations, but he also accurately captured the horror of what was happening.
In his recent newsletter, he shared the following:
… I want to double down on my journalistic values: not only describing what is happening but helping people actually make sense of it; bearing witness to suffering; speaking truth to power; revealing wonder in the obscure; and pushing for a more just and equitable world.
He has succeeded in adhering to his values (and received a well-deserved Pulitzer along the way). This has prompted me to consider what values I hold in my writing. (Are the values I hold in my professional role transferrable to my writing? Is writing part of my professional role? Why am I mincing my life into roles when they are interconnected, as per the first paragraph of this post?)
If you’ve seen the Barbie movie: I know most people are fawning over the song “I’m Just Ken”, but “Push” is the underrated gem. I’ll never hear the word “granted” the same way again.
There are valid reasons why people catastrophize (to imagine the worst possible outcome of an action or event): Terrible things happen. Uncommon calamities occur, things that we never thought would happen to us. Common catastrophes occur, too, things that we know will happen, and yet all of our preconceptions do not provide adequate preparation.
Are common catastrophes really “catastrophes”? Like death and dying? Death by “catastrophic implosion” is a catastrophe by definition. What about migrants drowning at sea? People dying from heart disease? overdoses?
Do the reactions and opinions of other people determine whether something is a catastrophe? If you’re the only one who thinks it is a catastrophe, is it still a momentous tragic event?
To catastrophize is to have an active and creative mind, one that brims with possibilities. These options are unlikely to happen, but they could.
One function of catastrophization is to provide mental rehearsals. Practice gives us a sense of mastery: We thought about a Thing, we considered the consequences of that Thing, and now we have plans to avert disasters related to that Thing.
Doesn’t “Emergency Preparedness” sound better and induce less anxiety than “catastrophization”?
However, “catastrophization” often omits the “preparation” part of “emergency preparedness”: We get lost in loops of apocalyptic ideas. Paralysis (and perspiration) ensues.
More recently I’ve wondered if catastrophic thinking reflects a lack of self-confidence, or at least a fear that we are incapable of dealing with disasters. We are terrified that we will not survive.
It seems the most debilitating aspects of catastrophization do not always involve material things. We may fear the flames engulfing our home, but we fret more about the potential destruction of our pets and loved ones who live with us.
Material destruction is distressing, though annihilation of our identities is intolerable. Who am I if my children die? What does it mean if I’m the only person left who has these memories? What will happen to “me” if I can’t deal with this Thing?
Maybe this is a lesson that only comes from time and experience: We can survive more than we think we can. The world can shatter our hearts in unimaginable ways, but we persist. What was unimaginable becomes part of our personal history. We weren’t eradicated; we endured.
This is not to say that the experience was “fine” or that we are “fine”. The external and internal wreckage is real, but we are still here.
How do we persevere among the ruins, though? What do we do when catastrophic thoughts descend upon us, demolishing the tenuous safety and security we think we have now? What do you do when your thoughts take you to a world that doesn’t exist right now (and may never come into being)?
It sounds trite and overdone: Bring yourself back again and again to this world and yourself. What is actually happening right now? Where are you? What are you doing?
See the summer trees, their limbs full of luscious leaves. Hear the wind rustle the branches, a green applause filling the air. Feel your toes in your shoes, the way the small bones in your feet support all of your weight. Do you feel your tongue in your mouth?
Indeed, what is the texture of the pain in your lower back? Is it mostly sharp right now? Or a monotonous throb? Can you trace the direction of the sensation? How do you respond to it? How does it respond to you?
The sirens that wail: Can you hear how they change pitch? When does the “WOOOOoooo” finally disappear? Did you hear it dissolve, or did you only hear its absence a few minutes later?
What are the shapes of the letters in that text message? What punctuation is present? What are the colors in the emojis? What might happen if you took a full breath before sending a message? What message are you sending yourself with a short breath? A long one? A noisy one?
Life, in all its beauty and ugliness, continues to unfold whether or not you are giving it your full attention. You could live your life entirely in your thoughts, one catastrophe to the next. What might you miss in the world outside your head if you do that?
And have your catastrophic thoughts diverted any disasters? Thinking about all the things that could go wrong might help us feel like we have control over something, but do we really? Things will go wrong whether we think about them or not… and things will go well even when we think they won’t. Thoughts are magical, but magical thinking is ultimately a collection of ideas in our minds.
In catastrophization we have great confidence in our thoughts. When living in this world, let us have more confidence in ourselves. We can make it, even if we don’t believe it.
Since my last post, I have recovered from illness, though spasms of coughing still occasionally overtake me. Other circumstances have changed, too, that have highlighted to me the importance of spending time with people we love. American culture often focuses on becoming financial millionaires when becoming time millionaires is vastly more important.
Here are some things I read while recuperating that may be of interest to you:
The Politics of Paying Real Rent Duwamish. This is of greatest interest to people who live in the Seattle-King County area. After reading this article I stopped paying Real Rent. The tagline is accurate: “Why a simple act belies a complicated history.”
What It Felt Like to Almost Die. “My near-death experience taught me not to fear those final moments.” I hope that this is true for us all.
Generation Connie. I am a bit older than the cohort of Asian American women who were named Connie (and my father said that my parents never considered the name Connie for me), though I definitely remember seeing Connie Chung with Dan Rather when I was growing up. Fun photos in the article.
A Killing on the F Train. Of all the writing I’ve read about Jordan Neely, the man experiencing homelessness and psychiatric symptoms in NYC who died when another subway passenger restrained him (via chokehold), this piece by John McWhorter resonates the most with me. His perspective is kind, nuanced, and empathic. Highly recommended.
Maria Yang, MD 