Like many of you, I’ve been having COVID-19 nightmares. The general theme is always the same. In my dream, I’m somehow exposed to the coronavirus, either because I’m put in a risky situation I can’t avoid, like being in a hospital, or because I’m around others who aren’t taking precautions. Either way, there’s always a 10-second, anxiety-filled gap between when I wake up and when I realize it was just a dream. A wave of relief comes over me. I wasn’t actually exposed. I’m still safe.
Then I grab my phone and jump on Facebook and realize that the nightmare is actually reality. I see my family and friends engaging in unnecessary risky behavior ― sometimes it’s just a tiptoe over the line, sometimes it’s an outright flouting of the guidelines. Either way, I quickly post a passive-aggressive response ― sometimes it’s an article presenting the latest grim data, sometimes it’s a video from a tired and desperate health care provider, sometimes I share my own data or story.
I have my own data and story because I am, in fact, a scientist. Specifically, I research how to disseminate and implement public health and health care information and practices among the general public. I also work at a large, urban medical center and receive dire emails every day about how many COVID-19 patients the hospital has and how many ICU beds are left in the area.
Not only do I have to face the facts every day, but I am an expert in how to share those facts with the public. I have published academic papers on how to disseminate COVID-19 guidelines and get people to follow them. However, despite my vocal and visible expertise, I still can’t get my family or friends to follow the guidelines.
When the pandemic kicked into high gear in March, I was a wailing public health siren on what we should be doing ― everyone stay 6 feet apart, stay home and wear a mask. But at the same time that I was serving as a trusted source of information to the public and my social network, I was grappling with the fact that some of my own friends and family were not following those guidelines. And in most cases, these were not people who thought the virus was a hoax. They were not people who felt masks were akin to slavery. They knew it was a real and highly contagious virus. It wasn’t that they didn’t know about the guidelines; they were just deciding not to follow them.
In late March, my mother told me she was going to make the four-hour-plus drive from rural Illinois to Tennessee to visit her husband, who was there working on a construction site (where he worked closely with hundreds of other people every day). She was even moving the trip up by a day so she could get on the road before Illinois went into full lockdown. I remember feeling really angry and frustrated. She knew she was supposed to be staying 6 feet away from people, staying home, reducing the risk of exposure and transmission. She also knew where I stood on the guidelines (follow them strictly, no matter how much it sucks). But she had her reasons why she wanted to go. What good would restating our positions do?
These are not people who don’t know the guidelines or who disbelieve science. ... There is a disconnect between what they know is the right thing to do and what they actually do.
She called a week later and said she had just been tested for COVID-19 because on her drive back from Tennessee she started to feel unwell. She had a headache, fatigue and a slight cough. She didn’t want me to worry. How could I tell her that I wasn’t worried ― that I was irate? I wanted to scream, “This is why you don’t do what you did!” But I remained the supportive daughter and told her to keep me updated. I sent daily check-in texts. On April 1, her test came back negative. On April 3, an academic paper I wrote about how to get rural Americans to follow COVID-19 guidelines was published. Other scientists and researchers around the country trusted my expertise, but not my own mother.
I wish I could say that my mother’s early scare set my family straight but as the pandemic has stretched on, the phone calls, Zoom chats and Facetime meetups have continued and the elephant in the room has never left. I talk about how I am living and working in this new normal. They say it sure is a crazy time to be alive and, oh, they had fun on a brewery bus tour last weekend. In October, I posted on social media a story about a man who had a small family gathering and inadvertently spread the virus to his entire family, some of whom died. My mom commented and said she understood, really, she did. And she guessed this meant I wouldn’t be coming home for the bonfire? They say they “respect my position” ― as if following the guidelines to save others is a difference of opinion. It’s like we are living in parallel universes and neither side acknowledges it.
I also wish I could say this was just a family matter but it extends to my friends. We often say our friends are our chosen family and we sometimes have, in some ways, a closer relationship with our friends than with our families. Families bring a lifetime of baggage, but friends, well, they are our people. Our squad. So it feels strange to see my friends gathering with others outside their households, often unmasked, even for small, outdoor gatherings. Again, these are not people who don’t know the guidelines or who disbelieve science. But, like with my family, there is a disconnect between what they know is the right thing to do and what they actually do.
The emotional toll this has taken on me is significant. Seeing those close to me ignore the guidelines feels like a slap in the face. This is not the first time that people close to me have discounted my expertise (and I say that humbly and acknowledge that everyone has expertise in certain topics and that expertise can be gained in different ways, education being only one of them). But this is the first time it’s felt like a matter of life or death. I’ve vacillated between rage and resignation. One moment I want to scream at the top of my lungs and call them out at every turn ― even if it means burning that bridge ― to try to keep them and others safe. The next moment I simply shrug and think, Well, they aren’t going to listen to me anyway, so what’s the point in repeating myself? If they catch it and die, it won’t be my fault. Either way, it’s a horrible feeling to have toward your loved ones.
There’s also a feeling of being gaslighted, which at least seems to be very on-brand for 2020. You begin to question if you’re the one being unreasonable. Maybe I am asking too much of people? You feel guilty for your privileges. Where do I get off lecturing people who knew me before I went and got my fancy degrees? Even now, I feel guilty for writing this. I’m worried about how my friends and family will react. Are they going to read this, feel as if I called them out, be angry with me and not speak to me anymore? Maybe I shouldn’t say anything.
In one of my research studies, I asked people to tell me about some positives that have come out of the pandemic. One person said that if the world ever has to go through something like this again, it is a positive to at least know how selfish and self-centered our fellow citizens are. A lot of us are facing that cold, hard truth with our own family and friends.
I know I’m not the only scientist or health care provider out there to experience this. While it may not be the case for the majority, this has been the reality for many of us for the last 10 months. We feel like we’ve been screaming into a void that we once thought loved, trusted and respected us. In one of my research studies, I asked people to tell me about some positives that have come out of the pandemic. One person said that if the world ever has to go through something like this again, it is a positive to at least know how selfish and self-centered our fellow citizens are. A lot of us are facing that cold, hard truth with our own family and friends.
I think about how this all ends. If I just keep pulling the expert card and screaming about the guidelines all the time, who does that help? It may feel good in the moment but it clearly doesn’t change behavior, which means it doesn’t help keep people safe. The only thing it consistently does is damage my relationships with friends and family. On the flip side, they don’t seem to appreciate how their actions are also damaging the relationship. It feels like I’m the only one carrying this very heavy emotional burden. As if this is my problem ― not theirs. And I don’t know how I simply box that emotion up and put it away after this.
Like any good teenager of the early 2000s, I watched the movie “Almost Famous” multiple times. Recently, I’ve been thinking a lot about one of the final scenes, when the band is on an airplane as it tumbles from the sky. In the panic of what appears to be the end, the bandmates have a “come to Jesus” moment. They speak their truths, many of them harsh, and say everything they’ve been holding back. Then, suddenly, the plane makes a miraculous recovery. They regain altitude and the chaos quiets. The bandmates, having just inflicted mortal emotional wounds on each other, sit awkwardly in silence.
I feel like I’m on that plane with my family, friends and the rest of the country. We’re going down and, whether intentionally or unintentionally, we’re inflicting mortal emotional wounds on each other. But what will happen when the chaos quiets? Are we just going to pretend this didn’t happen? How do we move on from this?
Recently, I wrote a commentary in my hometown newspaper about how the most effective messengers are those with whom the listener has a mutual trust. As the expert, that’s what I wrote because that’s what the scientific data on health communication shows. I just wish I could say I saw that in reality, too.
Beth Prusaczyk, Ph.D., is a researcher at Washington University School of Medicine in St. Louis, where she studies how to disseminate and implement public health and health care practices. She is passionate about making science and academia accessible to everyone.