• M. Christine Benner Dixon

The Before and After Effect

My personal reflections on the necessity of accepting change (text below).


It won’t go back. I have to keep reminding myself of this. Even if they develop a vaccine, even if they find treatments, there won’t be a world without some threat of this virus hanging over it. There will be a “Before” and an “After.” The solid fact of this change does not make it easier to remember. I am slow to adapt, slow to revise my vision of the world.

I suppose that, in truth, “Before” had already turned to “After” with first outbreak in China, but I didn’t know that yet. None of us really did. Even when I heard the news, and for a long while after that, I still thought that things could go back to the way they were. For me, the realization came months later; I was already locked down, already annoyed at people who were getting bored of quarantine and venturing out again like numbskulls. I was, unsurprisingly, scrolling Facebook. A friend from high school had reposted some rant from a doctor scolding people for only focusing on the Covid-19 death rates, when there were all kinds of other complications to worry about. My husband has been a newshound on this issue since its very beginning, so I was already familiar with most of the boogey-men on that list, from organ failure to long-term reductions in lung function. But then it caught my eye: coagulopathy. Crap. I didn’t actually know what it meant, but “coagu-anything” is going to raise a red flag for me. See, I carry a genetic mutation that makes me dramatically more prone to blood clots than your average human. And, lucky me, I got the mutated gene from both of my parents; my blood is extraordinarily clumpy. Needless to say, I had the coagulatory jitters right off the bat.

But then I looked it up. The first definition that popped up had “coagulopathy” as excessive bleeding, failure to clot. Phew. Sigh of relief--well, for me, anyway. Not great for the people who are bleeding excessively. But on a strictly personal level, if the problem is over-bleeding, I might actually have an advantage. I keep looking for my mutant superpower. Maybe this is it. (I’m still working on my X-Man name: Thrombo? The Clump?)

If I had read the very next definition, though, I would have seen that coagulopathy is sort of a catch-all term for something--anything--wrong with coagulation. Bad news, girlie--that’s you. (Better luck next time, Thrombo.) But I didn’t read that definition. I closed the tab and went back to scrolling Facebook. It is an act of mental self-defense, I think, reading only as much as makes me feel safe. It is not particularly conducive to long-term survival, perhaps, but it is comforting.

What wasn’t comforting, and what was harder to ignore, were the headlines that began to roll in about the high numbers of strokes associated with severely ill Covid-19 patients. Then came the headlines about otherwise healthy young adults who barely had symptoms at all but were throwing clots like confetti at the Super Bowl. Crap. Crap. Crap.

So, now I’m down the rabbithole, but this is no Wonderland. Or, you know, maybe it is. Lewis Carroll’s imagination was a dark, dark place. Day by day, I’m reading about the effect of inflammation on the endothelium of my blood vessels (it’s not pretty). I’m scouring Twitter for mentions of thrombophilic disorders in the context of Covid-19 (they are mostly people like me fretting about what it could mean for them). I have called my hematologist (he says there isn’t enough data to recommend anything other than caution). I’m being cautious (if you didn’t yet know anyone who washes their groceries, now you do). I’m fighting the urge to flip off every person I see who isn’t wearing a mask (if this is you, please know that I am flipping you off right now). And still, I don’t think I fully realize that I am on the far side of “Before and After.”

I feel like a kid who just went through a growth spurt and keeps knocking things over with their newly gangly limbs, like a septuagenarian who decides to climb a ladder to take care of that overgrown branch and then falls out of the tree because he’s not a kid anymore (I’m looking at you, father dear). My expectations of How Things Are and How Life Works are all still rooted in the “Before” part of my life. That’s reality, and I’m going to act accordingly. I mean, imagine if gravity just suddenly got a little more gravitous--how many times of tossing your undies two feet shy of the hamper would it take before you remembered that things fall faster now? A lot of times. It would take a lot of times.

I have nightmares, now, about accidentally hugging someone. The danger of the virus has slipped my mind, and I just go right up and hug them. Everyone is horrified at my indiscretion. In real life, I rather like my personal space and would not go throwing my arms around people willy-nilly. But the dream represents a very real concern. I’m afraid of forgetting where I am. When I’m out in my garden, chatting with the neighbor over the fence, it feels very like the “Before” world. When I’m stirring awake in dribs and drabs, turning to the other side for another half-hour of sleep, the world feels unchanged. Even when I have a firm grasp of the situation (because I’ve been reading articles back-to-back for the past ninety minutes), my mind will drift to future plans, not realizing that it’s painting with the palette of the past. My instincts are all tuned to the World that Was. I don’t flinch when I should, don’t notice when I’m about to step off the edge.

Transitions are hard. In transition, we stretch a long step from bank to bank, our crotches exposed and vulnerable. We are off balance and precarious. The trick to transitioning well is agility and momentum--the longer you dawdle in no-man’s-land, the more likely it is that you won’t make it to the other side. But even when you do swing over to the other side, the “Before” is hard to shake. It’s like moving out of an apartment you’ve lived in for years. For a while, when you open your eyes in the dark of night, you can’t figure out what that window is doing there. If there were a fire, you would run the wrong way.

That’s the danger, isn’t it? Going the wrong way. Running into the fire. It’s not like we’re trying to throw ourselves on some pyre of loyalty to the Way Things Were, but our brains are telling us that this is the way towards the exit, towards safety. I’m not that self-destructive, right? I’m not going to put myself at risk just because I miss the simplicity of a bygone era. Right?

I wish I could say it was so simple. I am, to my own alarm, harboring a dangerous resentment towards this new world, a pointless loyalty to the old one. I am, in some perverse corner of my heart, tempted by the defiance I see modeled around me. As I consider the possibilities of what “After” may mean for me, the choice does not feel obvious. Even if there’s a vaccine, it probably won’t be 100% effective. If this virus turns out to be seasonal, I’ll always be playing the odds on when the season starts. And if I lose that gamble, my lifespan could be . . . (how to put this delicately) . . . reduced. But if I were to play it perfectly safe from here on out--never attending another lecture in a crowded hall, never again renting a cabin with friends, never jumping in a pool with my nieces and nephews--my life itself would be reduced. I sometimes feel the urge to just say, “Screw it, I’m going to do what I want. I can’t live in fear!”

Thus, I’m not shocked that the prospect of continuing the quarantine is so exhausting, so repulsive to people. They want to stop straddling the gap. Frozen here, trying to figure out which house we’re in, our goose will get just as cooked as it would if we went charging through the wrong door. But hold that thought. Because just as cooked is still cooked. As far as I can see, the only non-cooking option depends on our being awoken to the fact that we now live in the “After.” I know you miss the old apartment. I do, too--I liked living in a world that wasn’t quite so pro-thrombotic--but I don’t really think this is the most opportune time for nostalgia.

Is there a word for future-oriented nostalgia? That’s what we need. We need something to draw us forward into the “After.” No, things won’t go back to the way they were--that’s not how linear time works--but life will be worth cherishing again. And if we play this right--if, for instance, our leaders would realize that incentivizing people to stay home is exactly what is needed right now--we can get there without (pick your metaphor): a) falling crotch-first onto a tree branch, b) inhaling too much smoke. But one thing is for sure: we can’t go back.

And we don’t want to. One of the dangers of being stuck at the transition point is that you aren’t close enough to see either side with clarity. “Before” was not a place without sacrifice, challenge, inconvenience, limitations (or whatever else you are afraid will be imposed on you if we deem this coronavirus a danger greater than economic loss). Your brain wants to tell you it was all safe and cozy back there. It wasn’t. For goodness’ sake, people, do you realize we were already living in a country that was playing fast and loose with public health by sending sick people to work? Don’t you remember that life-threatening pollution was accepted as a necessary by-product of the all-important commute? Don’t you remember that people were being exposed to undue threats to life and limb in jails and prisons every day? The “After” isn’t the only thing worth being afraid of.

That’s not to say that it’s not scary. As long as I’m still bumbling around in the haze of “Before,” the prospect of severely limiting my interactions with other people to avoid an endemic virus sounds pretty awful. But so does dying from a stroke and/or pulmonary embolism. It’s hard to reconcile to the very real, very unpleasant prospect of the “After.” My brain desperately wants to forget the new constraints. It backslides like a champ. But ignoring danger doesn’t make it go away.

I am irrevocably lurching towards the “After,” and so are you. We know we can’t go backwards, so let’s take a minute to plan a route out of here. There are things we don’t yet know (my particular disorder might not be exacerbated by this virus; the economy might benefit from a more cautious approach) and things we do know (it will always be a bad idea for me to be immobile for more than an hour at a time; losing thousands of citizens a day for weeks on end is going to take a toll on this country). But I believe that we have the potential to fill the “After” world with justice and strength and beauty (though heaven knows it isn’t a given that we will do the work). I have faith in the agility of humankind. I have faith that the enduring need for authentic connection and really good food will give rise to new kinds of restaurants. I have faith in our communities to recognize the efficiency of protecting ourselves by protecting each other (all of us). I have faith in art (my own and yours) to harness these new constraints as creative engines. I have faith in modern medicine--with their skills and our cooperation, the “After” can be a place where people flourish again. Let’s lean towards that “After”; let’s tip the scales.

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