In an airport I came across your writing prompt for stories and started crying. I haven’t been a patient at a psychiatric facility, but just a few weeks ago I spent one of the worst days in my life at one.
I had been dating a guy for barely a month, but it had been a quick ramp-up. Part of why our relationship had developed an intensity so soon was an early realization that we shared some mental wiring—or mental-wiring defects, to be more accurate. What I didn’t realize until it was too late was that although we both struggled with depression, he was on the cusp of a major breakdown.
Not that he had been dishonest, or that we hadn’t talked about it; I just didn’t realize how bad it was until suddenly I was driving him to a psychiatric facility so he could voluntarily commit himself. Sitting with him in the stark, cold bleakness of an ER psych room, trying to distract him and calm him and cheer him for nine hours, was one of the hardest things I have ever done. He was on a gurney, and I was in a chair, and there was nothing else in the room: bare walls, a picture window facing a hallway where the ER psych staff sat. It was frigid, and they knew that because they brought blankets in right away, but they didn’t offer to adjust the heat.
Other than the initial checking in and psych evaluation, all completed within two hours of us arriving, we were just waiting. They never told us why it took so long, and they hardly even checked in as the morning and afternoon wore on. I babbled on about anything that came into my mind, and I tried to help him think through practical matters: Who do you want me to call? Is there anything I can bring you from your apartment?
When the doctor came in for him to sign the paperwork, I learned that the law in our state is that if you commit yourself and change your mind, the hospital is allowed to keep you for five days to evaluate you. And even then, it can go to a judge who might still rule against you. Five full days.
He signed those papers. Watching him, everything in me screamed DON’T DO IT!, but I kept my face still and nodded encouragement. And then a few hours later I had to leave, had to walk away from him and leave him behind a locked door.
I hated visiting him there. I hated my anxious interactions with the staff, who unevenly enforced rules and always hovered nearby. I hated knowing how much power they had over him and over me while I was in those walls. I hated the overpriced parking garage. I hated having to sign in and wear a name tag. I hated locking my purse and coat and cell phone in the waiting area. I hated planning my entire schedule around the limited visiting hours.
A few years ago I went to the ER for an extreme panic attack. I took an Ativan, called my psychiatrist to adjust my meds, went home—and it took a year to pay off the massive hospital bill. This episode with my boyfriend brought that all back, and whatever strength or progress I’d gained crumbled in a matter of days.
And then he broke up with me—a searing rejection that seemed to confirm my worst fears about being unlovable.
Later, after he was out, I told him the day he committed himself was one of the worst days of my life—and he told me it was one of the best days of his. And so you can imagine our mental healths as two lines on a graph, his slowly creeping upward just as mine comes crashing down, and that day is where we intersect. Before I had been so healthy, so great. But now I know I am not so far from needing to be in that place.
When I told my therapist how much I hated being in the psychiatric ward, she agreed with me that they are not built to be therapeutic; they’re built to be emergency safety measures. I understand that. But I also know I will never voluntarily submit to such a place. I’ll die first. That’s the plain truth, dramatic as it sounds. I’ll swallow pills and cut my wrists and make damn sure there will be no hospitalization. It will not be an attempt.
If you or someone you know ever gets to that point, the National Suicide Prevention Lifeline is 1-800-273-8255. And if you, like our reader, have an experience to share about a loved one or yourself in a mental hospital, please send us a note—especially if you think it might help in some small way. It seems to have helped Eva, the reader who started this whole series. In response to me mentioning that her story sparked a wave of reader emails, she replied:
Thank you so so so much. That’s the biggest, most beautiful compliment I know. For someone to find brief comfort or compassion or someone who gets it—that really is the best gift I know. Better than health.
Depression really feels like you are in this alone. I’m never really sure why that’s so, but it feels comforting that people understand. And if someone buys that book Stay for another person, that also means something to me. It’s the only one of its kind I know as a librarian, the only one to combine anything and everything secular that there is to reject suicide with. I give the book whenever I can.
Update from a dissenting reader who makes a nuanced distinction between our reader’s story and the general impulse to commit suicide:
You quote a woman who, reflecting on her time in the psych ward, says, “I will never voluntarily submit to such a place. I’ll die first.” She’s not actively suicidal; she’s trying to convey how extreme her desire to avoid the psych ward is. You immediately follow her words with a suggestion that readers at “that point” should contact the National Suicide Prevention Lifeline. According to the policies on their website, “a crisis center staff member’s decision to initiate active rescue for unwilling callers at imminent risk should be made without concerning oneself of the potential effects of involuntary hospitalizations.” I know referring your readers to a respected institution seems like the responsible, caring thing to do, but this series itself should be a reminder that those well-intentioned actions can have dangerous, devastating consequences.
My name is Emily, and I’m writing in regarding your series on experiences under psychiatric care. On October 25, I was admitted to an inpatient hospital after having suicidal thoughts. Although I did not attempt suicide, there was definite ideation. For 15 years I’ve been dealing with anxiety, depression, and an eating disorder (which goes back and forth between bulimia, restricting and purging, and just restricting).
I spent 11 days inpatient, and I just “graduated” from an intensive outpatient program yesterday. I could go into lots of detail about what I went through, but here are the major bullet points I’ll remember for the rest of my life:
Bawling myself to sleep the first night, but then experiencing a calm in being isolated and separated from my daily life and the outside world. (There was joy in not having access to my cell phone or a computer; the break from social media was freeing beyond all belief.) While most people around me were talking about when they would be discharged, I felt an emotional and physical release, which ultimately turned into very deep revelations about myself and my core beliefs. Among them: I am unworthy of love. Arriving at that understanding as an inpatient allowed me to work through what it truly meant and to figure out a strategic plan for combating that line of thought once I was discharged to “the real world.”
There were actually some fun times in the hospital. One patient told me a story about how he was pulled over by a cop who asked if he could walk in a straight line. The patient’s response? “No, but I can snort one!” It was one of those “too soon or not soon enough” jokes on a psychiatric ward that made me chortle. Later on in my stay, I became friends with some women my age, and we sit together drawing in adult coloring books, sucking on the straws you use to stir coffee for the oral fixation, sipping on actual coffee, and pulling out of our coloring trances to discuss whether we were feeling anxious, angry, upset, depressed, etc. I also remember trying to do the worm in the common area, and every patient in the ward was laughing to the point of tears, myself included. I was told I looked like a fish flopping around on the land. I hadn't laughed like that in ages, and it felt so good to just naturally laugh like that while making a slight fool of myself.
Having my meds changed multiple times in a short time span and feeling like a guinea pig.
Seeing people detox off drugs and alcohol was terrifying and saddening, and it also made me reflect on my own drinking habits. I’ve now been sober for 46 days.
Making Girl Interrupted jokes to my best friends when I would call them on the patient landline—our only source of communication.
From a 67-year-old reader:
When I was 40, I had simple shoulder surgery that somehow went wrong—improper oxygen intake, most likely. By the end of that year, my IQ dropped from 132 to 78. I had cognitive problems, long- and short-term memory glitches, and some physical symptoms as well. For the next six years, I was in and out of the locked psych ward in my local hospital for major depression that was eventually deemed resistant to treatment. I was under suicide watch, so my room was filmed to ensure my safety.
I got to know a few patients very well over the years. Our paths would cross in a group or in outpatient therapy, and I found each patient’s story fascinating. We really wrestled with ways we could reshape each other’s thinking strategies.
One trick was to try to figure out what someone was in for, before they told us. Some were easy: the grandma who lifted her skirt up when someone came in the room, or the man hearing voices who just wanted quiet (so no TV or radio in common room). My only mistake was a friend I knew from different intakes who always had a journal and a pen. When her pen broke one day, I told her I had a pencil and tried to give it to her. I hadn’t been there long enough to realize she had a pencil problem—and it ends with the pencil in and through her hand. Not knowing that, I gave her the pencil, I hear running, and—yup, she’s done it, and now I feel terrible.
The group was so nice to me over the pencil incident—explaining all the good I had done and brought to the table—that I had to forgive myself (and now I know not to repeat it). Years later I ran into that woman at a seminar. She held up her pen to me and said, “I’ve accepted no #2s, so I bought a Mont Blanc that cost a ton, so I feel so good about it; it’s all I want. You gave me that suggestion.” It felt good.
Normally all the staff was great, but what I found the hardest was arts and crafts. The limited amount of things you could make were equivalent to camp projects for 8-10 year olds. But participation is a must, and for some, crafts were about all they could concentrate on. So, a tiled box, a pencil case, and a poem came home with me. I think I still have them.
My ideation of suicide remained for a few years, and I would put myself in the hospital when I didn’t feel I could trust myself. I felt very safe there and worked through the issue.
The hardest thing to see is those who come in being newly diagnosed. These individuals are doubters; they’re not sure they really have an illness or how long they’ll have it. That acceptance takes time to totally ingested, chewed on—and they either spit it out and leave or swallow and start accepting “this is your life.” It is truly tough.
This next reader bonded with one of her therapists:
Thanks for compiling these stories. It’s nice to know I’m not alone in my experiences. I’m not sure if my observations would be of value to anyone else, but I reflect on them occasionally and still marvel at how strange my experience was.
I agree with Eva that most people didn’t seem “crazy”—except for the cute guy I was chatting up at lunch who mentioned that he flies with the witches (moral of the story: don’t look for love in a mental hospital) or the older gentleman who would literally only converse about the weather. But yes, they were all memorable. And they taught me little nuances of patience and empathy that I don’t think I could have gotten anywhere else.
One thing I thought was weird about hospitalization was the occupational therapy. I had always pictured that as helping someone to relearn how to write after a hand injury, but I guess in this context it was about helping people find joy in life or some such. So we did little-kid crafts, which seemed bizarre, but it was better than getting yelled at by the nurses for lying in bed too much.
My hospital was in a college town, so we had an occupational-therapy student working with us. She and I were about the same age and liked the same music, so we struck up a sort of friendship. She would come get me early for craft time so I could help her set things up and we’d hang out and talk.
One time we went to a park and sat on the swings while she told me how she was cheating on her fiancé but it was cool because she was going to stop once she got married. I sort of laid out why I thought that was a bad idea and talked her through what she really wanted in her relationship. She thanked me for the advice afterwards. That conversation reminded me that we’re all screwed up in some way, and it also made me wonder what the hell my parents were paying this hospital for if I was the one providing therapy.
Another strange thing about hospitalization was the field trips. I assume along the same lines as the latch-hook rug making, the trips were meant to bring us some measure of fun. I thought of it as an opportunity to possibly run into one of my college classmates and have to explain to them why I’m bowling with a bunch of strangers and psychiatric nurses. Luckily I never saw anyone I knew.
Probably the worst field trip we took was to the movies. For whatever reason, the hospital staff had chosen Forrest Gump. I sat next to a guy who grew up near me and who I’d hung out with over the past couple of weeks. He had ended up in the hospital after some sort of a drug arrest and contended he was only there because of that issue, but having talked to him a lot, I sort of thought he was deluding himself. At any rate, somewhere early in the movie we both realized the absurdity of taking deeply disturbed people to see what I assumed was meant to be an uplifting movie. We talked about how life is not like a box of chocolates; it just fucking sucks sometimes and you can’t do anything about that.
So I guess I appreciated the solidarity I felt with him over our hatred of the movie. He committed suicide a few months later, which further solidified my distaste for that awful film.
If you or someone you know displays warning signs of suicide, the National Suicide Prevention Lifeline can help: 1-800-273-8255.
This next reader had a horrible time as an inpatient, and her feelings ranged from lonely boredom to the fear of sexual assault:
I can’t tell if the timing of Eva’s letter is great or awful for me, because I’ve been in an inpatient psych ward twice in my life—and due to various circumstances, I recently began to wonder if I’ll soon be forced into a third. Eva mentions that her experiences have been a mixed bag, and I guess I’d categorize my experiences similarly, overall. But the negative moments have been so horrendous that more than once I’ve caught myself thinking it’s not worth saving my life if I have to be trapped in one of those places again.
I’ve only been in psychiatric wards in the U.S., and they’re pretty uneventful. The most notable thing about them is the widespread boredom. Sure, there are group therapy sessions and arts and crafts and meals, but all of those occupy at most 30 percent of the time. The rest of the day I spent lying in bed, staring at the ceiling and crying, or sitting in the community room watching whatever soap opera was on TV that day. You were not allowed access to any electronics—not even a cheap MP3 player to help soothe yourself—for the entire stay, and there were no locks on any of the interior doors.
The other inpatients were rather benign. (The only issue I had in that regard was an older man who either seemed to want to be my drug dealer or my sugar daddy, I’m still not sure which. Maybe both.) What elevated dull hospital stays into “Never Again” is the widespread incompetence and cruelty of the doctors who “recommended” my hospitalization and controlled my fate once I was there.
The first time I was an inpatient I was 16. I had been depressed since I was 11, and my illness had recently progressed into self-harm with scissors. When my psychiatrist found out, he forbade me from cutting myself and threatened hospitalization. Of course, because I was 16, I agreed out loud but in my head told him to go screw himself. I kept cutting.
At my followup appointment a couple weeks later, he asked me if I was still doing it. I didn’t take his threat seriously, so I admitted, yes, I had. He gave this long, exaggerated sigh and said he had no choice: He had to admit me to a psych hospital.
In Michigan, where I live, involuntary psych hospitalizations, even for minors, can only be administered by a court if the patient is an immediate threat to themselves or others [more details here]. I was not suicidal at the time, but my psychiatrist found a loophole: He said I could refuse to admit myself to a hospital, but if I did, he would call social services and have me removed from my home. And oh, he says, looking at the clock on the wall, “You need to make a decision quickly, because I have another patient in 20 minutes.” His reaction to seeing a 16-year-old girl in so much pain that she felt compelled to hurt herself was to rip her from the only sense of safety she had left.
So my parents admitted me to the hospital, where I stayed a week. When I had my intake exam, the nurse tutted, “These scars are nothing”—but they kept me anyway. For the first two days, I slept fully clothed and didn’t shower, out of fear that one of the random men coming to check on me in the middle of the night would assault me.
While I was there, the doctor on-call adjusted my medication. “How are you feeling?” she asked me the next morning. When I said I was just as miserable, she actually seemed confused, but anti-depressants take weeks to work. If even the doctors didn’t know that, why the hell was I even here?
The one bright spot came when a nurse took pity on me and showed me her clipboard. She let me know that someone was always watching us, and that they kept track of whether we took part in group therapy, whether we talked to other patients, whether we ate and how much. She said that little checklist was how they determined who had to stay and who got to go. She didn’t say it in so many words, but the subtext was clear: Fake it. So that’s what I did.
During my final interview with the on-staff psychiatrist, he asked me if I thought I’d ever cut again. And like a seasoned pro, I said, “No, because I don’t want to end up here again.” He smiled and nodded his head. “Good,” he said. “That’s why the doctor put you here in the first place.” That one statement was so repulsive to me—wasn’t the point of psychiatric care to heal people, not just scare them into compliance?—that I promised I’d never go back. That I would be so selective of what I shared with everyone, but especially medical professionals, that they’d have no reason to suggest it.
Four years later, the mask slipped, but my therapist pointed out that because I was an adult and the stay would be voluntary, I could leave at any time. I fell for it, only to arrive at a hospital where they said if I decided to leave, they’d just send me to another hospital that had no illusion of choice at all, and that hospital could keep me as long as it wanted.
I am not against inpatient hospitalizations, either voluntary or involuntary, in theory. But in practice, I can say with complete certainty that they have done far more harm to me than good.
Update from our reader, responding to my thanks for sharing such a personal and powerful story:
You’re welcome. I always feel a bit uneasy about sharing my negative experiences because I don’t want to outright discourage someone seeking help, but informed consent is important. Not all intervention is good intervention.
Another slap in the face I forgot to mention: being coerced into the hospital, having it not work, and having my parents get a bill in the mail for over $2000. Fun times.
Out of the blue recently, a reader emailed hello@ with a simple note: “I would really love it if The Atlantic did an article or collected reader experiences of stays in psychiatric hospitals.” I asked Eva if she’s ever been to one herself, and she replied:
Yes, I am in a psychiatric hospital even now. Not crazy, but in a severe depression for a year and a half now, with bad anxiety. Bad stuff in life a couple of years ago triggered this, plus a certain amount of genetic predisposition, plus not the right meds. In a year and a half, it’s been three psychiatric stays in the States, one in Norway, and three in Germany. I’m joking sometimes now that I should write about international comparisons of mental facilities :)
I do have the feeling that I’m finally better—knock on wood. I do often think about the everyday routines in these type of hospitals: the many biographies and patients with various illnesses you encounter, the humiliating events that happen, the bleak hopeless days where you merely hang in there, the struggle to maintain a measure of dignity for yourself, or the small unexpected comforts one finds.
I can think of many things to write about. And I would just love to hear from other people who have these types of experience. It is more common than one thinks.
If you’ve had a memorable experience in a mental hospital, either as a patient or staff member, please send us a note: firstname.lastname@example.org. In a followup note, Eva elaborates on her experiences in poignant detail:
There are many small things about psychiatric hospital life that can cause tear and wear on your personality and dignity—the whole sum of it, really: the meal times; the bed times; medications you may not want to take; having to be back on the ward by certain times; having to ring bells and wait for doors to be unlocked; staff going through your underwear and personal things whenever; having to step out of the shower to show you really are present when presence is checked; having to strip down completely upon admission to get searched for scars, wounds, injection marks, drugs ... between your toes and fingers, underneath your breasts. Just all of it as a whole, and keeping a measure of dignity, adult self-determination, and personality—and I guess, sass.
Personally I found it very humiliating to return to the same hospital a second and then a third time—both after an overdose of pills—and for prolonged stays. I felt like shrinking into the ground, like not meeting anyone’s eyes for the first few days. Here’s Eva AGAIN, still depressed, still not cured, with yet another overdose.
Although there is wonderful staff, there really are quite a few Nurse Ratcheds everywhere, and the encounters with them can wither your pride and not let you keep your chin up and head held high.
My absolute lowest low, and greatest sense of humiliation ever, was just after my most serious suicide attempt and closest call. I did this—and I am truly ashamed of this—on the ward itself.
I woke up in intensive care. Apart from that close-to-death feeling getting under your skin, and the actual overdose itself making you feel awfully sick for days, it is the behavior of those around you that alienates and humiliates. I really do know what I did was wrong, and that suicidal people need a strict environment—but strict does not equal bone-chillingly-cold people who avoid you, are mad at you, or think you have deserved this misery.
For days after the suicide attempt, I received not a single smile, not a single kind word—no encouragement at all. Lots scolded me harshly, and each seemed to think they were the first and only people to do that. I started to not feel like a human being. I felt I was not worthy of having survived. My mom didn’t speak to me for one week and that was terrifying.
I first recall a woman whom I had initially seen as not that smart (shameful for me), judging by her spelling errors and reading skills. It turned out she had been kept home throughout her childhood and teenage years—she was the oldest of many children—and she had to run the household and look after the younger children while the parents randomly took off. She had never been allowed to go to school and no authorities had kept an eye on that. So she did not learn to read and write into her thirties. The abuse at home took a toll on her, but she was so warm-hearted and determined.
Really, it’s very hard to pick among patients. To me, about two-thirds seem very remarkable. I have simply never encountered such a high concentration of extraordinary life stories as in a psychiatric hospitals. Very few seem “crazy” by the conventional ideas that many have of the mentally ill. Patients are from both genders, all ages and professions. They’re just beaten up by life events, and some by genetic predispositions.
The addicts often really impressed me, the people who tried for the gazillionth time to get off alcohol and/or drugs. It takes so much trying to stop substance abuse. Also, it is pretty obvious to me that staffers treats addicts worse than other patients.
Anyone who keeps suffering from truly severe depression and keeps trying is perhaps the most impressive to me. That is only being one small step away from the dead, and to tolerate that state for months or years and not know if one can ever expect true improvement … there is simply nothing harder I can imagine. I was in that state for a year and a half. It is my biggest fear to ever ever be in such a state ever again.
However, I gave up on myself three times during that length of time and tried to commit suicide. There are people so much stronger than myself who managed to hang in there without resorting to that. I think the ability to hang in, out of sheer endurance, is so much more important than trying to achieve immediate dramatic changes.
The years 2015 and 2016 in German psychiatric hospitals also meant getting to know many refugees, who are now a noticeable presence not just in everyday life, but as patients in hospitals. Many of them were Syrian, probably 80 percent of them, but also Kurds from various regions (right now there is an African lady on my ward, as well as a Christian man from Iran). The refugees here have really enriched my life over the past year. They’ve had hardships and traumas I can barely imagine.
Losses, to me, were one of the hardest things to tolerate. I thought I had lost pretty much everything—my job, my marriage, my apartment, life as I knew it in the States. But many of the refugees have lost more. I still have my parents, my citizenship to a country willing to look after me medically for free, a good education, and an environment whose language I speak. Here are some individuals completely on their own, without German or English skills, who have recently not only lost homes and possessions, but loved ones. Many have experienced rape, war, cold, hunger. You really can start over from nothing, with just the clothes on your back.
I know now that I may have lost most things that most people consider the essentials of an adult life—but I have everything really important inside myself; the rest was mostly just stuff or things that time can heal. If I get and remain well, I can deal with the rest. Even if I didn’t get really well, my life is worth something.
Showers and soap—they make you clean and a little new and shiny when nothing else does. Locks on bathrooms—once you are well enough to have a regular room.
The movies and songs from the 1930s and ’40s. Fred Astaire. Putting a shine on your shoes and a crease in your pants. Art therapy—not because it was cathartic or anything, no such cliché, but just rediscovering I was actually good at painting and accomplishing paintings I am still fond of.
Jennifer Michael Hecht’s book Stay: A History of Suicide and the Philosophies Against It. Books books books in general. Perhaps predictably. But despite a severe depression, I was always still able to read. I basically read a book a day. I would not exist without books. How would the time have passed, especially in intensive rooms, when you are hardly allowed anything? What worlds could I have escaped to? Many people are not able to read while severely depressed. Thank God I was.
Speaking of Jennifer Michael Hecht, a few years ago I did a reader-based “Ask Anything” video series with her. A Dish reader called the following video “the most useful encouragement I’ve heard to keep your life.” In it, Hecht describes the suicide contagion effect that spreads to the family, friends, and even strangers of people who kill themselves, making it much more likely that others will follow suit. As she puts it, “If you don’t kill yourself, you’re saving someone else’s life”:
Critics are letting their disdain for the president blind them to geopolitical realities.
When a new coronavirus emerged in China and began spreading around the world, including in the United States, President Donald Trump’s many critics in the American foreign-policy establishment were quick to identify him as part of the problem. Trump had campaigned on an “America first” foreign policy, which after his victory was enshrined in the official National Security Strategy that his administration published in 2017. At the time, I served in the administration and orchestrated the writing of that document. In the years since, Trump has been criticized for supposedly overturning the post–World War II order and rejecting the role the United States has long played in the world. Amid a global pandemic, he’s being accused—on this site and elsewhere—of alienating allies, undercutting multinational cooperation, and causing America to fight the coronavirus alone.
The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out.
Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.
A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”
Widespread social-distancing measures have produced some jarring effects across land, air, and sea.
From inside her living room in London, Paula Koelemeijer can feel the world around her growing quieter.
Koelemeijer, a seismologist, has a miniature seismometer sitting on a concrete slab at the base of her first-floor fireplace. The apparatus, though smaller than a box of tissues, can sense all kinds of movement, from the rattle of trains on the tracks near Koelemeijer’s home to the waves of earthquakes rolling in from afar. Since the United Kingdom announced stricter social-distancing rules last month, telling residents not to leave their home except for essential reasons, the seismometer has registered a sharp decrease in the vibrations produced by human activity.
With fewer trains, buses, and people pounding the pavement, the usual hum of public life has vanished, and so has its dependable rhythms: Before the spread of COVID-19 shut down the city, Koelemeijer could plot the seismometer’s data and see the train schedule reflected in the spikes, down to the minute. Now, with fewer trains running, the spikes seem to come at random.
Far from making Americans crave stability, the pandemic underscores how everything is up for grabs.
Fear sweeps the land. Many businesses collapse. Some huge fortunes are made. Panicked consumers stockpile paper, food, and weapons. The government’s reaction is inconsistent and ineffectual. Ordinary commerce grinds to a halt; investors can find no safe assets. Political factionalism grows more intense. Everything falls apart.
This was all as true of revolutionary France in 1789 and 1790 as it is of the United States today. Are we at the beginning of a revolution that has yet to be named? Do we want to be? That we are on the verge of a major transformation seems obvious. The onset of the next Depression, a challenge akin to World War II, a national midlife crisis—these comparisons have been offered and many more. But few are calling our current moment a revolution, and some have suggested that the coronavirus pandemic—coinciding as it has with the surge in Joe Biden’s bid for the Democratic presidential nomination and the decline of Bernie Sanders’s—marks the end of any such possibility. “The Coronavirus Killed the Revolution,” declared the headline of a recent essay in The Atlantic by Shadi Hamid, who argued that the COVID-19 crisis makes people crave “normalcy” over deep structural change. As a historian of 18th- and 19th-century France, I think claims like these are mistaken.
How the coronavirus travels through the air has become one of the most divisive debates in this pandemic.
Updated at 7:22 p.m. ET on April 4, 2020.
As the coronavirus pandemic continues, many people are now overthinking things they never used to think about at all. Can you go outside? What if you’re walking downwind of another person? What if you’re stuck waiting at a crosswalk and someone is there? What if you’re going for a run, and another runner is heading toward you, and the sidewalk is narrow? Suddenly, daily mundanities seem to demand strategy.
Much of this confusion stems from the shifting conversation around the pandemic. Thus far, the official line has been that the new coronavirus, SARS-CoV-2, could be transmitted only through close contact with infected people or contaminated surfaces. But recently, news reports have suggested that the coronavirus can spread through the air. After 60 choir members in Washington State rehearsed together, 45 fell sick, even though no one seemed symptomatic at the time. Now people who were already feeling cooped up are worrying about going outside. Many state guidelines are ambiguous, and medical advice can muddy matters further. When the writer Deborah Copaken came down with COVID-19 symptoms, her doctor chided her for riding her bike through New York City a week earlier. Going outside in the city wasn’t safe, the physician implied, with “viral load everywhere.”
Local officials and health-care workers are losing faith in the national response, and struggling to improvise their own solutions.
The federal government’s stockpile of medical supplies, gloves, and masks is nearly exhausted, President Donald Trump admitted at a White House briefing on Wednesday. Meanwhile, individual states are scrambling, bidding against one another for the equipment they need.
“The coronavirus pandemic is a damning indictment of this country’s health-care system,” Joseph Kantor, the assistant state health officer for the Louisiana Department of Health, told me. “The richest country in the world is scrounging around for ventilators” and personal protective equipment.
Kantor is one of a dozen health professionals across the country with whom I spoke this week. Taken together, those conversations reveal a federal government that has failed to protect, supply, and prepare the country and its cities. These health-care workers are looking with horror at the chaos in New York City, as evidence of what can happen to a vibrant city in the absence of national strategy and preparedness. As they struggle to avoid a similar crisis, they’re losing faith in the federal government, and resorting to their own improvised solutions.
The coronavirus outbreak may last for a year or two, but some elements of pre-pandemic life will likely be won back in the meantime.
Updated at 4:40 ET on March 30, 2020.
The new coronavirus has brought American life to a near standstill, closing businesses, canceling large gatherings, and keeping people at home. All of those people must surely be wondering: When will things return to normal?
The answer is simple, if not exactly satisfying: when enough of the population—possibly 60 or 80 percent of people—is resistant to COVID-19 to stifle the disease’s spread from person to person. That is the end goal, although no one knows exactly how long it will take to get there.
There are two realistic paths to achieving this “population-level immunity.” One is the development of a vaccine. The other is for the disease to work its way through the population, surely killing many, but also leaving many others—those who contract the disease and then recover—immune. “They’re just Teflon at that point,” meaning they can’t get infected again and they won’t pass on the disease, explains Andrew Noymer, a public-health professor at UC Irvine. Once enough people reach Teflon status—though we don’t yet know if recovering from the disease confers any immunity at all, let alone lifelong immunity—normalcy will be restored. (It may also turn out to be the case that people who are immune to the disease can still pass it on under certain circumstances.)*
More young people in the South seem to be dying from COVID-19. Why?
In a matter of weeks, the coronavirus has gone from a novel, distant threat to an enemy besieging cities and towns across the world. The burden of COVID-19 and the economic upheaval wrought by the measures to contain it feel epochal. Humanity now has a common foe, and we will grow increasingly familiar with its face.
Yet plenty of this virus’s aspects remain unknown. The developing wisdom—earned the hard way in Wuhan, Washington, and Italy—has been that older people and sicker people are substantially more likely to suffer severe illness or die from COVID-19 than their younger, healthier counterparts. Older people are much more likely than young people to have lung disease, kidney disease, hypertension, or heart disease, and those conditions are more likely to transform a coronavirus infection into something nastier. But what happens when these assumptions don’t hold up, and the young people battling the pandemic share the same risks?
Trump is utterly unsuited to deal with this crisis, either intellectually or temperamentally.
For his entire adult life, and for his entire presidency, Donald Trump has created his own alternate reality, complete with his own alternate set of facts. He has shown himself to be erratic, impulsive, narcissistic, vindictive, cruel, mendacious, and devoid of empathy. None of that is new.
But we’re now entering the most dangerous phase of the Trump presidency. The pain and hardship that the United States is only beginning to experience stem from a crisis that the president is utterly unsuited to deal with, either intellectually or temperamentally. When things were going relatively well, the nation could more easily absorb the costs of Trump’s psychological and moral distortions and disfigurements. But those days are behind us. The coronavirus pandemic has created the conditions that can catalyze a destructive set of responses from an individual with Trump’s characterological defects and disordered personality.
The Trump administration has just released the model for the trajectory of the COVID-19 pandemic in America. We can expect a lot of back-and-forth about whether its mortality estimates are too high or low. And its wide range of possible outcomes is certainly confusing: What’s the right number? The answer is both difficult and simple. Here’s the difficult part: There is no right answer. But here’s the simple part: Right answers are not what epidemiological models are for.
Epidemiologists routinely turn to models to predict the progression of an infectious disease. Fighting public suspicion of these models is as old as modern epidemiology, which traces its origins back to John Snow’s famous cholera maps in 1854. Those maps proved, for the first time, that London’s terrible affliction was spreading through crystal-clear fresh water that came out of pumps, not the city’s foul-smelling air. Many people didn’t believe Snow, because they lived in a world without a clear understanding of germ theory and only the most rudimentary microscopes.