Influenza Series, Part IV: The tricky part for me--making sense of risk

I started writing this series on influenza because I felt compelled to write about my fears--both the reasonable aspect of them, and the more extreme. My goal for each of these posts is not only to show some of the research I've done, but also to let you into the workings of my mind on this. The photos of clockwork gears that you see throughout are my attempt to represent that process.

I said at the outset of this post series that my worries about H1N1/09 are only amplified because of my own tendencies to crave control and fear illness. A fear of illness, is, of course, an ultimate expression of the need for control over chaos. I recognize all of this about myself. I'm constantly grappling with my judgement about risk, questioning whether my worries are based in logic or not.

In most areas of life, I know that from time to time I downplay real risks, as a way of minimizing my worries, and I know that, conversely, sometimes I overcorrect by being too cautious. Fortunately, what was once more of a constant obsession now only surfaces from time to time; when these worries do surface, they don't stay long.

However, in the spring of 2009, the advent of H1N1 brought my anxieties about health into clear, focused energy once more.

I remember I was in our kitchen, cleaning up the dishes from a Sunday morning pancake breakfast when I saw the first footage coming from Mexico City. The headline said something about influenza, and the reporter was wearing a white face mask. My own transformation was extraordinary. A fear that I had set aside years ago came roaring back like a wind in my head, and I abandoned the dishes to follow the story.

As the numbers of infected and seriously ill people in Mexico were reported, I grew more concerned. The new classification as "swine flu" made me think immediately of 1918. I told a few people about my worries for what may be coming down the pike, feeling like a Cassandra.

Meanwhile the world spun neatly on its axis. Spring blossomed in our yard as quietly and gently as every other year. The sky, to my relief, did not crash down. H1N1 continued in its elegant way to infect people all over the world, enough people, in fact, that the WHO declared it pandemic by early June.

For the most part, I kept sane about it. No, I didn't stop traveling, nor going to public places like theaters. But I did have that nagging feeling that this fall may bring a surprise with it.

Now we are well into the fall, and I feel the pull between the reasonable and the extreme each time I consider the "what to do" about the H1N1 situation.

What I'm doing:
I'm attempting to get the vaccine for us. Ada has had one dose, and needs a followup that may come by January. Esme and I have had no luck in locating one, though I check clinics a few times a week. My husband should get one at work, but--like everyone else's--his vaccinations have been delayed.

I'm also practically swimming in alcohol-based hand cleaners. The girls are pretty well trained on washing up after every trip outside, and before meals, and after visits, and on getting in the car...and so on. Ada tries to be conscientious about that stuff at school, as much as she can. And I have her change her clothes when she comes home from school.

When a whopping 20% of her school was out, we kept Ada home for over a week. After 10 days, it was my hope her first vaccine had at least kick started an immune response against H1N1. A leap of faith for me, but...

I beg off shaking hands, saying "Oh, I've got a cold." Inoffensive, I hope--effective? Who knows? But it make me feel like I'm at least doing something...

What I want to do (but don't):
If I think about it too much, I sort of want to hide in our house. I get nervous about going to a big public gathering, especially one where there are lots of other little kids who sneeze, and wipe, and do all that gross stuff kids do (hey, I know--my kids do it, too.) I want to huddle down in our own little nest and just wait it all out. I want to beg or bribe or get that vaccine right now, and cross my fingers and cast some special spell to keep the flu away from us.

You might have noticed that many sensible and rational people, given the same facts, have a less alarmist reaction about getting this year's flu, or getting sick in general. They trust that whatever happens won't be so bad, that either it's no big deal to start with, or, if it does get to be a problem, that someone will take care of it.

Both of these sensible reactions are based on trust, and as I examine my own fears, I realize I don't feel it. At least not in this capacity. My own concern about the influenza outbreak this year is based on fact, yes--but it is amplified 100 times by my own insecurities.

As I've brooded, I've also tried to see my own process of worrying in an objective way. What is setting me off, I've wondered? I've wondered this especially as I find myself watching a newscast and replying back to the television, retorting something a reporter said about influenza. Why am I acting like this? This is not where I want my energy to go--into stridently arguing with a reporter on tv. Or reading every little thing I can about H1N1. When I step back far enough from myself, I can see that what Kirie is doing is called obsessing.


It's hard to admit that. It's hard to say that what I perceive as a real threat might not be as real to someone else. It makes the ground under me feel shaky. But the fact is there: my obsessions might be based on fact to start with, but they spiral way out of reach of normal at some point. And they tend to be related to my own need to control my environment, to create an illusion of impenetrable safety. On so many levels, I crave predictability, because it solidifies that illusion, like a playback loop whispering: all is well; you are safe. all is well; you are safe.


I've said that this year's H1N1 influenza scenario hits all my panic buttons. Essentially, for me it created two perfect storms. One of those storms is, certainly, the reality that this is a pandemic. The other storm is clearly in my mind--the storm of unpredictability and distrust.

The first issue for me is the unpredictability. The virus is unpredictable, and easily spread, even by people who seem well (because it is contagious even a day before symptoms appear). What appears to be one thing: "just flu" or "don't worry, I don't have it!" might be something else entirely. Of course, the flipsides to these (the ones that slip my mind too often) are a) most people who get sick with flu WILL NOT find themselves at death's door, and b)most people who are walking around town are not in a contagious state of influenza.

The second issue for me is the trust. Basically, I don't trust people in general to take this flu seriously. I really don't trust people to wash their hands, to cough in their sleeves. I don't trust that there will be adequate vaccinations for people who want them *before* the virus peaks. I don't really trust that a cold is just a cold at this point. If I hear someone is coughing, I'm assuming it's flu. I don't trust the media to give a clear portrayal of what flu is, or isn't. I don't trust the government to really stay on top of tracking the changes of the virus, to put funding toward a new method of making the vaccine. I don't trust people to believe me. (Ah, the irony!)

I don't trust, I don't trust. I hear these all strung along in my head as I write this and I feel another feeling echoing it: I feel lonely. That Cassandra-like sensation of being disbelieved is, at its heart, isolating. And overwhelming. Feeling isolated and overwhelmed are cues for me that my worries are not completely related to the influenza pandemic alone. Really, my worries are rooted in my past.


A little headshrinking: My childhood was relatively chaotic--my parents, though they loved me, were somewhat absentee. The day-to-day of my life was far from predictable, people's emotions were volatile--my own, my brother's, my parents'. My own physical environment felt out of my control, and very different from that of my peers. I often felt different and alone, and misunderstood by most people. I could not, if pressed, have imagined what my future would look like. I didn't really trust that I would have a real adulthood--because I couldn't imagine what that could be.


Of course, my adulthood did come to be. Sometime in my early 20s I discovered that I could try to shape my own existence a little. And in my grown-up life, I have predictability in abundance. Calm rules the day--literally, it leads the list of our family rules, which we have written out. Sure, there is the messiness of life with little kids, but it is joyful, and welcomed. Trust is the keystone between my husband and me, between my kids and me. I often catch myself saying to them, "You're doing great. You can do that. I trust you." And I do trust them. I have, as an adult, become faithful in a religious sense, and I trust God, too.

So--here is the contradiction, right: With all this goodness, and all this solid trust and predictability in my life, why worry? Why indeed? Because as much good and beauty as I see, I also get glimpses into the underbelly of life, too, and it unsettles me, deeply. There is room for both, I know. A need for both, in fact. I am practicing holding both the beautiful and the dreadful in my mind at once, and letting it be.

It was not my hope in writing this series to spin up fears, but rather to show how the genesis of my own worries about influenza. I also hoped that writing through my own thought process would help bring some clarity to me about why I have become obsessed. If you have gotten this far into my posts, you must see that, as a threat, influenza sits neatly someplace between something very scary and something to be brushed off as inconsequential. When you consider it, it's best to recognize both extremes as unreasonable, and try, as I am, to find some middle way.

Yes, H1N1 is frightening because it does have a potential to become a terrible flu--one that resembles 1918. Actually, that potential is in every influenza. Given those facts, any objective person would admit that flu shouldn't be taken lightly.

But of course, the potential is there for this to NOT become a deadly flu. And the numbers indicate--in fact, they indicated this in 1918 as well--that the vast majority of people who get influenza recover. Given those facts, any objective person would admit that hiding from the world doesn't actually mitigate the risk--the minimal risk.

The scary potential and the benign potential exist simultaneously, all the time, in all actions. Just writing about that uncertainty makes me catch my breath. I refocus, I breathe, I vow to accept that calmly. I have to push myself to remember these things, but I do. I do push past them and go out into the world, send Ada back to school, take Esme to swimming class, make my art, have playdates, Halloween parties, and see my friends and neighbors. To meet me, you would never guess at the contradictions wrestling each other in my mind, but they are there. And someday, I hope, to accept them without anxiety.

If you are interested in catching up with the rest of the series:

Part I: The Introduction

Part II: A Little Primer on Influenza

Part III: The Anti-definition of Flu