Tough Choices in a Pandemic

Saving a life’s work.

Posted Aug 04, 2020

Artist poster filing series (Library of Congress) / PICRYL
Bicycle Road Maps
Source: Artist poster filing series (Library of Congress) / PICRYL

My patient Bethany runs a small nonprofit that may not survive the pandemic. It’s vulnerable because its focus is on refugee camps — where healthcare has largely collapsed — and because it brings people together through physical activities that could easily spread the virus. Even as the lockdown gradually loosens, who’ll want to shout and sweat and exacerbate the risk? And even if people show an interest, governments will likely resist until any risk is remote (when could that be?). 

“You know,” said Bethany, “I just don’t see how our work can continue. I would hate if we got anyone sick.”  

To Bethany, the pandemic is an existential threat. If her work can’t resume, then everything she’s built disappears. “I would disappear,” she suggests, “this is who I am.” She’s given her life to her work. There’s no daylight between them.  

About 15 years ago, she gave up PR to help the thousands of people — especially children — displaced because of genocide, natural disaster, and encroaching drought. Her goal was to promote their sense of continuity by teaching them songs, dances, and games from their traditional past. “They have to remember who they are,” she explained. “If they do, they won’t become alienated. They’ll have a culture to hold onto as they recreate their lives.”

But now what? The mentors, educators, and elders that Bethany normally commissioned still won’t enter the camps. Her fundraising has fallen off a cliff. Her small staff had to be furloughed and, besides, they couldn’t travel anyway without going into quarantine. 

It was a total bust. 

When Bethany came to me, she felt as though she was not unlike the people that she helped. “We’re all displaced. I don’t know what to do any more than they do.”  

When Bethany left her career in PR, she was in her early 40s, and at the top of her game. Her specialty was product rollouts. She knew how to excite retailers and attract consumers. She was sure that she had the connections and skills to be a social entrepreneur. Fundraising would be easy. Who doesn’t want to help refugees? (Even the more cynical would rush in to help, if only to stem emigration). As it turned out, international celebrities had offered their support and, over the years, the organization had acquired cache.  

When the pandemic hit, she was blindsided. “Maybe if I had been in the crisis management side of PR — like with Tylenol — I’d know what to do. But I just don’t see any options,” she said. The worst part was that now, in her late 50s, she felt too old to start anything else but too young just to retire. It might be possible to wait things out, but she just couldn’t handle protracted uncertainty. “Am I supposed to sit around and wait for five years?”

Yet while Bethany was uncomfortable with inaction, she felt that action was also fraught with uncertainty. “If I undertake a new project in one of the camps, and I make commitments that we can’t keep, I’ll feel like my ego got the best of my integrity — people would be right for writing me off.” Since the virus could hang around for years, she felt that acting unrealistically would be seen as tempting fate, a kind of deluded vanity. 

I was moved by Bethany. She wanted to do what was right for her organization, for herself, and for people whom she cared about deeply. But she was paralyzed, in part because she feared that whatever she did to preserve her organization could as likely tarnish it, as well as her own reputation.  

As we spoke about what she could do (a far cry from what she should do), I realized how much the pandemic had thrown people’s identities into disarray. These were solid, high-functioning people who, under most circumstances, would not have consulted a mental health professional. But now they were suffering acute stress. All of a sudden, seemingly out of nowhere, their reason to get up in the morning — their reason to throw themselves into work they believed in and that defined them — had seemingly vanished. They were unprepared, even somewhat flustered because they couldn’t just get up and say, “Okay, now here’s what we’ll do.”

Their moxie was suddenly gone. They were unaccustomed to being unable to rise to the occasion.

So, the first thing I wanted to talk about with Bethany was that it was okay to feel bewildered. Most people feel bewildered in this pandemic. One of my patients told me that she had nowhere to buy shoes and nowhere to get her shoes fixed. It wasn’t earth-shaking, but it was still indicative of the slow encroachment of powerlessness that everyone was feeling.

“You have to recognize,” I said, “that there may be no right answer. You may have to cobble together an answer from what scant information is out there.” Life had become a maze. More specifically, the so-called re-opening was only tentative. You can’t necessarily get from A to B without going through some detours or hurdles or even running into major problems.

I suggested that Bethany begin to address her prospects by talking with friends in the nonprofit sector. Did they think she should tough it out for the next year or so, and then make a decision? This wasn’t just kicking the can down the road but, rather, it was taking advantage of the collective risk assessment. Nonprofits around the country were facing existential questions and were beginning to formulate new approaches to salvaging their basic mission. I thought Bethany should join the conversation.

I also thought that by listening to the ideas of others, she would not be liable to turning her head into an echo chamber for her own ideas. Now more than ever, an intellectual community is necessary, even if only to keep us from convincing ourselves that we will never exit the maze intact.

“You could look for Facebook groups, or maybe you could start one,” I suggested. The point was that Bethany needed a way to retrieve some measure of confidence that there was a way forward. Without any sense of self-confidence, she would be unable even to evaluate advice.

I reminded Bethany what it was like when she had lost her father in college. He had been her anchor, and she felt lost and confused without him. Yet she found her way — worked hard, made good choices — and built a meaningful life. She felt heartened by the reminder. Bethany recognized that she had helped a tremendous number of people and took pride in it. She still wanted to do more. 

While it was a delicate subject, I also told Bethany to be prepared for the possibility of giving up her organization. After all the advice came in — and the funds perhaps didn’t — that might be the best option. We talked about the existential problem of so entirely identifying one’s life with one’s work that one cannot imagine oneself without it.

Normally, most people don’t face the need to give up on what they’ve worked for, but now that necessity is not uncommon. Small businesses are closing, professionals are being furloughed. “You are still smart, and you know a lot. Perhaps you could start another nonprofit that doesn’t put people at risk.” I suggested that she look around at what was likely to be a landscape full of need.

I am not sure what Bethany will do. My goal was to raise her spirits up — and her confidence — enough so that she didn’t fall into inaction and despair. I felt that she would suffer terribly if, in the end, she had to close her organization. But I felt it was critical that she be receptive to new opportunities. “Our world has changed,” I told her. “We need to be ready for it.”