A trauma specialist's open letter outlines some essential truths about our lives right now
Photo by Claudia Wolff on Unsplash

Let's step back for a moment and take stock of our situation, shall we?

We are currently living through a global pandemic which, up until a month ago, was a theoretical disaster we'd only ever seen in movies and history books. We now tap into the news each day and watch the numbers of confirmed cases and deaths rising. A growing number of us have family, friends, or acquaintances who have fallen ill or died. Even if we don't, we may have loved ones who are elderly or immunocompromised or we may fall into that category ourselves, so we fear what exposure to this virus might bring.


At the same time, we are stuck in our homes without our normal social outlets. Some of us are alone and lonely. Some of us are trapped in homes that are not healthy or safe. Even those of us who appreciate having some extra family time might be feeling the strain of constant togetherness. People are stressed over trying to work and educate kids and try to provide structure and security in the midst of chaos.

Some of us are forced to go to work in essential jobs that put our lives at risk. Some of us are newly and unexpectedly unemployed, while others are watching businesses they've built crumble before their eyes. Some of us are wondering how we're going to put food on the table. Many of us have watched future plans and goals and dreams being swept away, just like that. We know that the economic fallout of this will be huge, but we don't know how huge or what that will mean for us individually or collectively.

Our lives have been upended, quickly and with very little warning. We're surviving, most of us, but that doesn't change the fact that life as we know it has been dramatically altered. And we don't know when or how or if things will return to "normal."

Then there's the human toll of the virus itself. We bear witness to heartbreaking stories from medical workers on the front line. Medical workers who don't have enough supplies and are having to pile bodies into refrigerator trucks. Bodies of patients who died without loved ones by their side. Patients whose belongings are piling up in hospital storage rooms, waiting for the day when family members can come retrieve them. Family members who can't even gather together for funerals to comfort one another as humans do.

And that's just an overview. And it's only been a month. And we're not yet at the peak. And we're being told there may be resurgences in coming months, meaning we don't know what the next year holds.

This is no small thing, friends.

Trauma is defined as the emotional response to a terrible event. And it's totally understandable that a global pandemic and sudden, widespread economic hardship would evoke a strong emotional response in most of us. And yet, many of us likely haven't thought about this experience as "trauma" because it hasn't been one single event. It's a slow emergency of sorts, one we had to prepare for before we saw it for ourselves. And now we're living in a weird state of limbo where nothing feels normal, widespread worry and uncertainty surround us, and yet it's all covered in a thin veneer of calm.

That veneer is deceptive. On the surface, we're just being asked to sit at home and watch TV—what's so traumatic about that? But simplifying it in such a way denies the entire reason we're doing it—to prevent mass death and suffering as much as possible. That's a heavy reality. We've had to upend life as we know it in order to preserve lives in general.

And yet even with our seemingly extreme efforts, we're still watching the numbers climb and seeing the terrible stories. Even if we aren't directly impacted, we're still immersed in it and experiencing trauma vicariously. If we have any sense of empathy, we will have an emotional response—one that we might not recognize, since this is like nothing we've experienced before.

Licensed professional counselor Jennifer Yaeger shared some words of wisdom about our current circumstances and the importance of acknowledging the emotional and psychological toll of it all on Facebook. She wrote:

"I want to acknowledge that living through this pandemic is a trauma.

As a trauma specialist, I think there are a few things that are helpful to know:

- Parts of our brain have shut down in order for us to survive

- As a result, we are not able to fully process a lot of what is going on around us

- Feeling somewhat numb and out of touch with our emotions is normal, especially if you have lived through trauma before

- Some people are also more apt to feel hypervigilant or anxious, while others become hypoactive or depressed. Neither means anything other than indicating your predisposition to dealing with extreme stress

- In-depth processing of trauma happens years later, when we feel emotionally safe to deal with it

- When in the midst of trauma, just getting by emotionally and functionally is okay. Lowering expectations and being kind to yourself and others is vital."

So don't judge whatever you're feeling—or what anyone else is feeling—through all of this. When you feel overwhelmed or stuck or numb—or even guilty for not feeling any of these things when you're in a state of joy or gratitude—just let it be. Most of us are experiencing a dozen different feelings every hour, so do what you need to do to care for mental and emotional health.

Be gentle and patient with yourself, and do the same with others. This is hard, but we'll get through it. Our emotions are one thing that unite us as human beings, so if nothing else, we can at least take comfort in the fact that none of us is alone in what we're feeling.

The airline industry was one of the hardest hit by the COVID-19 pandemic, as global and domestic travel came to a screeching halt last spring. When the pandemic was officially declared in March of 2020, no one knew what to expect or how long the timeline of lockdowns and life changes would last.

Two weeks after the declaration, Delta pilot Chris Dennis flew one of the airline's planes to Victorville, CA for storage. He shared photos on Facebook that day of empty planes neatly lined up, saying it was a day he would remember for the rest of his life.

"Chilling, apocalyptic, surreal...all words that still don't fit what is happening in the world," he wrote. "Each one of these aircraft represents hundreds of jobs, if not more."

He added:

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The airline industry was one of the hardest hit by the COVID-19 pandemic, as global and domestic travel came to a screeching halt last spring. When the pandemic was officially declared in March of 2020, no one knew what to expect or how long the timeline of lockdowns and life changes would last.

Two weeks after the declaration, Delta pilot Chris Dennis flew one of the airline's planes to Victorville, CA for storage. He shared photos on Facebook that day of empty planes neatly lined up, saying it was a day he would remember for the rest of his life.

"Chilling, apocalyptic, surreal...all words that still don't fit what is happening in the world," he wrote. "Each one of these aircraft represents hundreds of jobs, if not more."

He added:

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True

Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."