COVID-19 UP CLOSE AND PERSONAL

The best thing you can do to help is avoid spreading the virus. This building in South Africa has a subtle hint about how you can do that. (AP Photo/Nardus Engelbrecht)

By this time, I would bet that nearly everyone on Earth has been touched one way or another by COVID-19. Global pandemics are an unfortunate experience that unites all of humanity. Similarly, medical providers around the world have been called upon to step up, just as they would in any similar event whether historical, fantastic, or science fictional.

We’re all in this together. Let’s not be that guy.

Nurse Green treating consumption patients in a New York sanitorium in 1843, Doctor White treating AIDS patients in Zimbabwe in 1997, and Healer Black treating bubonic plague patients in Constantinople in 546 all have the same general goals and similar biological challenges.

Medic Silver treating space plague in patients on the Third Moon of Alpha Centauri is likely to find xirself facing the same situation.

Doctors, nurses, aids, technicians, assistants, medics, and medical workers of every other kind have been making this plea, posting photos from all over the world.
(Richmond, Maryland)

For most of us, all but urgent care medical appointments have been postponed or cancelled. Even urgent care has changed drastically. I recently had an appointment for a root canal in a nearly empty clinic. The receptionist told all patients to wait in their cars until called, and only the dentist, his assistant, one office worker, and I were in the building the entire time I was in the chair.  Of course, most of us see these changes from the perspective of the patient. What about the providers? 

Philadelphia

A chiropractor who has a one-man practice told me that so many patients are canceling (or not making appointments in the first place) that he is worried about what’s happening to his personal income, and whether he can continue to pay his one office worker. My dentist is the head of a small practice (fewer than 50 employees) and he said the same thing: trying to keep the practice open and employees paid when they are seeing only urgent care cases. A dental assistant, recognizing that the practice is vulnerable, worries that she won’t be able to pay the rent.

Malaysia

These people are the tiniest of samples and most would agree they aren’t front-line workers in this pandemic. For that perspective, I am fortunate to have a colleague who lives in a veritable nest of doctors, nurses, medical students, and first responders, and here are things they had to say.

Israel

Is this sort of thing what you had in mind when you applied to med school?

Australia

 Absolutely not.  When I went to medical school, I thought I wanted to go into surgery, but I realized that I hated rounding and getting dressed up. As far as the current pandemic, I don’t think anyone envisioned something like this.  We haven’t had anything close to this since 1918 with the Great Influenza Pandemic.  And in probably every humans’ mind, medical care has advanced so much since then.  How could anything like that happen again?

Not at all. I had visions of helping patients overcome their physical or medical disabilities so they could live their lives. Now I am at the frontline of protecting about 100 elderly, disabled patients who were recently hospitalized for other reasons and are now at risk for coming down with COVID-19. We have already diagnosed it in quite a few of our patients. It is likely many of the others also have it but only mild or asymptomatic cases. However, they are still contagious, and we must be extremely careful so we don’t spread it around to other patients, ourselves, and our families.

Italy

I always knew working with high-risk patients meant that I would be saying a lot of good-byes, and I thought I was okay with that. I could at least make them feel a little bit better, maybe smile a little. But now I feel like I’m saying that final good-bye every time I leave a patient’s house. Like, will this person even be here the next time I come over?

Pretty much, yeah. I always knew the communities where I wanted to work would be full of infection and contagion, without a lot of medicine or cleaning. But there was always something I could do, yeah? Now there’s no medicine, no vaccine, no ventilators, nothing but me in the same mask I’ve been wearing for a week and trying so hard to convince families that grandmother must stay away from her grandbabies.

Nope. I think a lot of this is media driven.  And people fear arguing against safety. But being too safe can have its own trade off and risk other forms of safety.

If we did not want that responsibility, we would not have chosen this career path.

Chile

In general, how do you avoid bringing work stress or infections home?

Not bringing infections home is easy.  The scrubs I wear for work stay and get laundered at the hospital.  I have separate shoes for the hospital which stay in my office.  And I use hand sanitizer before I leave the building.  We deal with some pretty nasty resistant bugs at work.  I don’t need to bring that home to my wife and daughters. I try not to let work get to me.  I try to make sure everyone is having fun at work, so it keeps my stress level down.  But even with that, it can build up. 

Jordan

It’s been tough, lately. I cry every night. I try not to, but I see so many people sick and nothing I can do. I never let my family see me.

Showers when I get to work and before I leave work. There’s a clean line between my two lives. I don’t bring any of that culture home with me. No stickers or special license plates on my car, just the parking decal.

The key to avoiding bringing infections home is the same as avoiding spreading it at work, always good hygiene and using protective equipment. There really is no difference. And as long as I work as hard as I can and do the best I can, stress is not an issue. Only fatigue, which comes to anybody who works long, hard hours.

Sudan

Do you prioritize symptoms, patients, contagion, contact, etc. differently now?

It used to be mostly elective or scheduled operations, so we had time to make sure patients are prepped and optimized for surgery ahead of time.  On the bus [ambulance], we don’t get to pick and choose our patients.  They call us when they are in their worst time.  There’s a big difference between a sterile operating room, and the side of the road at 2am.  But in the end, a patient is a patient.  It’s about the ABCs and then go from there.

India

Patients have prioritized themselves differently. Nobody will come to the clinic if they can find something else to do. I had a girl come to my house with a broken arm because her parents did not think she should be risk being exposed.

PPE is at a premium.  At work, I’m reusing my N-95 masks between patients because otherwise we’d run out.  But if I have to intubate a known or suspected COVID patient, we are in full protective gear to include a respirator.  We do have new protocols in place for use of PPE on the ambulances when we suspect a COVID patient.

So far we do not have to prioritize anything other than can they leave their room on a closed ward? Should they be cohorted with someone else who also has the virus? Many of our patients have other contagious diseases or infections; we must be careful.

Actually less people are calling 911. Looking at the county stats the call volume has dropped 10-20% over the past month.  Generally you can look at a person and tell if they are in distress or not.  There used to be a lot of people who called for help when they just wanted a ride. I typically deal with one patient at a time. 

Wales

What behaviors in the general public infuriate you from a health care view (at any time, not just now)?

I used to get really worked up with people smoking.  There is so much data about how bad smoking and drugs are for you, yet young people still start using them.  But I realized I can’t change everyone, and it would just cause me undue stress.  So I just focus on who I can help in front of me.  I also realize people are going to make their own choices, good or bad.  All I can do is give them the information and hope they listen to it.

India

There are so many people who are just forgotten about and so they have no one to help them. They are stuck at home because they are old or no one will talk to them because they are weird or whatever. And then they are sick and no one knows because no one thinks to go and check.

People get a little bit of information and then suddenly they’re the expert and telling everyone else what to do and then people actually do it! Or they follow what the aunties say to do, even if it makes no sense, just because no one wants to upset the aunties. Like, drinking fever tea is not going to cure COVID-19, even if it makes your fever feel a little better.

The only behavior that infuriates me is when I see people carelessly congregating and likely spreading the virus but acting as if it is a joke. It’s infuriating because they are then passing it on to even more possibly highly vulnerable people who have nothing to do with their irresponsible behavior.  Otherwise the public’s behavior does not infuriate me. I feel very bad for family members who are not allowed to visit their family members. Must be terrifying being in such a helpless position. When they get obviously upset or even angry, we know it’s understandable.

When a crowd gathers to watch a hospital ship that has come to help with a quarantine, that kind of defeats the purpose….

Passing the liability on to others.  “Oh my insurance or doctor said call 911.” And the fact that life is not sunshine and rainbows. Just because you’re not feeling well doesn’t mean you’re going to die.

Jakarta

Have you changed your routines at home or work in the past few months?

I always believed that the immune system is something that needs frequent practice to be strong, and I still do believe that.  But with COVID-19, the game has completely changed.  I’m now washing my hands much more frequently, or using hand sanitizer whenever I touch something public in the hospital.  I wipe my desk, computer, phone, and ID badge down with a sanitizing wipe before I leave work.  And I always wash my hands when I walk into my home first thing before I do anything else.

Patients who used to come to me for stomach virus and insulin checks stay far away from the clinic now, especially the pregnant ladies. Now I see only people who are afraid they have coronovirus or that their aunties have coronovirus.

Malaysia

I share a flat with other medics, but I’ve moved back into my parents’ house, where the cellar has a separate washroom and entrance. It’s easier to stay isolated there, even if it’s a longer commute.

In the past two or three weeks our entire day has changed. We do not focus as much on the primary reason the patients are with us, which is to be evaluated and treated for various disabilities. Instead, we are more focused on signs or symptoms suggesting that they may be coming down with the virus. We don’t want to miss them for their sake, and for the increased risk of them spreading it to other patients and staff.

I definitely pray a lot more. I’ll admit it’s a little strange to see His Holiness over video broadcast in an empty room, but it’s very nice to know that I’m not alone to say the Rosary even when I can’t go to Mass here.

Stepped up the disinfecting.  And wearing more healthcare protective equipment.  We don’t got in nursing homes unless they can’t be brought outside. And we tell people to meet us outside.

I spend more time at each house because a lot of my patients aren’t having any other visitors. All the community outreach stops at the front door now.

England

Have you seen anything good as a result of the recent insanity?

I try to focus on the good, but it’s so hard when there is so much bad.  I guess… traffic is fantastic now.  I think everyone is trying to do their part to support local restaurants and businesses.  Most people seem to want to do the right thing.

Italy

With so many people made to stay at home, I think a lot of families are spending more time together. And everyone seems to be thinking up some way they can help, kids giving birthday money to shelters and medical students doing childcare for health workers.

Communities are recognizing that shop clerks, drivers, cleaners, they’re all absolutely necessary. It’s not just the politicians and rich folk who matter. Where would we be without rubbish clean-up and food delivery?

Difficult times like this often bring out the best that is already in people. The best has been in them all the time, but now they are expressing it and experiencing it more. 

People are learning that hospitals are disgusting places and that there are risks in going to them. 

Kenya

Is there anything you wish management, government, media, or whomever would do differently?

All those different entities do so many things wrong, it’s hard to know where to focus.  I’ve learned for the most part that there is little that I can affect on a large scale, such as with government or the media.  So I tend to not pay attention to either much.

Armenia

Some countries have been able to mobilize testing of millions of people very rapidly.  It would help us to determine who has already had the virus and is very low risk for acquiring it and passing it on, and is therefore fairly safe working on the front lines. They can also get back to work in what is currently called nonessential businesses. Without enough testing, we are fighting this battle blindfolded.

Why do travel companies keep offering cheap tickets?!

The media has been distorting the message. We keep hearing how certain drugs have not been approved for this virus, but really nothing has been approved. That doesn’t mean we shouldn’t at least try. About 20% of all medications used have not been approved for the thing doctors are prescribing them for. This is called off label use and we use this approach all the time for many medications. For a governor to ban certain medications because they have not been approved is the same as practicing medicine without a license.

India

The amount of bad information floating around is so dangerous. I understand that people are scared and no one has all the answers, but I wish people would stop telling things that aren’t true. Washing your mouth with bleach, drinking boiling water, filling your room with smoke… No, don’t do these things.

I wish there was more reliable information available in every language. My neighbours like to assume that, because I speak English, I have all of the answers that are being hoarded by British and American doctors.

It’s become a social and status symbol to say that you’ve been tested or have it. No one cares. Just stay home. 

Hawaii

What keeps you up at night?

The one thing that has kept me up at times is when I have a patient that has a complication, whether I contributed to it or not.  I tend to “Monday Morning Quarterback” every little thing I did and blame myself even when it’s not my fault.

Holland

Nothing currently keeps me up at night. As long as I do my best in my family is okay, I sleep well. It’s been a long time since I’ve been unable to sleep.

I worry about the people no one seems to help – the families who can’t get food, the people stuck behind barricades, the old ones left at home with no neighbors to check on them.

Dead kids tend to make it harder to sleep for a while.

Philippines

The question we all really want to ask: How do you keep your hands from drying out and cracking when you wash them every twenty seconds?

Nantucket

Make sure you rinse really well. Little bits of soap film, especially in the knuckles or between your fingers, can cause irritation.

Soap and water is so much better than hand sanitizer. The alcohol in hand sanitizer is usually what dries out skin. Plus, soap and water is more effective.

Lotion, but make sure it’s not scented.

Healthcare is exhausting!

BOOOOORED!

Sir Terry Pratchett always knows the best words.

I’ll skip defining boredom. It’s so common that it doesn’t need definition, any more than hunger or sunlight. Nearly everyone feels bored at one time or another, more or less often, sometimes daily. Men, in general, are more often bored than women. And people with little education are more likely to report being bored. As with nearly everything, there are two sides to boredom.

Sometimes it’s hard to tell if they’re bored or if they’re just being dogs.

The Downside of Boredom

Boredom is generally seen as an unpleasant emotional state. Why do people feel bored? Shahram Heshmat, Ph.D. identified eight common reasons for boredom.

1. Monotony in the Mind — When people are not interested in the details of the task at hand, or when a task is highly repetitive, they are likely to feel bored. We lose interest in things that are too predictable, too much of the same thing, too little stimulation. This can often lead to feeling trapped.    

Piracy is just so dull sometimes.

2. Lack of Flow — Flow is total immersion in a task that is challenging but within one’s abilities, a task with clear goals and immediate feedback. Tasks that are too easy are boring. Tasks that seem to be too difficult may lead to anxiety.

3. Need for Novelty — People with a strong need for novelty, excitement, and variety—i.e., sensation seekers—are at risk of boredom. For these people, the world moves too slowly. The need for external stimulation may be why extroverts are particularly prone to boredom, which they try to cure by novelty seeking and risk-taking

4. Paying Attention —What bores us never fully engages our attention. After all, it is hard to be interested in something when you cannot concentrate on it. People with chronic attention problems, such as attention-deficit hyperactivity disorder, are more likely to suffer boredom.

5. Emotional Awareness — People who lack self-awareness are more prone to boredom, unable to articulate what it is that they desire or want to do. They have trouble describing their feelings. Not knowing what we are searching for means that we lack the capacity to choose appropriate goals.

6. Inner Amusement Skills — People who don’t have the inner resources to deal with boredom constructively rely on external stimulation. In the absence of inner amusement skills, the external world will always fail to provide enough excitement and novelty. 

7. Lack of Autonomy — People often feel boredom when they feel trapped. And feeling trapped—stuck or constrained so that one’s will cannot be executed—is a big part of boredom. Adolescents are often bored, largely because children and teenagers don’t have a lot of control over their schedules and activities.

8. The Role of Culture — Boredom is a modern luxury. As the Enlightenment was giving way to the Industrial Revolution in the late 18th Century, boredom came into being. When people have to spend most hours of the days securing food and shelter, boredom isn’t an option.

The Upside of Boredom

Boredom does have its benefits. It is a “call to action.” Nietzsche suggested that men (sic) of rare sensibility value boredom as an impetus to achievement.  So…

1.  Boredom can be a catalyst for action.

2.  It can provide an opportunity for thought and reflection, a search for life’s meaning. 

3.  It can also be a sign that a task is a waste of time—and thus not worth continuing.

4.  Boredom can spur creativity.

Challenges for writers:

  • Writing boredom in an engaging way
  • Choosing ways for characters to handle boredom that forward the plot
  • Milking boredom for tension and/or emotional acting out

UNSTRUCTURED TIME

One of the side effects of COVID-19 is that many people have more unstructured time than usual—much more. By unstructured time, I mean periods of time with no plan in place for what one must/wants to get done

Poking everything with a stick does not count as a plan.

Two points made by openlinecounseling.com resonate for me.

(Note:getting into mischief is not a healthy goal.)
  1. Stretches of unstructured time often bring pressure and anxiety, sometimes existential panic.
    • Worrisome thoughts are more easily set aside when busy. But with unstructured time, it’s easy for self-doubts to come to the fore. 
      • Am I too fat?
      • Have I done a good job as a parent?
      • Will anyone remember me when I’m dead? 
    • When we have lots of time available, it’s easy to procrastinate. One can fritter away the time, flitting from one indulgence to another, from reading a novel to online shopping. Come the end of the day, one then feels guilty for not having been productive—or not productive enough. The feeling that one has “wasted time” is uncomfortable.
Lithuanian Military photographed by adasvasiliauskas
  • Being constantly on the go is often linked to self-worth—in which case not being productive leads to low self-esteem, as in “I’m a failure” or “I’m lazy.”
    • Making the most of every minute of every day isn’t recognized as an impossible, not to say unhealthy, goal.
Don’t let fear drive you to hide away in a box.

When deprived of the activities that usually fill our days, we often drift into unhealthy activities.

  • Being physically inactive
  • Drinking and/or smoking more
  • Snacking and/or eating too much
  • Online gambling
  • Binge shopping
Structure can keep you from climbing the walls… or windows.

Being suddenly confronted with unstructured time can be disorienting. This is often true of the newly retired. Regularly scheduled activities—which could be anything from work to volunteering, golf or poker to orchestra rehearsals—make people aware of the time of day as well as days of the week or month.

For me, COVID-19 cancellations make every day feel like Monday, my formerly “free” day. I have to pause and think what day of the week it is. 

Make sure to change out of your pajamas every day. I recommend formal gowns for coloring time.

Also, the “natural” day for humans isn’t exactly 24 hours: it’s somewhere between 24 and 26 hours. We reset to 24 hours based on outside constraints. My personal day is longer than most, and it’s easy to stay up and wake progressively later and later—say 3:00 to noon. For those on lock-down due to COVID-19, with no scheduled activities, the time of day might feel “off.”

The short solution to all these negatives is simple: make plans.  Keep the list of plans brief — say three — and doable. The plans could be relaxing activities such cutting flowers, taking a walk, etc. The idea is that making plans decreases the likelihood that you’ll pass days in haphazard activities or listlessness.

Enjoy an elegant tea party with inanimate friends!

Astronauts, being experts in the field of isolation, have offered some advice to those of us down here on the planet.

  • Keep a consistent sleeping schedule
  • Go outside and get some sun, so long as you do it by yourself
  • Separate work and leisure time, if you still work from home, so that one does not overtake the other
  • Stay in touch with people online or over the phone
These astronauts seem to have missed the rule about staying 6 feet apart.
(Don’t worry; the baby isn’t sitting on the dog while reading to him… not that he’d notice if she was.)

As more people are staying at home, many organizations are creating virtual activities to keep your mind active. You can take a virtual tour of a museum or national park, audit classes in a variety of subjects, join exercise or meditation groups, watch ballets or operas or Broadway shows, even have a cocktail or movie party with your friends! If all else fails, there are ways to help your community from the comfort of your living room.

  • OpenCulture has gathered many of these links to allow people to browse their options.
  • To fix the growing shortage of protective gear among healthcare workers, many people have started making face masks for local hospitals and fire stations.
  • Coursera is currently working with many universities to allow students to earn college credit
  • Many independent, foreign, classic, and documentary films are available to watch online for free
  • All kinds of educational materials for k-12 students are free online
  • The Guggenheim has made 300 ebooks about art available for free

Takeaway for writers: consider the role of structure in the lives of your characters.

The Worst of Times, The Best of Times

One of my favorite guest bloggers has agreed to provide her always unique perspective on current events. With all that’s been written on the current pandemic, we sometimes need to take a step back and look from a (very) different angle. Kathleen Corcoran is a local harpist, teacher, writer, editor, favorite auntie, and tenuous believer in the goodness of humanity.

Whenever society collapses (or maybe wobbles a bit), we seem to see the extremes in people come out. The very best of heroes stand up, and the very worst villains take advantage. As the late, great Sir Terry Pratchett wrote in Good Omens, “Where you found the real McCoy, the real grace and the real heart-stopping evil, was right inside the human mind.” Of course, disaster also sometimes brings out the very weirdest elements…

Note: The examples provided below are by no means a comprehensive list of incidents. They represent my own personal opinions and are not endorsed or promoted by any other entity.

Volunteers at the Sunnyvale Community Services food distribution site
(Karl Mondon/Bay Area News Group)

The Best Side of Humanity

During the Plague of Justinian, the official Court Historian Procopius kept notes on how the plague affected the Roman Empire. In addition to some rather bizarre medical theories, he saw the way the plague brought out the very best of humanity. “[T]hen all, so to speak, being thoroughly terrified by the things which were happening, and supposing that they would die immediately, did, as was natural, learn respectability for a season by sheer necessity.” From History of the Wars, II.xxii–xxxiii translated by H.B. Dewing.

  • One constant in every disaster is the appearance of some form of healthcare worker, whether professional or volunteer, providing care for patients despite personal danger, overwhelming circumstances, inadequate supplies, exhaustion, and every other possible obstacle.
    • As far back as the Plague of Justinian, the court historian Procopious wrote about the exhausting and selfless labors of those who cared for plague patients, though it seems the main job of a nursing aid at the time was stopping their patients from committing suicide before they died from the plague: “When they were struggling to rush headlong out of their houses, they would force them back by shoving and pulling against them.”
    • Elsie Maud Inglis started a women’s medical corps during WWI and established two hospitals on front lines. When the German army advanced, she was taken prisoner with her patients rather than be evacuated. During a later prisoner exchange, Elsie Inglis refused to be released unless her captors also released her patients, saving 13,000 injured Serbian POWs.
    • During the 1918 Influenza Pandemic (sometimes called Spanish Flu), the ease of infection and limited hospital space resulted in incredibly high mortality rates among everyone who worked near the sick. Stories emerged after of nurses working straight through their shifts only to die at the end, of medical students taken out of classes to run entire hospital wards, of doctors continuing to direct care rotas despite being confined to bed themselves.
    • Corporal Desmond Doss repeatedly ran into enemy fire to recover wounded soldiers as a medic in WWII. Despite refusing to carry any weapon as a conscientious objector, he saved nearly 100 wounded soldiers under fire and was awarded the Medal of Honor.
    • After running 26.2 miles, many Boston marathoners who crossed the finish line after the 2013 bombing continued running several more miles to Massachusetts General Hospital to donate blood.
    • Despite having been hit earlier by Hurricane Katrina, Cuba was one of the first countries to offer aid to the US victims of the hurricane, offering to send 1,586 doctors and 26 tons of medicine.
    • Kellan Squire, an ER nurse who ran for Lieutenant Governor of Virginia (in part to fix the healthcare system) has this to say about healthcare workers in the current pandemic: “We’re going to get infected, we’re going to die and get ICUed at a rate a few times above other subgroups, we’re going to charge in without the resources or support we need to do our jobs. It’s just what we do. It’s not like we’re going to stop… especially now.”
  • Despite facing serious threats to themselves or their families, there are always people who are willing to face that danger in order to aid or shelter others.
    • Ninety percent of the Jewish population of Denmark survived the Holocaust because nearly the entire Danish population worked together to hide or evacuate their friends and neighbors when the Nazis invaded.
    • Every part of Harriet Tubman’s life was pretty heroic.
    • In 1943, hundreds of non-Jewish women married to Jewish men who had been deported gathered every day at the Rosenstrass e 2-4 Welfare Office to demand the release of their relatives, risking harassement, arrest, and execution while completely unarmed themselves. The “Rosenstrasse Protest” was successful; all of the arrested men were released, and the protesters faced no repercussions.
    • In Kenya in 2015, al-Shabab terrorists started a pattern of entering an area, separating Muslims and non-Muslims at gunpoint, and then massacring all of the non-Muslims. A bus leaving Nairobi in December was boarded by terrorists who demanded that the passengers separate by religion, but Kenyan Muslims on board refused to move, sheltering their fellow riders in their ranks. The al-Shabab terrorists eventually left without firing a shot.
    • The families of Sarajevo business partners Yosef Kavilio and Mustafa Hardaga wound up saving each other, decades apart. In the 1940s, Mustafa Hardaga and his wife Zejneba hid the Jewish Yosef Kavilio and his family in their cellar. Decades later, in 1992, Kavilio’s descendants in Israel saw on television the danger Zejneba Hardaga faced from Bosnian troops. The petitioned the Israeli government to locate Zejneba and her daughter, who were safely evacuated to Israel.
  • Sometimes doing the right thing means deliberately disobeying laws or going against direct orders from a superior.
    • Dominican Friar Najeeb Michael, who was in charge of digitizing thousands of ancient volumes of Iraqi history, refused to leave his abbey in Mosul when ISIL invaded. Instead of evacuating immediately as his superiors orders, he kept boxing up and moving cases of books to prevent them from being destroyed. Even when he finally started to leave the city, he kept stopping his car to children and disabled passengers on his way to safety.
    • Hugh Thompson was a helicopter pilot in Vietnam who landed his helicopter between American soldiers and the fleeing residents of My Lai, threatening to open fire on the soldiers if they did not stop killing civilians and destroying homes. He then flew dozens of survivors to receive medical care. Despite direct orders to cover up the My Lai Massacre, Major Thompson cooperated fully with the investigation into the incident. He was later ostracized by fellow military members, receiving anonymous death threats and mutilated animal bodies left on his front porch.
    • Tibor Rubin repeatedly broke out of North Korean POW camps to smuggle food back in to fellow prisoners. He also provided medical aid to other POWs, using skills he picked up while surviving Mauthausen concentration camp during the Holocaust
    • In 1944, Nazi ships tried to round up all of the Jews in the Ionian Islands of Greece. When the SS demanded that Mayor Loukas Karrer of Zakynthos provide a list of all Jews on the island, Bishop Chrysostomos handed them a list with two names on it: Mayor Loukass Karrer and Bishop Chrysostomos. Meanwhile, the 275 Jews on the Zakynthos were hidden by residents of nearly inaccessible mountainous villages; every person on the island collaborated in saving their Jewish neighbors.
    • The Edelweiss Pirates was a loosely connected network of ex-Hitler Youth, mostly between the ages of 14 and 18, who did everything they could disrupt the Nazi war effort in Germany, including blowing up railways and helping Jews escape execution.
    • Sergeant Dakota Meyer was ordered to ignore a distress call at Ganjigal and to fall back instead. He drove into the battle zone five times, transporting wounded soldiers in his Humvee and providing cover fire for other military personnel to escape.
    • Dr. Albert Battel was a lieutenant in the German army who stopped the SS from entering Przemysl ghetto in 1942. While the SS was stalled trying to get through the blocked bridge, Lieutenant Battel and his unit moved families out of the ghetto and hid them at his own Army headquarters, preventing the SS from deporting them to the Belzec Extermination Camp.
  • With the stock market practicing pogo moves, kids needing extra childcare, people missing shifts, and every possible industry seeing some kind of disruption, it’s still amazing to see businesses putting the good of the community over profit.
    • Zahid Iqbal has donated and delivered thousands of “coronavirus kits” from his convenience store in Edinburgh, Scotland. He and his employees have made the kits from toilet paper, antibacterial handwash, tissues, and anti-inflammatories and then brought them to retirement homes and the homes of at-risk neighbors.
    • Healthcare workers in America are facing a serious shortage of Personal Protective Equipment (PPE), putting them at additional risk of infection while they work. Several medical tv shows are donating PPE used on sets (still sterile boxes of gloves, face masks, surgical gowns, hairnets, etc.) to EMTs, fire stations, and hospitals.
    • Lazy Magnolia Brewing Company in Mississippi has converted its distillery to make spray disinfectant.
  • There are some very creative methods of giving back to the community and helping society that take a specific blend of available talent and courage to perform.creative methods of giving
    • Chef José Andrés closed all of his restaurants in DC to comply with restrictions on social gatherings. With empty kitchens and refrigerators full of food, he decided to go back to work making packaged meals to distribute to people in quarantine, healthcare workers, and anyone else in the area who needs help feeding their families.
    • Other restaurants that have to close for social distancing are donating massive amounts of food (as well as cooking and packaging supplies) to local food banks, shelters, Meals on Wheels, and community kitchens.
    • Chiari Hospital in northern Italy needed ventilator valves to help COVID-19 patients breathe. Engineers from Isinnova collaborated with the 3-D printing company FabLab to produce replicas of the valve quickly, allowing the ventilators to stay in use.3-D printing ventilator valves.
    • Musicologist Ahmad Sarmast graduated from school and then returned to his native Afghanistan to record oral musical traditions he feared would be lost in chaos and uncertainty. Along the way, he started teaching girls to play orchestral instruments in defiance of religious restrictions. He has already survived one bombing assassination attempt and continues to record, notate, and teach despite now being nearly deaf and riddled with shrapnel.
Dr. Ahmad Sarmast with some of his students

The Worst Side of Humanity

Unfortunately, there will always be people waiting to take advantage of any situation. Some betray their neighbors to save themselves. Some see any opportunity for profit or personal gain. Some seem to hurt people for no other reason than the pleasure they feel when hurting people. Again, Sir Terry Pratchett said it best: “Evil begins when you begin to treat people as things.” (from I Shall Wear Midnight)

  • The phrase “adding insult to injury” comes to mind when reading these next examples. People who are kicked when they are down, sometimes in the most petty of ways.
    • After the students protesting in Tiananmen Square were gunned down in 1989, the Chinese government reportedly charged families of victims a “bullet fee” for the cost of the bullets used to execute their dead family members.
    • During Irish Potato Famine, Sultan Abdul Medjid Khan of the Ottoman Empire tried to donate £10,000 and ships full of food to send to Ireland. British ambassadors told him it was forbidden for anyone to donate more than Queen Victoria, who had only donated £1,000.
    • People running from Hurricane Katrina were turned back at gunpoint when they tried to cross the bridge into neighboring town of Gretna.
    • White Star Line billed the families of Titanic victims for freight shipping cost of having bodies returned, used a weird contract clause to fire every employee the moment the ship started to sink, and billed the families of the band members for the cost of uniforms that weren’t returned (because they were too busy playing to keep people calm as the ship sank to worry about taking off their clothes and stowing them safely on a lifeboat for return to the company).
    • The Mongol army was busy beseiging the city of Kaffa (present-day Feodosiya) on the Crimean Peninsula when they were forced to retreat because their ranks were so depleted by the Black Death. Stories from the time claim that the Mongols catapaulted the bodies of soldiers who died from the plague over the city walls into Kaffa on their way out.
    • At the end of WWII, Soviet soldiers held in German POW forced labor camps were returned to Russia. Trains carrying these soldiers home were diverted to Russian forced labor camps, gulags, where most of the soldiers were sentenced to 10-20 years for the “crimes” of assisting the enemy and having possibly been exposed to Capitalist Western POWs.
  • A scapegoat can always be found for any disaster or atrocity. Xenophobia and bigotry are easier than understanding the facts.
    • Armenians were blamed for the Ottoman Empire’s defeat in WWI, providing a convenient justification for the Armenian Genocide.
    • Jews, Romani, witches, and sailors were all blamed for Black Death at one point or another. Terrified plague mobs expelled, burned alive, deported, stoned, and performed every other imaginable atrocity on whichever group was most convenient at the time.
    • Mentally and physically handicapped Robert Hubert was not in London during the Great Fire of 1666; his ship didn’t even arrive until two days after the fire was extinguished. Nevertheless, he was tried and hanged for firebombing London and starting the Great Fire.
    • Jerry Falwell and Pat Robertson went on TV and announced that the 9-11 terrorist attacks were the fault of “liberal civil liberties groups, feminists, pagans, homosexuals, and abortion rights supporters.”
    • The current novel coronavirus COVID-19 pandemic has been blamed on China (especially Wuhan province), Chinese people, people of Chinese descent, people of partial Chinese descent, and people who might look a bit Asian if you tilt your head at just the right angle. Government officials (including those in very high office) have blamed the Chinese government, and it trickles all the way down to children being bullied for “spreading the virus.”
  • It seems there will always be someone willing to take advantage of others’ fear, selling the Brooklyn Bridge and a guarantee to Heaven all in one convenient package.
    • Spiritual leaders” whose primary goal is to raise funds have started asking for donations in return for prayers, going so far as to ask for donations to build a hospital for patients with coronavirus (conveniently leaving out the bit about the hospital being a spiritual place rather than an actual building where medical care is provided.)
    • The prices of everything from face masks to canned food have skyrocketed around the world.
    • Price-gouging of food and fuel became so severe during WWII that enabling price controls was one of the primary reasons the government enforced a rationing system.
    • “Doctors” during the Black Plague in Europe charged extreme prices for very expensive treatments, such as eating a paste of ground emeralds or bathing in the urine of uninfected mothers.
  • People hoard anything they think might become scarce, even if they don’t immediately need it, even if others need it more.
    • While people starved by the millions in 1845-1847, the worst years of Ireland’s Great Hunger, millions of bushels of grain were shipped to England, along with livestock, dairy, and beer. Landlords only allowed the peasants to eat potatoes, which had all been destroyed by blight.
    • In Australia, people with stockpiles of food have received death threats.
    • People panic buying medical supplies, especially in the US, have caused a shortage in hospitals, clinics, fire stations, nursing homes, etc. Doctors and nurses are re-using face masks, making surgical gowns at home, and not doubling gloves in an attempt to make their increasingly limited supplies last.
Soviet POWs got the short straw everywhere.

Um… What?

Fear makes people do all sorts of strange things, like buying loads of toilet paper in preparation for an illness that doesn’t cause any increase in toilet use.

  • City officials seeking to cure the “Dancing Plague” in Strasbourg in 1518 asked medical officials how to help people who were literally dancing themselves to death, flailing and jerking around for days on end until they dropped dead from exhaustion. The doctors decided that these people had a sickness that needed to be shaken off… by forcing them to keep dancing!
  • A strip club in Las Vegas is advertising that the lap dances on offer are guaranteed to be free from coronavirus.
  • People have begun sharing very odd photos and videos of the ways they are passing time while in quarantine or isolation. Pets wearing ties or being unhelpful coworkers are a popular photo subject, as are twitter competitions for things like jumping on the bed or holding one’s breath.
  • The Justinian Plague often began with very high fevers, causing hallucinations. These visions were often interpreted as signs from God of punishment to come or evidence of demonic possession. Exorcism was a common prescription, usually carried out by a tonsured monk. There were also people who believed that the monks were demons and the cause of the plague and fled from the sight of any man who was getting a bit bald on top.
  • According to some reports, the Dutch are hoarding cannabis in preparation for whatever COVID-19 brings, while the French are building stockpiles of red wine.
  • Something the Justinian Plague and the 1918 Influenza Pandemic had in common – people often wore name tags, armbands, toe tags, or some other external form of ID because the illness could kill so quickly that it was often the only way of ensuring your body would be identified if you dropped dead on the street.
  • With the aquariums in Chicago closed to visitors, the penguins have taken over!
Who put these guys in charge?

Be the Best!

You can be one of the good guys. Here are some ways you can show the best of humanity during this pandemic (and at any other time!)

  • Donate blood! The Red Cross really needs blood donations from healthy people to meet the needs of virus patients on top of all their regular needs.
  • Buy vouchers or gift certificates online for local restaurants, bars, shops, etc. Redeem them when things are back to normal. Think of it like a microscopic micro-loan.
  • If you are crafty, make reusable face masks for medical professionals. Here are some instructions.
  • Donate to organizations working to help the most vulnerable people in our societies.
  • Call, text, email, video chat with your friends, family members, work acquaintances, that guy down the street you wave to while walking your dog. Social distancing, while necessary for physical health, is not great for mental health. Make an extra effort to reach out to isolated people and stay connected.
  • https://www.flattenthecurve.com/
The Best: Lines of people waiting for hours to donate blood after the Orlando mass shooting

WRITING PANDEMICS

Beware the Carnosaur Virus!
from the movie Carnosaur

We are currently enduring a coronavirus pandemic (COVID-19).  But perhaps I can tell you some things about pandemics in general that you don’t know! 

Writers note: you will find below several bits of information you absolutely must have if you are going to write a story involving a pandemic—or even an epidemic.

ALZ-113 (Simian Flu) from Planet of the Apes

First you need to know the different levels of the disease’s severity within a community.

  • Sporadic: a disease that occurs infrequently and irregularly (rabies, polio)
  • Endemic: the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area (chicken pox in American schoolchildren, malaria in certain areas of Africa)
    • Hyperendemic: persistent, high levels of an endemic disease occurrence, above the expected “normal” levels
Disinfection of workers at an Ebola clinic, 2016
  • Epidemic: an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area (Ebola in 2014, Zika in 2018)
    • Outbreak: carries the same definition of epidemic, but is often used for a more limited geographic area
  • Holoendemic: essentially every individual in a population is infected, though not all show symptoms (modern occurrences are not common, but one example is hepatitis B in some areas of the Marquesas Islands)
  • Cluster: aggregation of cases grouped in place and time that are suspected to be greater than the number expected, even though the expected number may not be known
  • Pandemic: is an epidemic so big it crosses international boundaries and affects large numbers of people.
Bubonic Plague
Squirrel Army!

Pandemics can occur in crops, livestock, fish, trees, or other living things, but I’ll be sticking with people here.  You may want a plot line that has people battling a pandemic in another species. What happens to the food supply if all the wheat or corn or soybeans die off? How would people protect themselves from an entire population of aggressively rabid squirrels?

A wide-spread disease or condition that kills many people is a pandemic only if it is infectious. E.g., cancer and diabetes are not pandemics.

Until recently, I thought—in a vague sort of way—that pandemics were a thing of the past, mostly centuries ago. Wrong.  Currently, besides COVID-19, HIV/AIDS is an active pandemic world-wide. For example, several African countries have infection rates as high as 25%, or even 29% among pregnant South African women.

Distribution of AIDS cases worldwide

Any given pandemic is seldom one-and-done. Maybe none of them are.

Black Death, Venetian miniature. Middle Ages, Italy, 14th century. (Photo by DeAgostini/Getty Images)
Seattle PD wearing newly distributed face masks to prevent the spread of respiratory disease
  • Plague: contagious bacterial diseases that cause fever and delirium, usually along with the formation of buboes, sometimes infecting the lungs. In past centuries, plagues killed 20%, 40%, even 50% of a country’s population. The first U.S. plague outbreak was the San Francisco plague of 1900-1904. 
    • Writers note: isolated cases of plague still turn up in the western U.S.
  • Influenza (a.k.a. Flu): the first flu pandemic recorded was in 1580, and since then influenza pandemics have occurred every 10 to 30 years
  • Cholera: seems (to me) to be nearly perennial, with pandemics recorded 1871-1824, 1826-1837, 1846-1860, 1863-1875 (in 1866 it killed some 50,000 Americans), 1881-1896, 1899-1923, 1961-1975. 
  • Typhus (a.k.a., camp fever, gaol fever, and ship fever): caused by bacterial Rickettsia prowazekii and characterized by a purple rash, headaches, fever, and usually delirium. It spreads rapidly in cramped quarters, often carried by fleas, lice, and ticks. It’s common in times of war and famine.
  • Smallpox: caused by the variola virus, it raged from the 18th century through the 1950s. Vaccination campaigns beginning in the 19th century led the World Health Organization to declare smallpox eradicated in 1979. 
    • Writers note: it is the only human infectious disease to have been completely eradicated. But for your purposes, maybe not!
  • Measles: historically, before the vaccine was introduced in 1963, 90% of people had the measles by age 15. Measles is an endemic disease, so groups of people can develop resistance. But it is often deadly for those who get measles, and it has killed over 200 million people over the last 150 years. Worldwide, in 2000, measles killed 777,000 out of 40 million cases.
  • Tuberculosis (a.k.a, TB): a very present danger, as new infections occur at a rate of one per second. A quarter of the world’s current population has been infected, and although most of those are latent, 5-10% will progress to active disease. Left untreated, TB kills more than half of its victims.
  • Leprosy (Hansen’s disease): caused by a bacillus, it is a chronic disease. It has an incubation period up to five years, but it can now be cured. It’s been estimated that in the early 13th century, there were 19,000 leper hospitals (leprosariums) across Europe.
  • Malaria: widespread in tropical and subtropical regions around the world. 
    • Writers note: consider the implications of climate change. Once common, malaria deaths became all but non-existent due to drug treatment. However, growing drug resistance is a major concern. Malaria is resistant to all classes of antimalarial drugs except artemisinins.
Yellow fever was vaguely understood to be carried by sailors on long voyages
  • Yellow fever: a viral infection carried by mosquitoes. In 1793, it killed approximately 10% of the population of Philadelphia.
  • Ebola virus: one of several viral hemorrhagic fevers (along with Lassa fever, Rift Valley fever, Marburg virus, and Bolivian hemorrhagic fever) that seem to be pandemics in waiting because they are highly contagious and deadly. On the other hand, transmission requires close contact and moves fast from onset to symptoms, so effective quarantines are possible.
    • And on the third hand, writers note: it could always mutate and adapt.
  • Coronaviruses: a large family of viruses that cause illnesses ranging from the common cold to MERS-CoV, SARS-CoV, and the current Coronavirus-19, which is a new strain of SARS-CoV-2. Common effects of all of these are fever, cough, shortness of breath, and breathing difficulties. 

Historians have identified five (sometimes six) “major pandemics” that have affected enough of the population to cause a significant change in the social order. They are often referred to as plagues, despite not being caused by the bacterium Yersinia pestis.

  • The Plague of Justinian (541-543) continued to cause famine and death after the primary infection had been contained because the sudden lack of a labor force meant that crops weren’t planted and harvested.
    • The horrific conditions during and after the plague are believed to have created an ideal atmosphere for the rapid spread of Christianity.
    • Though he survived his infection, Emperor Justinian had to shelve plans to consolidate power and expand the Roman Empire.
Plague victim demonstrating a bubos
  • The Black Death of 1347 to 1351 is believed to have killed as much as half the world’s population.
    • Historians have estimated that resulting labor shortage allowed for the end of the feudal system and the beginning of the Renaissance in Europe.
    • The population of Greenland was so diminished that the Vikings didn’t have the manpower to continue their raids in North America.
  • The Colombian Exchange is a general term used to cover all of the species of plants, animals, people, and diseases moved from one continent to another during the European invasion of North and South America.
The worst-hit areas of the Third Plague
Hong Kong
  • The Third Bubonic Plague began in 1855 and reached every part of the world before it died down in the 1960s.
    • Researchers confirmed that the disease was spread by bacteria in flea bites, allowing for major breakthroughs in quarantine methods.
    • Some of those early quarantines involved such draconian measures in colonized areas that they contributed to rebellions in Panthay, Taiping, and several regions of India.
Public information campaigns helped to reduce transmission
  • The 1918 Influenza outbreak, commonly known as the Spanish Flu, infected 500 million people around the world and killed more people than World War I. In 25 weeks, it killed more people than AIDS did in its first 25 years.
    • The close quarters of soldiers involved in World War I contributed to the rapid spread, but the contagion raised public awareness of how disease is transmitted and how to prevent it.
    • Note: The “Spanish” flu was present around the world, but it gained its name because the Spanish government did not censor information on the pandemic. Because most other countries worked to suppress information so as not to disrupt the war, people got the impression that the disease was coming from Spain, the source of their information.
Keith Haring, AIDS activist and artist
  • Though it was first reported in 1981, HIV/AIDS is believed to have originated in a mutated genetic strand of the virus from a monkey in the 1920s.
    • Sex education in schools and sexual practices among some portions of the population (notably among sex workers) changed drastically to focus on safety.
    • Because it was first prevalent among the gay community, many religious leaders claimed the virus was a divine sign that homosexuals were evil.
Leprosy hospitals still exist in India

“Alien” diseases are more deadly than local ones. Writers note: what are the implications of colonizing Mars?

Medieval dead cart
  • In 1529, a measles outbreak in Cuba killed 2/3 of the natives who had previously survived smallpox.
  • Malaria was a major threat to colonists and Native Americans when introduced to the Americas along with the slave trade.
  • In Colonial times, West Africa was called “the white man’s grave” because of malaria and yellow fever.
  • European explorers often had devastating effects on indigenous people—and vice versa. For example, some believe that the death of up to 95% of the Native American population of the new world was caused by old world diseases such as smallpox, measles, and influenza.
  • On the other hand, syphilis was carried from the new world to Europe after Columbus’ voyages.
Attempts to combat typhus after the liberation of Bergen-Belsen

Many notable epidemics and pandemics involve transmission from animals to humans, zoonoses.

  • Influenza/wild aquatic birds
  • SARS-CoV/civet cats
  • MERS-CoV/deomedary camels
  • COVID-19/bats’
  • Avian influenza (bird flu)/birds in Vietnam (a pandemic in waiting)
During the Third Plague, researchers definitively proved that flea bites spread Bubonic plague

Writing about pandemics—or any disease, actually, you need to decide on:

  • Name, fictional or real
  • Disease type/ who’s most susceptible (childhood/ common/ rare) 
  • Cause (bacteria, virus, parasite, fungus, imbalance of bodily humors, witchcraft, divine intervention, etc.) 
  • Transmission (airborne, body fluids, food or water, touch, telepathy, miasma, etc.)
  • Virulence (how likely a person is to catch the disease after coming into contact with it) 
  • Length of the incubation period: a person could be showing symptoms and become infectious almost instantly or it could take years 
  • Symptoms of this disease
  • Whether it’s treatable and/or curable
  • How people react when they encounter someone with this disease
    • For a first-hand idea of what people thought during the Black Death, check out this Eyewitness to History!
Houses with sick inhabitants were marked for quarantine in London

BOTTOM LINE FOR WRITERS: pandemic are tried and true for creative fiction, whether historical or current, sci-fi or known world, mystery/action adventure or romance. Go for it!

Let’s end this on a more cheerful note:
Happy Saint Patricks Day!

SLEEPING ALONE AND TOGETHER

People who get the recommended eight hours of sleep in twenty-four are spending a third of their lives in bed. Granted, things other than sleep happen in bed, but it’s absolutely undeniable that people—and therefore realistic characters—go to bed, sleep more or less well, and get up often. Whether the sleeper spread-eagles across the bed or looks like a soldier at attention, a preferred sleep position can be indicative of character, personality, and even health issues.  

Writers take note: it pays to pay attention to your protagonist’s sleep habits.

Sleeping Positions and What They Say About Personality

  • The Fetal Position is a favorite: 41% of all people habitually adopt this position at night. It involves curling your knees towards your chest, as if sleeping in the womb. 
    • Secret Softy is the basic personality type associated with this position.  This sleeping position means tough on the outside and soft on the inside. The person may be shy to begin with, though they usually open up and relax quite quickly.
    •  Left-side sleepers tend to be creative and  well-educated.
    •  Right-side sleepers are more likely to smoke and depend on caffeine.
  • The Thinker—much like the fetal position—will sleep curled up but with a hand gently resting on the chin, as if pondering something.
    • The personality associated with this position is an  Emotional Evaluator. Those who habitually sleep in this position are more emotional than other sleepers, with both positive and negative emotions running high.
  • The Log: 15% of people enjoy sleeping in the log position, the second most popular position. To snooze in this position, one sleeps on one side with both arms and legs straight.  (It must be comfortable even if it doesn’t look it.)
    • Logs are Naturally Carefree people.  But conventional wisdom says that those who tend to sleep like this also tend to be social butterflies, friendly, carefree, and popular.
    • Writers Note: A trusting nature means also likely to fall into the trap of being gullible. 
  • The Yearner is also a common sleeping position that involves sleeping on one side with straight legs but arms stretched out, as if trying to reach something.
    • Such people are thought to be Complex Characters. People who sleep like this are a bit of a mixed bag, being both open-minded and cynical, inviting but suspicious of new friends and acquaintances.
    • “Yearners” tend to make good, reliable friends. Slow and deliberate decision makers, they are often unsure of their own decisions, though they have a firm resolve once they’ve come to a conclusion. 
  • Soldier Stance, as the name implies, looks like a soldier sleeping at attention, lying on their back with arms straight by their sides.
    • Controlled Characters tend to sleep in this position. They will usually be strong, quiet, focused, and reserved.
    • They may also expect themselves and other people to adhere to strict moral codes and high standards.
  • The Freefall (also called The Skydiver) sleep position makes the sleeper look a relaxed skydiver freefalling through the sky, often with arms wrapped around a pillow while sleeping on their stomach. 
    • Sleeping in freefall indicates someone who is bold, sociable, and fun, though they may not have the thick skin necessary to deal with criticism or uncomfortable situations.
    • They may be anxious, and seek control of situations.
  • Spread-Eagled Starfish (sometimes called Mattress Hog), the starfish sleeper spreads arms and legs in a carefree manner over the entire bed surface while lying face-up, is the least common position.
    • A starfish is likely to be a flexible friend, willing to listen to anyone who needs to talk or help anyone who needs a hand.  Although unconventional, they probably don’t really like to be the center of attention.
  • The Stargazer position isn’t the most popular, possibly because it can mean the sleeper gets too cool overnight. The position is a vulnerable one, with stargazers lying on their backs, arms wrapped around their head.
    • They are likely to be the Best BFF’s, giving priority to their friends, doing everything they can for those they hold dear.
    • Usually, these sleepers will have a happy, easy-going disposition.
  • Pillow Huggers are self-described. They hug pillows close to their bodies, and usually have arms and legs wrapped around it in some way. 
    • Pillow huggers like to get cosy and be cuddled, cherishing the relationships they have with the important people in their lives above all else.

Other Factors Related to Various Positions

Positional Side Effects

  • The Log
    • Some claim this position, aligning neck and back, makes it one of the best for back and neck pain; others point out the potential for arm numbness, as well as neck and shoulder pain for some people.
    • May also put pressure on hip joints, sometimes eased by a pillow between the knees.
  • The Soldier 
    • Unless the sleeper uses too many pillows or sleeps on an uneven surface, this position aligns the neck and spine if not too many pillows. This position can distribute weight evenly across shoulders. Its relationships to acid reflux is unclear. Back sleepers are more prone to snoring, and those with sleep apnea can aggravate the condition by sleeping like this.
    • On the other hand, the effects of gravity means it can help prevent the development of wrinkles on beck and face. Dianna Ross once said she trained herself to sleep on her back for that very reason. 
    • Another reason to train oneself to sleep in this position is to elevate or avoid aggravating injuries, such as broken arms, knee or ankle surgeries, abdominal sutures, shoulder strain, or any other painful event that may have happened to a character.
  • The Starfish
    • Also a flat back position, the starfish has the same side effects as the soldier. Only 8% of sleepers prefer back sleeping.
    • Back sleeping tends to lead to more refreshing sleep, with the least readjusting during the night. May be a good choice for people with arthritis.
    • On the other hand, it may aggravate back and neck pain. Back sleeping (keeping face off the pillow) may reduce acne breakouts.
  • Freefall/ Skydiver 
    • Research suggests that this position is one of the worst for health because it puts strain on the neck, back, and spine. It increases the risk of neck and back pain as well as airway blockage. A sleeper can ease stress on neck, upper back, and airways by sleeping face down with a pillow under forehead.
    • On the plus side, it also has the the potential to ease snoring and sleep apnea.
    • Only 7% of people sleep on their stomach.
  • Side Sleepers
    • Side sleeping reduces snoring and relieves sleep apnea. It can reduce back and neck pain and carpal tunnel syndrome. Side sleeping helps the brain’s lymphatic system clear waste during sleep.
    • Side sleepers are more likely to develop face and neck wrinkles (compared to back sleepers). Consistently sleeping on one side can lead to noticeably asymmetrical wrinkling.
    • Sleeping on one’s side may lead to the down-side limbs “going to sleep.”
    • Which side matters:
      • Left side sleeping is helpful for acid reflux, and it may aid digestion.
      • Right side sleeping may lower nervous system activity, reducing heart rate and blood pressure.
    • Fetal Position
      • Sleepers in the fetal position have the fewest sleep interruptions.
      • It’s also the best position for back pain. 
    • The Thinker shares side effects with the fetal position.

Age

  • With age, more people gravitate to a side-sleeping position. This may be related to protecting heart function during sleep.
  • As they get older, people move less drastically during the night, move less frequently, and spend more time in a position before moving on to another. Children shift sleep position more than twice as often during the night compared to those 65 and over.
  • Sleep position matters more with age. Older people are less flexible and more prone to stiffness and pain.

Gender

  • Twice as many women as men tend to sleep in the fetal position.
  • Pregnant women are urged to sleep on the left side, for reasons mentioned above. Back sleeping can create back pain, breathing problems, and heartburn, lower blood pressure and reduce circulation. The fetal position keeps pressure off the liver. 

Dreams

  • Right-side sleepers may have fewer nightmares. Disturbing dreams might be lessened by sleeping on the other side.
  • Back sleepers are also more likely to have nightmares and to recall less of their dreams.
  • Stomach sleepers have more vivid, intense, and sexual dreams. They’re also more likely to have dreams of being immobilized or restrained.

SLEEPING TOGETHER

  • Spooning is a fairly well known term. It’s where one partner snuggles up behind the other. It’s practiced by about 18% of couples and indicates a dynamic in which one partner takes a protective role with the other.
  • The Loose Spoon is exactly what it sounds like, the spoon but with less physical contact. It is typical of couples who start off spooning but relax as the relationship matures. It still says “I’ve got your back,” but is less sexual than spooning.
  • The Chase is like the spoon, except as the spoonee moves to the edge of the bed, the spooner follows. It might mean that the spoonee wants to be pursuedpursued OR that s/he wants more space. Clearly, these two motivations have quite different implications about the state of the relationship.
  • The Tangle is extremely intimate, the partners facing each other, arms and legs entwined. It is most common at the start of a romantic relationship, or in a situation of intense emotion. Couples that maintain the tangle throughout their relationship may be overly enmeshed, too dependent on each other.
  • The Unraveling Knot starts as a tangle that lasts about ten minutes, then the two people move apart. It’s a sign of a stronger relationship than the tangle, allowing for both intimacy and independence—the best of both worlds.  Only 8% of couples exhibit this two-step style.
  • Liberty Lovers sleep back to back, not touching, indicating the people in the relationship are connected and secure, sharing both closeness and independence. It’s relatively popular, the preferred sleeping style for 27% of couples.
  • Back Kissers are like liberty lovers except their backs or bottoms touch. It’s more common among newer couples, those who have been together for less than a year.
  • The Nuzzle involves one partner resting his/her head on the other’s chest, legs often intertwined. It’s often seen in early relationships, sometimes rekindled ones. This is considered a nurturing position that creates a sense of protection and trust.
  • The Leg Hug is like playing footsie in bed—one partner’s leg over the other’s. It represents a craving for an emotional or sexual connection. They can’t get enough of each other, and their lives are so intertwined that they function as a pair—taking care of each other, finishing each other’s sentences, etc.
  • The Space Hog is when one partner takes the starfish position, indicating selfishness, especially when/if the sprawler pushes the other partner so s/he is hanging off the bed (or falls off). This often indicates a lack of honest conversation. It can demonstrate which partner is dominating the relationship. The person sleeping closest to the headboard tends to feel more dominant and confident, while the one who is farther from the headboard tend to be submissive and have lower self-esteem.

Bottom line for writers: Consider the sleep habits of your characters to make their private lives richer, add tension, and possibly demonstrate intimacy (or lack thereof).

NAVIGATING THE RAINBOW

The following is an excerpt from the March 2, 2020 issue of The New Yorker, in a letter to the editor, headed “Fifty Shades of Gay.”

As a temperamentally conservative white Christian man, Buttigieg is as palatable as gay people get—a fact that makes this moment in queer history anticlimactic for the nonwhite, non-cisgender, non-male individuals who don’t relate to the queerness that America is most comfortable with.  … our political system, which is so concerned with the emotional equilibrium of the white cis-het majority…”

In order to understand this letter, I had to go online. It turns out that non-cisgender means someone whose gender identity doesn’t match the sex recorded on his/her birth certificate.  Cis-het means someone whose gender identity matches the birth certificate and who is heterosexual.

Note to writers: if you are writing contemporary fiction, know the current jargon. For your edification (perhaps), here is a dictionary of some terms that might come in handy. Bear in mind that the following terms may have different meanings or connotations in different societies, and a term that is used with pride in one community may be an insult in another.

Abrosexual Pride Flag

abrosexual – adj. : being fluid in sexuality. This means a sexuality that changes very often and fluctuates among several sexual orientations.

Agender Pride Flag

agender – adj. : a person with no (or very little) connection to the traditional system of gender, no personal alignment with the concepts of either man or woman, and/or someone who sees themselves as existing without gender. Sometimes called gender neutrois, gender neutral, or genderless.

androgyny /“an-jrah-jun-ee”/ (androgynous) – noun. : a gender expression that has elements of both masculinity and femininity;  2 adj. : occasionally used in place of “intersex” to describe a person with both female and male anatomy, generally in the form “androgyne.”

Androsexual Pride Flag

androsexual / androphilic – adj. : being primarily sexually, romantically and/or emotionally attracted to men, males, and/or masculinity.

Aromantic Pride Flag

aromantic /”ay-ro-man-tic”/ – adj. : experiencing little or no romantic attraction to others and/or has a lack of interest in romantic relationships/behavior. Aromanticism exists on a continuum from people who experience no romantic attraction or have any desire for romantic activities, to those who experience low levels, or romantic attraction only under specific conditions. Many of these different places on the continuum have their own identity labels (see demiromantic). Sometimes abbreviated to “aro” (pronounced like “arrow”). For insight on writing aromantic characters, I recommend this guide by Bran Lindy Ayres.

Asexual Pride Flag

asexual – adj. : experiencing little or no sexual attraction to others and/or a lack of interest in sexual relationships/behavior.  Asexuality exists on a continuum from people who experience no sexual attraction or have any desire for sex, to those who experience low levels, or sexual attraction only under specific conditions. Many of these different places on the continuum have their own identity labels (see demisexual). Sometimes abbreviated to “ace.” For insight on writing asexual characters, I recommend this guide by Bran Lindy Ayres.

Bicurious Pride Flag

bicurious – adj. : characterized by an openness to or curiosity about having sexual relations with a person whose sex differs from that of one’s usual sexual partners curious about exploring or experimenting with bisexuality

Bigender Pride Flag

bigender – adj. : a person who fluctuates between traditionally “woman” and “man” gender-based behavior and identities, identifying with both genders (or sometimes identifying with either man or woman, as well as a third, different gender).

binder – noun : an undergarment used to alter or reduce the appearance of one’s breasts (worn similarly to how one wears a sports bra).  Binding – adj. : the (sometimes daily) process of wearing a binder. Binding is often used to change the way other’s read/perceive one’s anatomical sex characteristics, and/or as a form of gender expression. 

biological sex – noun : a medical term used to refer to the chromosomal, hormonal, and anatomical characteristics that are used to classify an individual as female or male or intersex. Often referred to as simply “sex,” “physical sex,” “anatomical sex,” or specifically as “sex assigned at birth.”

biphobia – noun : a range of negative attitudes (e.g., fear, anger, intolerance, invisibility, resentment, erasure, or discomfort) that one may have or express toward bisexual individuals. Biphobia can come from and be seen within the LGBTQ community as well as straight society.  Biphobic – adj. : a word used to describe actions, behaviors, or individuals who demonstrate elements of this range of negative attitudes toward bisexual people.

Bisexual Pride Flag

bisexual – noun & adj. : a person who experiences attraction to some men and women. 2 adj. : a person who experiences attraction to some people of their gender and another gender. Bisexual attraction does not have to be equally split, or indicate a level of interest that is the same across the genders an individual may be attracted to. Often used interchangeably with “pansexual”.

butch – noun & adj. : a person who identifies themselves as masculine, whether it be physically, mentally, or emotionally. ‘Butch’ is sometimes used as a derogatory term for lesbians, but can also be claimed as an affirmative identity label.

cisgender /“siss-jendur”/ – adj. : a gender description for when someone’s sex assigned at birth and gender identity are the same (e.g., someone who was assigned male at birth, and identifies as a man). A simple way to think about it is if a person is not transgender, they are cisgender. The word cisgender can also be shortened to “cis.”

cisnormativity – noun : the assumption, in individuals and in institutions, that everyone is cisgender, and that cisgender identities are superior to trans* identities and people. Leads to invisibility of non-cisgender identities.

Transgender people murdered in 2018

cissexism – noun : behavior that grants preferential treatment to cisgender people, reinforces the idea that being cisgender is somehow better or more “right” than being transgender, and/or makes other genders invisible.

constellation – noun : a way to describe the arrangement or structure of a polyamorous relationship.

One variation of the Demiromantic Pride Flag

demiromantic – adj. : little or no capacity to experience romantic attraction until a strong sexual connection is formed with someone, often within a sexual relationship.

Demisexual Pride Flag

demisexual – adj. : little or no capacity to experience sexual attraction until a strong romantic connection is formed with someone, often within a romantic relationship.

Racism in the gay community is particularly prevalent and visible on online dating apps.

down low – adj. : typically referring to men who identify as straight but who secretly have sex with men. Down low (or DL) originated in, and is most commonly used by, communities of color.

NYC Dyke March

dyke – noun : referring to a masculine presenting lesbian. While often used derogatorily, it is also reclaimed affirmatively by some lesbians and gay women as a positive self identity term.

Erin Davies drove her “Fagbug” around to film reactions to anti-LGBTQ vandalism for five years.

fag(got) – noun : derogatory term referring to a gay person, or someone perceived as queer. While often used derogatorily, it is also used/reclaimed by some gay people (often gay men) as a positive in-group term.

feminine-of-center; masculine-of-center – adj. : a phrase that indicates a range in terms of gender identity and expression for people who present, understand themselves, and/or relate to others in a generally more feminine/masculine way, but don’t necessarily identify as women or men.  Feminine-of-center individuals may also identify as “femme,” “submissive,” “transfeminine,” etc.; masculine-of-center individuals may also often identify as “butch,” “stud,” “aggressive,” “boi,” “transmasculine,” etc.

feminine-presenting; masculine-presenting – adj. : a way to describe someone who expresses gender in a more feminine/masculine way. Often confused with feminine-of-center/masculine-of-center, which generally include a focus on identity as well as expression.

femme – noun & adj. : someone who identifies themselves as feminine, whether it be physically, mentally or emotionally. Often used to refer to a feminine-presenting queer woman or people.

fluid(ity) – adj. : generally with another term attached, like gender-fluid or fluid-sexuality, fluid(ity) describes an identity that may change or shift over time between or within the mix of the options available (e.g., man and woman, bi and straight).

FtM / F2M; MtF / M2F – abbr. : female-to-male transgender or transsexual person; male-to-female transgender or transsexual person.

Third Gender Pride Flag

gender binary – noun : the idea that there are only two genders and that every person is one of those two.

gender expression – noun : the external display of one’s gender, through a combination of clothing, grooming, demeanor, social behavior, and other factors, generally made sense of on scales of masculinity and femininity. Also referred to as “gender presentation.”

Genderfluid Pride Flag

gender fluid – adj. : a gender identity best described as a dynamic mix of boy and girl. A person who is gender fluid may always feel like a mix of the two traditional genders, but may feel more man some days, and more woman other days. Ashley Lauren Rogers provides a range of references for writing characters with a different gender identity.

gender identity – noun : the internal perception of an one’s gender, and how they label themselves, based on how much they align or don’t align with what they understand their options for gender to be. Often conflated with biological sex, or sex assigned at birth.

gender neutrois – adj. : see agender.

gender non-conforming – adj. : a gender expression descriptor that indicates a non-traditional gender presentation (masculine woman or feminine man).  2 adj. : a gender identity label that indicates a person who identifies outside of the gender binary. Often abbreviated as “GNC.”

gender normative / gender straight – adj. : someone whose gender presentation, whether by nature or by choice, aligns with society’s gender-based expectations.

Genderqueer Pride Flag

genderqueer – adj. : a gender identity label often used by people who do not identify with the binary of man/woman.  2 adj. : an umbrella term for many gender non-conforming or non-binary identities (e.g., agender, bigender, genderfluid).

gender variant – adj. : someone who either by nature or by choice does not conform to gender-based expectations of society (e.g. transgender, transsexual, intersex, genderqueer, cross-dresser, etc).

Gray Ace Pride Flag

gray asexual – noun : a person who is somewhere between being asexual and sexual. They might only experience sexual attraction on very rare occasions, feel sexual attraction but not desire sexual relationships, or experience a feeling somewhere in between platonic and sexual.

Gynesexual Pride Flag

gynesexual / gynephilic /“guy-nuh-seks-shu-uhl”/ – adj. : being primarily sexually, romantically and/or emotionally attracted to woman, females, and/or femininity.

Rebis, a Medieval alchemical hermaphroditic principle

hermaphrodite – noun : an outdated medical term previously used to refer to someone who was born with some combination of typically-male and typically-female sex characteristics. It’s considered stigmatizing and inaccurate.  See intersex.  (The word comes from the Greek myth of Hermaphroditos, the son of Hermes and Aphrodite.)

heteronormativity – noun : the assumption, in individuals and/or in institutions, that everyone is heterosexual and that heterosexuality is superior to all other sexualities. Heteronormativity also leads us to assume that only masculine men and feminine women are straight. Leads to invisibility and stigmatizing of other sexualities: when learning a woman is married, asking her what her husband’s name is. 

heterosexism – noun : behavior that grants preferential treatment to heterosexual people, reinforces the idea that heterosexuality is somehow better or more “right” than queerness, and/or makes other sexualities invisible.

heterosexual/straight – adj. : experiencing attraction solely (or primarily) to some members of a different gender. 

Original flag design by Gilbert Baker in 1978

homosexual – adj. & noun : a person primarily emotionally, physically, and/or sexually attracted to members of the same sex/gender. This [medical] term is considered stigmatizing (particularly as a noun) due to its history as a category of mental illness, and is discouraged for common use (use gay or lesbian instead).

Intersex Pride Flag

intersex – adj. : term for a combination of chromosomes, gonads, hormones, internal sex organs, and genitals that differs from the two expected patterns of male or female. Formerly known as hermaphrodite (or hermaphroditic), but these terms are now outdated and derogatory.

Lesbian (Labrys) Pride Flag

lesbian – noun & adj. : women who are primarily attracted romantically, erotically, and/or emotionally to other women.

LGBTQ; GSM; DSG – abbr. : shorthand or umbrella terms for all folks who have a non-normative (or queer) gender or sexuality, there are many different initialisms people prefer. LGBTQ is Lesbian Gay Bisexual Transgender and Queer and/or Questioning (sometimes people add A + AT the end in an effort to be more inclusive); GSM is Gender and Sexual Minorities; DSG is Diverse Sexualities and Genders. Other options include the initialism GLBT or LGBT and the acronym QUILTBAG (Queer [or Questioning] Undecided Intersex Lesbian Trans* Bisexual Asexual [or Allied] and Gay [or Genderqueer]).

Lipstick Lesbian Pride Flag

lipstick lesbian – noun : usually refers to a lesbian with a feminine gender expression. Can be used in a positive or a derogatory way. Is sometimes also used to refer to a lesbian who is assumed to be (or passes for) straight.

metrosexual – adj. : a man with a strong aesthetic sense who spends more time, energy, or money on his appearance and grooming than is considered gender normative.

MSM / WSW – abbr. : men who have sex with men or women who have sex with women, to distinguish sexual behaviors from sexual identities: because a man is straight, it doesn’t mean he’s not having sex with men. Often used in the field of HIV/Aids education, prevention, and treatment.

Mx. / “mix” or “schwa” / – noun : an honorific (e.g. Mr., Ms., Mrs., etc.) that is gender neutral.  It is often the option of choice for folks who do not identify within the gender binary: Mx. Smith is a great teacher.

Neutrois Pride Flag

neutrois – noun : an umbrella term for neutral genders (includes agender). Sometimes, it refers to genderlessness, sometimes a neutral combination of male and female.

Novosexual Pride Flag

novosexual – noun : someone who does not know what their sexuality is. This is different from questioning, however, as they know they are a different sexuality (from heterosexual/straight), but that sexuality keeps changing and they can’t pinpoint which one it is.

Pansexual Pride Flag

pansexual – adj. : a person who experiences sexual, romantic, physical, and/or spiritual attraction for members of all gender identities/expressions. Often shortened to “pan.”

passing – adj. & verb : trans* people being accepted as, or able to “pass for,” a member of their self-identified gender identity (regardless of sex assigned at birth) without being identified as trans*2 adj. : an LGB/queer individual who is believed to be or perceived as straight.

PGPs – abbr. : preferred gender pronouns. Often used during introductions, becoming more common as a standard practice. Many suggest removing the “preferred,” because it indicates flexibility and/or the power for the speaker to decide which pronouns to use for someone else.

Polyamory Pride Flag

polyamory  (polyamorous) – noun : refers to the practice of, desire for, or orientation toward having ethical, honest, and consensual non-monogamous relationships (i.e., relationships that may include multiple partners). Often shortened to “poly.”

Polysexual Pride Flag

polysexual – noun : the attraction to multiple genders. Bisexuality and pansexuality are forms of polysexualityPolysexuality generally rejects the idea of a gender binary rather than a spectrum of genders. Polysexuals do not necessarily engage in or support polyamory.

queer – adj. : an umbrella term to describe individuals who don’t identify as straight and/or cisgender.  noun : a slur used to refer to someone who isn’t straight and/or cisgender.  Due to its historical use as a derogatory term, and how it is still used as a slur in many communities, it is not embraced or used by all LGBTQ people. The term “queer” can often be used interchangeably with LGBTQ (e.g., “queer people” instead of “LGBTQ people”).

questioning – verb, adj. : an individual who or time when someone is unsure about or exploring their own sexual orientation or gender identity.

Progress Pride Flag: includes PoC, Trans, Ace, Nonbinary, and HIV/ AIDS awareness

QPOC / QTPOC – abbr. : initialisms that stand for queer people of color and queer and/or trans people of color.

Bawabu, the symbol used for same-gender loving movement in the 1990s

same gender loving (SGL) – adj. : sometimes used by some members of the African-American or Black community to express a non-straight sexual orientation without relying on terms and symbols of European descent.

sexual orientation – noun : the type of sexual, romantic, and emotional/spiritual attraction one has the capacity to feel for some others, generally labeled based on the gender relationship between the person and the people they are attracted to. Often confused with sexual preference.

Linda Ikeji, before and after transitioning

sex reassignment surgery (SRS) – noun : used by some medical professionals to refer to a group of surgical options that alter a person’s biological sex. “Gender confirmation surgery” is considered by many to be a more affirming term. In most cases, one or multiple surgeries are required to achieve legal recognition of gender variance. Some refer to different surgical procedures as “top” surgery and “bottom” surgery to discuss what type of surgery they are having without having to be more explicit.

Skoliosexual Pride Flag

skoliosexual – adj. : being primarily sexually, romantically and/or emotionally attracted to some genderqueer, transgender, transsexual, and/or non-binary people.

spornosexual – adj. : a man concerned with personal appearance, but who places more emphasis on having a fit, toned, virile body than on grooming or fashion. Spornosexuals are said to be on the quest for the ultimate body so they can show if off on social media, preferably shirtless, not to be confused with a metrosexual.

stealth – adj. : a trans person who is not “out” as trans*, and is perceived/known by others as cisgender.

straight ally – noun : a heterosexual and cisgender person who supports equal civil rights, gender equality, LGBT social movements, and challenges homophobia, biphobia and transphobia. Also known as a heterosexual ally.

stud – noun : most commonly used to indicate a Black/African-American and/or Latina masculine lesbian/queer woman. Also known as ‘butch’ or ‘aggressive’.

third gender – noun : for a person who does not identify with either man or woman, but identifies with another gender. This gender category is used by societies that recognize three or more genders, both contemporary and historic, and is also a conceptual term meaning different things to different people who use it, as a way to move beyond the gender binary. Many cultures have a separate word for members of this third gender.

top surgery – noun : this term refers to surgery for the construction of a male-type chest or breast augmentation for a female-type chest.

Transgender Pride Flag

transgender – 1 adj. : a gender description for someone who has transitioned (or is transitioning) from living as one gender to another.  adj. : an umbrella term for anyone whose sex assigned at birth and gender identity do not correspond in the expected way (e.g., someone who was assigned male at birth, but does not identify as a man).

transman; transwoman – noun : an identity label sometimes adopted by female-to-male transgender people or transsexuals to signify that they are men while still affirming their history as assigned female sex at birth (sometimes referred to as transguy) noun : identity label sometimes adopted by male-to-female transsexuals or transgender people to signify that they are women while still affirming their history as assigned male sex at birth.

Transgender people murdered in 2019

transphobia – noun : the fear of, discrimination against, or hatred of trans* people, the trans* community, or gender ambiguity. Transphobia can be seen within the queer community, as well as in general society.

transphobic – adj. : a word used to describe an individual who harbors some elements of this range of negative attitudes, thoughts, intents, towards trans* people.

Chevalier D’Eon, recently confirmed to be a painting of a transvestite

transvestite – noun : a person who dresses as the binary opposite gender expression (“cross-dresses”) for any one of many reasons, including relaxation, fun, and sexual gratification (often called a “cross-dresser,” and should not be confused with transsexual).

two-spirit – noun : is an umbrella term traditionally within Native American communities to recognize individuals who possess qualities or fulfill roles of both genders.

ze / zir / “zee”, “zerr” or “zeer”/ – alternate pronouns that are gender neutral and preferred by some trans* people. They replace “he” and “she” and “his” and “hers” respectively. Alternatively, some people who are not comfortable/do not embrace he/she use the plural pronoun “they/their” as a gender neutral singular pronoun.

Suicide and mental illness rates among LGBTQIA people, especially young people, are more than twice as high as those among the general population.
Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling

How Touching!

Skin is the largest sense organ in the human body—and it is the most developed sensory function in infants. Matthew Hertenstein is a big name in touch research, and he has characterized touch communications in three categories:

  • Universal 
    • Anger, fear, disgust, love, gratitude, and sympathy 
  • Prosocial  
    • Surprise, happiness, and sadness 
  • Self-focused 
    • Embarrassment envy, and pride

Numerous researchers have attempted to define how much information is communicated between humans through touch alone. In a practical sense, touch is seldom communicated without other verbal or nonverbal cues, so Hertenstein developed a series of controlled experiments. Pairs of participants were placed in a very artificial situation: the two sat on opposite sides of a curtain. The encoder would try to express a specific emotion by touching the decoder’s forearm with no visual or verbal cues; the decoder would then select the emotion received.

Bottom line: Human beings are surprisingly successful at this! Romantic partners were more successful than strangers.

  • Romantic partners were accurate:
    • 53% of universal emotions
    • 60% of prosocial emotions
    • 39% of self-focused emotions
  • Strangers were accurate:
    • 39% of universal emotions
    • 56% of prosocial emotions
    • 17% of self-focused emotions

But there is more than one way to group emotions.  Klare Heston (LCSW) discusses ways to convey specific positive emotions in real-life situations. Writers can expand these narrow groupings to fit a wide variety of situations and communication needs.

  • Using Touch to Convey Positive Emotions
    • (Always determine whether it is appropriate to touch the other person.)
    • Offer congratulations and praise with a pat.
    • Show love with hugs and kisses.
    • Flirt with a person.
    • Welcome a person warmly according to cultural norms (rub noses, etc.).
    • Say thank you.
    • Convey sympathy.
  • Expressing other Emotions with Touch
    • Gain a person’s attention.
    • Let a person know you’re in charge.
    • Reveal surprise.
    • Disclose fear.
    • Indicate anger.

Bottom line for writers here: As evident in the previously cited research, any given act—e.g., touching the forearm—can support, emphasize, or outright convey many emotions.

Touch is strongly dependent on culture and context. Do you want your reader to be clear on the meaning of a touch or keep them guessing?

The Impact Of Touching Behavior on Everyday Health focuses on the impact of touching.

  • Touch is absolutely necessary for normal child development, especially the ability of children to handle stress. The touch bond between mother and fetus begins in the womb. Human babies struggle to survive without a sense of touch, even if they retain sight and hearing.
  • Research indicates that for adults, touch can  change the way bodies function, e.g., lower blood pressure and heart rate. Depression and eating disorders have been linked to touch deprivation in adults, and it is more common for men than women because of the stronger social prohibitions against same-sex touch for adult males.

This article cites five areas of touch in typical nonverbal communication:

  • Functional/ Professional
    • Besides doctors and others whose work requires touching, touching in the workplace can have both positive and negative effects. Everyone knows the “power handshake,” that those who are dominant shake harder and longer. Bone crushing is generally considered to be bad. Also, superiors feel freer to touch subordinates than vice versa, whether pats on the back or touches on the forearm. Touching stresses how important a message is and the dominance of the toucher.
  • Social/Polite.
    • Different areas of the body are appropriate to touch in different social situations. Women are freer being touched by a member of the same sex. Men are more comfortable being touched by a female stranger than women are with being touched by a male stranger. Holding a handshakes longer than two seconds will result stop the verbal communication.
  • Friendship/Warmth.
    • Women are more likely to express friendship or warmth through a hug; men shake hands. Within families, women are more likely to touch; but also same sex family members are more likely to touch than opposite sex family members.
  • Love/Intimacy.
    • Men are more likely to make the initial moves on intimate touches. Holding hands or an arm across the shoulder is a territorial marker. Touch is more important to women than to men.
    • Touching between married couples seems to help maintain good health. University of Virginia psychologist Jim Coan found that women under stress were immediately relieved by merely holding their husbands’ hands.
    • Violence in intimate relationships falls into two categories:
      • Intimate terrorism involves a need to control or dominate, escalates over time in terms of frequency and severity. 
      • “Common couple violence” comes in episodes and doesn’t escalate over time.
  • Sexual/Arousal.
    • First touch often involves a neutral body part and seems “accidental.”
      • Hugging. Intention to touch, e.g., extending a hand across a table.
      • Kissing. The final case, love-making, may include kissing, nuzzling, gentle massage, and other foreplay.

Alternatively, wikipedia.org lists seven categories of touch meanings.

  • Positive affect
    • Support, appreciation, inclusion, sexual, affection
  • Playful
    • Can be affection or aggression, tend to lighten the interaction
  • Control
    • Compliance, attention-getting, encouraging a response
  • Ritualistic
    • Mostly greetings and departures, but also includes the chest bumps, etc., shared among athletes (related to wins) and the ritual handshakes at games end
  • Hybrid
    • Greeting/affection; departure/affection
    • Couldn’t the hybrid be negative?
  • Task-related
    • Everything from hairdressers to dance/ yoga instructors to emergency responders
  • Accidental
    • Consist mostly of brushes, but results in better tips for wait staff, fosters cooperation, and even makes people feel better about libraries (!)

the1thing.com points out that the U.S. is a low-touch culture. They go on to suggest five ways people can communicate more effectively by using touch.

  • Accompany praise with a pat on the back
  • Build cooperative relations by starting discussions with touch
  • Make business handshakes more effective by extending it for a beat
  • Give and get massages to strengthen and deepen bonds
  • Consider location when you touch (i.e., private or public)

Depending on situation, touch can be perceived as threatening or creepy, especially if it’s prolonged. To be safe, keep touch brief and keep to the arm, shoulder, hand.

The most important things we reveal through touch are degree of dominance and degree of intimacy.

Bottom line for writers: We often touch with little or no planning, and perceive the communication of touch without conscious thought. Given context, your reader will know the meaning of a touch. And consider that touch is often the fastest means of communication. A touch can communicate stop, fear, affection, etc.

 

SINISTER DEXTERITY

All writers should seriously consider including one or more lefties among their cast of characters – think of the possibilities! Let’s begin with ways being left-handed in and of itself creates obstacles for the leftie.

By definition, a left-handed  person is in the minority: with no overt effort to control handedness, lefties make up only 10% of the population today (9% of females, 11% of males). There is evidence that 500,000 year ago, neanderthals were characterized by this 90/10 split.  Simply living in a right-handed world is a challenge. Consider the number of things that are made to be used right-handed, from scissors to guitars to golf clubs. Yes, special implements are available, but that is just the point—they are “special,” and often more expensive. In some places, and at some times, special accommodations aren’t even available. 

Writers Note:  Any right-handed implement being used by a leftie could make a nice scene, and the way the leftie copes would clearly illuminate the leftie’s character.

Biases Against Lefties

  • “Right” phrases for positive things (such as right answer, right-hand man) vs. “left” phrases for things that are clumsy or bad (e.g., two left feet or a left-handed compliment).
  • Because the left hemisphere of the brain (which controls the right side of the body) is responsible for words, in almost every language the words for the right side of the body are positive and for the left side are negative.
    • In English, the direction “right” also means correct or proper.
    • In languages derived from Latin, left also means unlucky; sinister means evil.
    • In French, gauche means left, awkward, and clumsy; droit(e) means right, straight, as well as law.
  • In Ghana, a person can’t point with a left hand because the left hand is reserved for dirty things.
  • In some Islamic cultures, people are said to step into the mosque with the right foot, into the toilet with the left.
  • Only the right hand can be used for eating in most cultures where eating with bare hands is the norm.
  • Across cultures, words with more letters on the right side of the keyboard are rated more positively than average; words with more left side letters were rated more negatively. Since 1990, names with more right-side letters are wildly more popular.
  • Most religions have a strong bias for the right hand, particularly in Christian cultures:
    • The faithful sit at the Right Hand of God.
    • Black magic and Satanism are often referred to as the Left-Hand Path.
    • “And he shall separate them one from another, as a shepherd divideth his sheep from the goats. And he shall set the sheep on his right, but the goats on his left.” Matthew 25: 32–33
  • When asked to judge two alien creatures side-by-side on the page, right-handers attributed more positive to the one on the right, while lefties were more positive toward the one on the left (attribution of honest, intelligent, attractiveness).
  • Lefties can learn to behave like right-handed people, and some cultures and periods in history have pushed strongly to suppress left-handedness.
Left-handed children were forced to use their non-dominant hand in school well into the 20th Century in the US.

Writer questions: How does your leftie cope with these biases on a daily basis? What if a leftie from a more accepting culture finds him/ herself in a stricter culture, and had to learn to write right-handed, and not hand anything to someone with the left hand?

The Downside of Left-Handedness

  • Mental illness is more common in left-handed people.
    • Lefties have a higher risk of psychosis. Lefties make up 20% or more of people diagnosed.
    • Lefties make up 40% of people diagnosed as schizophrenic.
    • Scientists have also found an increased risk for autism, ADHD, and dyslexia.
    • Lefties are more affected by fear, often showing subtle behaviors like people with PTSD.
    • Lefties are more prone to having negative emotions, such as anger.
    • Lefties seem to have a harder time processing their feelings.
    • Lefties report feeling more inhibited, shy, and embarrassed.
    • For mood disorders, such as depression and bipolar disease, lefties make up 11%, close to their proportion in the general population.
During certain time periods, being left handed was enough to be convicted of witchcraft.
  • Left-handedness is positively correlated with lower-birth-weight and complications.
  • 40% of children with cerebral palsy were left-handed.
  • Lefties are more likely to break bones.
  • Lefties are more likely to have heart disease and to die earlier as a result.
  • For women 
    • Left-handedness is associated with a 62% increased risk for Parkinson’s disease.
    • A higher risk of developing multiple sclerosis.
    • Lefties have a higher risk of breast cancer, especially in post-menopausal women.
  • Paraphiliacs (exhibiting atypical sexual interests, typically involving extreme or dangerous activities) have a higher rate of left-handedness.
  • Greater rates of left-handedness have been documented for pedophiles.
  • Overall lefties salaries are 10% lower on average than right-handers. (Among the college educated, lefties earned 10-15% more than their right-handed colleagues.)

Writers: choose the psychological or health issue your leftie has(to) overcome.

Several members of the British Royal Family are left-handed.

The Upside of Left-Handedness

  • Lefties are more likely to develop some measure of dexterity in their non-dominant hand, most likely a result of years using tools designed for righties.
  • Lefties have a lower rate of arthritis.
  • Lefties have a lower rate of ulcers.
  • Lefties are better at divergent thinking, which generating ideas that explores many possible solutions.
  • Lefties tend to be drawn to careers in the arts, music, sports, and information-technology fields, and are often successful.
  • A slightly larger proportion of lefties are especially gifted in music and math.
Link from Legend of Zelda Is one of the few canonically left-handed video game characters.
  • Lefties have an advantage in hand-to-hand combat, analogous to throwing a curveball.
  • Lefties have an advantage in sports that involve aiming at a target, and are over-represented in baseball, tennis, table tennis, badminton, fencing, cricket, and boxing.
  • Some cultures have historically accepted or even revered left-handed individuals:
    • The Incas positively regarded left-handed individuals as people who possessed special spiritual abilities.
    • In Buddhism, the natural persuasion to use the left hand implied wisdom, according to it’s teachings.
    • In early Russia, “levsha” (left-hander) became a common noun for a skilled craftsman of status.
  • Women who hold their infants in their right arm (presumably to leave their left hand free for fine-motor skills) are less likely to suffer from post-partum depression.

Writers: At last! Ways your leftie might thrive.

Also Related to Handedness—or Not

  • Immune system disorders are not more common for lefties.
  • The research on handedness and homosexuality is not consistent.
  • A childs dominant hand is clear by age 3 or 4.
  • Genetic males with female gender identities were more than twice as likely to be left handed than the control group
  • Lefties drink more
    • But they are no more prone to alcoholism.
  •  How speech is heard:
    • Right-handed people like rapidly-changing sounds like consonants;
    • Lefties hear slowly-changing sounds like syllables or intonation better.
  • People use their non-dominant hand for negative gestures
  • Handedness is a combination of genetics, biology, and environment; although left-handedness does tend to run in families, but a left-handed identical twin’s twin is right-handed about 30% of the time.
  • Overall, people gesture more with their dominant hand, especially when saying something positive.
Castles were built with clockwise spiral staircases to provide an advantage to defenders coming down the stairs.
  • People attack with their dominant hands, defend with the other.
  • Lefties are biased in favor of candidates on the left side of the ballot. (Everyone is biased in favor of people listed near the top of the ballot.)
  • Four of the last seven U.S. presidents were left-handed (Obama, Clinton, George H.W. Bush, and Ford); earlier, Garfield and Truman were lefties, and maybe Reagan was born a leftie but made into a right-hander. Info isn’t available for earlier presidents due to widespread efforts to suppress left-handedness.

Writers: Some of this info might help your hero/ine leftie in a fight, or it could just make for and interesting behavioral quirk.

Left-handed Chinese fencer Li Na again South Korean Shin A-lam

Not addressed in this blog: There is a lot of research on handedness and brain lateralization which I haven’t touched on. I focused instead on observables and emotions that might be useful to writers.

BOTTOM LINE FOR WRITERS: a left-handed character could be a gold mine. Start prospecting!

AND LEFTIES HAVE THEIR OWN DAY: AUGUST 13 IS INTERNATIONAL LEFT-HANDERS DAY.  Since 1992, it is a celebration of sinistrality—i.e., left-handedness! Mark your calendar for 2020.

PAIN IS GOOD

Well… Perhaps not good, but certainly useful for writers!

If you are a writer, you don’t have to be a masochist to appreciate pain. It’s a great tool for plot, tension, and character traits. I won’t bother defining pain. We all know it when we feel it. Instead, I’ll focus on types, implications, and uses.

Three Pain Anomalies 

Any of these can twist the action of your story.

  • Experiencing pain in response to a stimulus that is normally painless (allodynia). It has no protective biological function. 
  • Feeling pain in a part of the body that has been amputated (phantom pain). Actually not so anomalous: it’s experienced by 82%of upper limb and 54% of lower limb amputees.
  • Insensitivity to pain stimuli (asymbolia). Indifference to pain present from birth. These people don’t avoid situations/activities that cause pain and bodily damage. Some die before adulthood, all have a reduced life expectancy.

Temporary (Acute) vs. Long-term (Chronic) 

Sometimes, the effects aren’t all that different.

  • Behavioral deficits caused by being in pain: attention/focus, working memory, mental flexibility, problem solving, and information processing speed
    • Use the deficits to ramp up the tension when your hero/ine is trying to achieve a goal
    • Use success in spite of these deficits to make your character come across as stronger, more resourceful, more reliable
  • Intensified negative emotions of depression, anxiety, fear, and anger, when in pain
    • Use any of these to create tension between characters 
    • Use any of these as challenges for the hero/ine to overcome and remain functional
  • Following an acute pain episode, people reported feeling better than people who hadn’t been in pain. It feels so good when it stops?
Medieval Torture
  • Chronic pain is associated with several long-term negative side effects: 
    • Weight gain or loss associated with medications (steroids, nerve pain drugs, opioids) and decreased exercise and activity
    • Unpredictable mood swings and increases in scores on tests of hysteria, depression, and hypochondriasis 
    • Decrease in patience
    • Grief for the person s/he once was
    • Lifestyle changes:
      • Unable to work or provide for family
      • Need help to function (get dressed, bathe, eat)
      • Loss of prior skill (e.g., can’t play the harp any more)
    • Skin, hair and nails can take a beating: increased sensitivity, intermittent spots on face, hair loss
    • Intimacy often suffers:
      • Sex may be painful
      • Ill person may be less energized in finding what works and adapting
    • Financial hardship adds to stress, which makes things worth; money goes to medications, lotions and potions, treatments, travel to and from appointments

How to Show Pain When the Character Isn’t Telling  

Sometimes, people/characters try to hide their pain. Other times, s/he isn’t able to communicate it. Using these behaviors, you can let the reader or another character know the person is in pain.

  • Facial grimacing
  • Guarding (trying to protect a body part from being bumped or touched)
  • Increase in vocalizations such as sighs or moans
  • Changing routines
  • Decreased range of motion
  • Appearing withdrawn, anxious, depressed, or fearful
  • Decrease in social activities
  • Decreased appetite
  • Increases in confusion or display of aggression or agitation
  • Decline in self-care
  • Side effects from hidden medication
    • Over-the-counter pain medication often causes stomach irritation and nausea; people taking these medications may uncharacteristically refuse alcohol
    • Prescription pain medication, even when taken responsibly, often cause random itching, slowed breathing, constipation, and nausea; drowsiness and confused thinking (agitation, euphoria, etc.) are probably the most noticeable side effects

Why Would Someone Want to Hide Pain?

  • Don’t want to look weak
  • Showing pain is impolite
  • Showing pain is shameful
  • Pain is seen as a deserved punishment
  • Pain was self-inflicted as a maladaptive coping mechanism
  • To avoid treatments against one’s religious beliefs
  • Afraid it means death is near
  • To avoid treatment that might lead to addiction
  • Don’t want to admit needing help
  • To avoid being disqualified from certain careers or activities
  • To shield another character from the knowledge
  • Showing pain would lead to more pain being inflicted

Gender and Pain  

  • Socially and culturally, acknowledging pain is more acceptable for women than for me. Women are expected to be emotional, men stoic.
  • Female pain is often stigmatized, leading to less urgent treatment, longer wait times in emergency rooms, and doubting the accuracy of women’s reports of pain.
  • Statistically, women are more likely to be prescribed sedatives for pain; men are more likely to be prescribed actual painkillers.
  • Study shows men more prone to hypersensitivity when exposed to an environment in which they remembered feeling pain.

Beauty Knows No Pain

Many activities require some amount of pain, if only at the beginning. Lifting weights, running, bicycling, and other workout routines can cause severe soreness and muscle aches the first few times a character exercises. What would make a character get up and do it again? Training to compete in a sport is likely to cause some pain as the human body is pushed beyond its previous limit. How much is too much, enough to make a character quit?

Developing the callouses necessary for manual labor, martial arts, playing stringed instruments, some types of dancing, etc. almost always involves blisters and bleeding along the way. Some activities always involve some level of pain, such as dancing en pointe, Tough Mudder runs, or boxing. What might make a character work past the pain to perform any of these? How might characters convince themselves to repeat the necessary movements, knowing how much they will hurt?

Beauty and fashion often come with pain of their own: tattoos, corsets, high heels, neckties, piercings, trendy clothes too hot or too cold for the environment… Why? Consider the different standards of beauty at different time periods or in various cultures; how much pain would a character be willing to undergo to achieve these standards?

Describing Pain More Vividly 

Here. It hurts right here.

Be precise about location, intensity, whether it’s continuous or intermittent, whether it’s burning, sharp, deep or superficial, diffuse or focused. In a medical environment, patients are often asked whether their pain is new (acute) or ongoing (chronic). There is a difference between shooting pain and stabbing pain; there is a difference between a stomachache and a pressure ache in the upper, right abdomen. Pain in ligaments, tendons, bones, blood vessels, fasciae, and muscles is dull, aching, poorly-localized. For example, sprains and broken bones are felt as deep pains. Minor wounds and burns are superficial. Is this pain burning, tingling, electrical, stabbing, pins-and-needles? Further examples of pain descriptors can be found here or here.

Give That Baby Sugar? 

Fun tidbit: sugar taken by mouth reduces pain in newborns resulting from lancing of the heel, venipuncture, and intramuscular injections. It does not remove pain of circumcision. The reduced pain of injections might last till age 12 months.  Mary Poppins was right: a spoonful of sugar really does help the medicine go down!

Bottom line for writers: pain is incredibly useful in numerous ways.

It’s lucky for us that pain is so easily treated! Even for children!