O{pen}ion ~ COVID and Writing (with Fountain Pens)
We have all spent the last 2 years worrying about COVID. This is undeniable. We have spent time apart from our loved ones and spent probably just as much time couped up in our own homes. In the Australian setting, we have seen some of the most grueling lockdown rules in the world. Combine this with concerns around vaccination and perceived heavy-handedness of policy. Many of us have certainly been tested to our limits.
For most of the pandemic I have shied away from saying anything publicly, instead focusing on my patients locally and their wellbeing as well as the wellbeing of loved ones around me. There has always been a plethora of speakers out there on all sides of every fence imaginable, so my two pence was hardly needed. I wrote briefly about some of the unintended costs of the pandemic as published by Clinical Labs (one of the many pathology labs in Australia) as I deeply felt this is major issue that was being lost in the discussion.
More recently, however, as the situation seems to be moving glacially towards a zeitgeist of acceptance and “moving on” as a country, I am once again using this time to reflect on some of the good coming out of this pandemic. I wrote about my experience with telehealth in Australia. Good news — as predicted — telehealth is indeed here to stay in Australia. I mean, Duh!
Many of my patients in the initial days of the pandemic also thought this was a great opportunity to do many of the things they had been putting off for a long time. Many wanted to try something new. And for many this was a great adjustment into the etiquettes of WFH (Work From home — in case you’re a pleb like me whose not au fait with the lingo).
Many of my patients lost weight, some going as far as booking their bariatric surgeries. Others quit smoking, whilst others gave up alcohol! These patients are a significant proportion of my patient base given my Addiction Medicine and Emergency background. Many took up a new hobby, and many fathers enjoyed more time at home with family. Despite this good however, for a massive majority of my patients this was a time of great mental health strain and turbulence.
The situation still changes fast, on a weekly or even daily basis. One minute we’re talking about the origin of the virus, next minute we’re talking about infection rates, the next it’s ICU availability and all of a sudden we’re locked down and the country is closed for 2yrs. We’re all without our loved ones, and many of them are left stranded away from home. Funerals are streamed online (something I did 3yrs prior to the pandemic — much to the horror of everyone at the London crematorium back then — oh, how things change), weddings are cancelled, birthdays with no friends, everyone looking like dollar-store Sub Zeros (Mortal Kombat reference) and holidays are now rare. More recently, as my corner of Australia is finally hit, we’re seeing daily changes to the rules, leading yet again to more sickness and stress, lost earnings, parents stranded at home again with no financial support, businesses closing and most importantly once again, I’m seeing the other healthcare needs of people slipping aside. On minute children can go to school, then they can’t, yes they can, but with a RAT; no it’s 14days off, no wait, now for all under 18's its 7days isolation, but they can still leave isolation to go to school if they meet certain criteria… #mindblown.
For me, as an essential worker, I continue to work and continue to change my practice and advice, in line with the changing rules. I continue to see patients in my clinic room and via telehealth. I continue to try and support my family whilst I do my best for my community. I somehow try to keep myself level headed and keep up my self-care — which hasn’t been easy. I had a new baby in 2020 to add to the mix, with professional exams the day she was born and more exams later in the year.
I call 2021 “the year of the vaccine”, for obvious reasons. It has also been the year my own mental health has suffered greatly but also the year I re-discovered fountain pens! Decades of adulting had me forget how much I loved these objects in primary school. I recall fond memories of classroom antics and flicking ink everywhere for no good reason other than pissing off whoever was sitting within my splatter locus! This is where expressive writing comes into the picture.
Up until about mid-October 2021, I had been trying to find every excuse I could to use my new fountain pens everywhere. I started reviewing them, watching videos, making friends in the community and writing frequently. I have five penpals now and write cards and letters to whoever wants one via Reddit (r/randomactsofcards, r/randomactsofhappymail, r/fountainpenpals mostly). I write to most of my friends around the country and globally and will soon send postcards to space! But, I had forgotten about journaling and expressive writing!
I spend all day talking about journaling, diarising and reflective practice/expressive writing (or whatever else you want to call it) with my patients in mental health consults, yet, I had forgotten to use it myself. Not only as a tool for my own mental health stability but yet another excuse for fountain pen use (which is clearly far more important!)
A cursory search online will bring up a plethora of sites discussing the uses of expressive writing in all and every situation in life. I don’t deny this isn’t the case but there is robust data one can also turn to.
Again, even a cursory search shows that those who are more expressive naturally benefit more from expressive writing than those who aren’t. Maybe this is why traditionally “keeping a diary” has been something girls have done more than boys? Work with veterans is showing that expressive writing amongst these (largely) male cohorts is also useful. Mainly for those with “less complex psychosocial issues” where a therapist or psychiatrist may not necessarily be required.
The picture certainly gets more complex with higher acuity psychological issues or as social situations get more complex. Women followed during their post-partum period (up to 6months) were no more likely to use expressive writing than any other intervention for their post partum health and recovery. If you’ve had kids then you can probably understand the obvious reasons why. Expressive writing showed no added benefit to “physical health, anxiety, depression, mood or quality of life at 1 and 6 months” compared to other interventions. Similarly, in females with eating pathologies, although “expressive writers significantly reduced their dietary restraint” this did not translate to BMI improvements. Lastly, in women with breast cancer suffering body-image related pathologies expressive writing was inferior to online psychology courses.
Other studies show that writing positively, stirs positive emotions. Whilst other studies showed that for some, expressive writing can be more attainable, and less fraught with issues (“lack of comfort and connection with others, negative social comparisons, and the potential for receiving bad advice”) when compared with support groups.
Nonetheless, all these studies despite their vast array of limitations and caveats, confounding factors and biases recognise that at the simplest level expressive writing, “is a simple and light touch intervention that has the potential to be widely applied”.
In Mid-October 2021, we managed to escape on a quick getaway interstate. It was the down time I very much needed. Just time to see family, catch up with friends and be with my thoughts in the evenings — no COVID, no work, no stress. This state has a dedicated pen store, so naturally I visited. I bought a Kaweco Brass Sport and the Pilot Iroshizuku Yama-Budo ink. And then it hit me. Start JOURNALING!
I have been doing it ever since. I don’t write every night and that’s not really the style that agrees with me. I use it as an opportunity to document significant events rather than a daily dairy. I’ve spent the last 2 “pandemic yrs” filing away these thoughts and feelings and this was my opportunity to offload that mental load. I’m a methodical, rule driven, evidence based (as it’s been drilled into me) sort of person. I like order and tidiness of thought. So, true to my nature, I decided to start systematically from Jan 2020.
I made a list of all the significant events of the year, roughly in order. I used my camera pics and emails as a guide in case there were things I’d totally forgotten. There were MANY experiences I’d totally forgotten about in 2020, and it was eye-opening to go through all that again. I was surprised by just how much happened that year!
I kept asking myself, “Where on earth did I have the time to do all that?”
I started to write. I picked an Endless notebook, I’d been waiting for a good excuse to use the few I’d panic bought, thinking they were going out of fashion or something. I started writing on holiday in the evenings once everyone was asleep, with my Kaweco and Iroshizuku ink, so that decision was already made for me. And I haven’t looked back since.
Naturally writing brought back a lot of thoughts and feelings — writing this way was naturally a reflective and retrospective process. These were events in the year that I’d gone over many times in my head so I felt like my recollections were still true to the original. Naturally, there would be some recall bias in there, but I found that as the writing session prolonged I delved deeper and more of my original thoughts and feelings spilled onto the page in a very natural way.
I never felt that anything I went through was too traumatic to write down. In fact, the more difficult the scenario, the more useful I felt it was to get it down in the most detailed way possible — but that’s just me. I spent probably something like 40pages just talking about the COVID virus and what we knew at the time and how I felt about it. Other issues such as the effect lockdowns had on us financially, in regards to childcare arrangements and how it disproportionately effected my wife (and many other (working) mothers), I probably spent another 20–30pages discussing. Whereas, things like birthdays, Diwali celebrations and my childrens’ first Rakhi were quicker to jot down. My parents were stranded in India for something like 2months and this was a huge drama ending with my cousin actually ended up in prison! So yeh, another 10–15 pages there! Multiple Exams that year, birth of my daughter and those early days of being a parent to 2 kids, legal drama I was volunteering my time to and other big things — 20pages each! I’m about 150 pages in now and still going.
I’m glad I’ve put as much as I can down as now feel I’ve emptied up space in my brain for other things. I can go back to those entries whenever I want and maybe even pass those journals on to the kids if they every want to learn about how their dad was in his younger years, during mad times!
I change pens and inks all the time when I write. I still write mostly at night, or at work in between patients or in my lunch break/allotted study times. My journal isn’t pretty and doesn’t really look coherent. It’s got all sorts of random ink colours, nibs and nib sizes used in it all over the place, often going back and forth between the same inks. Just using whatever I’m using for that day. I still mostly use my Kaweco Brass Sport for long form writing and am thinking to check out their premium steel nib to make the experience that much more special. I’ve tried to pretty it up with washi tape and stickers for the margins etc, but honestly it just looks shit. I couldn’t care less. It’s the words in it that matter.
In sum, I’d highly recommend journaling in these COVID days. Despite the mixed evidence, it’s a light enough, low risk activity that anyone can try. If, like a friend of ours, you try it and don’t really like it, you haven’t lost anything. It has helped me greatly. It’s making me a better doctor. I’m focusing on my self-care more and regularly offloading the burden of mental loads I pick up along the way — positive or negative.
And best of all it’s the perfect mash-up of both my passions!
Thanks so much for reading and remember no matter who you are, “first, do no harm.”
