On the "anniversary effect."

How're you feeling? No, really?

Our recycling bin is currently feathered with the torn-up shreds of last week’s New York Times magazine, and the reason is that I’m a freelancer. Since I’m self-employed, I have to buy my own health insurance. My plan’s monthly premium is a staggering $435.70. That still doesn’t cover all of the insulin and continuous glucose monitor supplies I need to survive. When I go to get refills, more frequently than not, the pharmacists balk as they ring me up and ask, “Are you sure? You know this one box costs $400, right?” With warmth, but exasperation, I usually say something like, “Well, I’ll die if I don’t take it, so yeah.” In fact, many people with diabetes do die because they can’t afford their meds, which are criminally expensive. To say that insulin “costs an arm and a leg” is not only a metaphorical idiom. 

Anyway, healthcare challenges aside, freelancing is a gift that’s been accessible to me via the privilege of random natural skill and family support and higher education and a whole lot of luck, plus stubborn independence that I have to be careful not to confuse with the rugged individualism ingrained in white supremacy culture. It means I’m always able to work remotely, so the pandemic didn’t change that or render me jobless. In fact, my income was higher for those first few months than it’s ever been before or since, because I took on too many client projects and worked myself to the bone. The great thing about working yourself to the bone is that you don’t have to feel things besides stress and exhaustion, so there was only so much energy I could spend consciously processing my fear of what might happen if I got sick. But I dreamed about COVID a lot. I still dream about COVID. Anxieties about forgotten masks and noncompliant strangers and hospital visits sneak their way into almost every sleep. Here is the actual data: people with Type 1 diabetes, like me, are statistically about three times more likely to die from COVID than those without. The stats are nearly identical for people with Type 2 diabetes, the more common kind (which is, unlike Type 1, reversible, though this also requires privilege and is a subject for another day). Numerous factors have been found to be significantly associated with illness severity; “modifiable factors,” like average blood glucose that can fluctuate in tandem with one’s health habits, have a smaller impact than “static factors,” like race. This, too: a January study found that Black patients with Type 1 diabetes and COVID were four times more likely than white patients to develop ketoacidosis, which is an urgent and life-threatening diabetes complication.

Today, California is beginning to offer COVID vaccine appointments to folks with chronic health conditions. But Type 1 diabetes does not make the cut. Type 2 diabetes does, as long as your A1C (a test that measures a person’s average blood sugar levels over a three-month span) is above a certain number, thus deemed “unhealthy” enough. (An A1C of 7.5 counts, but 7.4 does not. This is the difference of…maybe one slice of toast in that entire three-month span? It’s meaningless, almost arbitrary, in a way that an actual human assessment of a patient’s intersectional risks would not be.) I emailed my endocrinologist — the doctor who costs $435.70 a month to access — to ask if there’s anything she can do or suggest for me, copying and pasting the data I found. She responded in less than 24 hours. She basically said, Nope! Just keep checking the website for updates!

And so — because I can; because I drastically lowered my freelance workload over the course of the pandemic so the stress alone wouldn’t kill me, but not quite enough to qualify for unemployment support; because I ultimately shifted the direction of my freelance projects when lockdown rendered the risks worthwhile for the sake of greater emotional/mental satisfaction, and now I really make my own hours and often find myself alarmingly responsible for my free time — I spent over an hour in the middle of last Tuesday just trying to figure out a vaccination option. And also reading more and more diabetes mortality data. And also thinking about how this country punishes people for taking juuust good enough care of ourselves, or trying to; about how many ways it chooses money over lives; about how more than 500,000 Americans are dead (is it 530,000? 538,000? The exact number doesn’t matter, is meaningless; too many is too many) and we’re just supposed to be grateful. 

I scanned the room for something disposable. Contemplated shattering a glass, but grabbed the New York Times magazine instead. Tore it at the seam and ripped it up, scattering the shreds like anti-confetti across the kitchen floor while I sobbed. And then looked at the mess, sobbing harder, lungs heaving. Bent down and crumpled up the magazine bits. Moved them to the recycling bin, handful by handful. 

The system doesn’t grieve, doesn’t get angry, doesn’t choose right from wrong. We, the humans, must. The embodiment is our responsibility. 

You are meant to feel things right now. As we roll back around to the one-year anniversary of a mass trauma, you are built to feel it. (Numbing, feeling “nothing,” might count as feeling something.) 

I want you to look at the pandemic’s legacy from a social justice perspective, but I have a hunch you’re already doing that. I have a hunch you’ve intellectualized, you’ve contextualized, you’ve tried to see the bigger picture. Right now, I want you to zoom in on your own life, to where it’s tender, where you’re present with its preciousness. I want you to feel what needs to be felt there. I want you to listen to what the loss has to say today.  

But I’m not just trying to be poetic about it this. There’s psychological grounding for heightened emotions right now. It’s called the “anniversary effect”: an array of “unsettling” thoughts and feelings that arise on the anniversary of a significant event or trauma. Sure, the whole internet is reflecting on March 2020, and so it might seem as if we’re simply being prompted and primed; but as Jennifer L. Rolnick, Psy.D. explains here (thanks to @queersextherapy for the link!), the reaction tends to happen on a bodily level before we make the cognitive connection. That’s because the body was first in line to feel the trauma’s impact, and it holds the memory like an imprint. It acts as a safeguard for the soft soul beneath.  

Anger, headaches, stomach aches, trouble sleeping, shifts in appetite, difficulty focusing, exhaustion — these are all common symptoms of the anniversary effect. They fall into three different categories: arousal, which is an edgy, jumpy, hyper-aware state; re-experiencing, which is the re-activation of the same emotional, mental, and physiological responses that were sparked by the original event; and avoidance, which is the refusal to engage with any stimuli that are linked to the trauma. 

The body is clever, isn’t it? Creative. Committed to self-protection. It outwits the conscious brain, sometimes at its own cost. 

I knew that I needed to destroy that magazine. I knew the wild beast of me was begging to break something. I knew that to suppress or subdue would not just endanger my health (yes, really), but would disrespect the truth. I’m not going to tell you that I felt better after, because I didn’t, probably because it was not enough, probably because I could have ripped 12 more magazines or smashed every plate in the cabinet and it still would not have been enough. But at least I felt honest. 

Turns out, I did get my first vaccine dose on Friday, but not because of my diabetes.

The needle hit a vein as it went in, I guess, so blood went dripping down my arm as I winced. “Oh, you’re bleeding,” said the pharmacist who administered the shot, wholly unemotional. She wiped it away, sort of, and then pasted the band-aid to the wound with the agility of someone who has done so hundreds of times. She called “next.”

I stood up, woozy, and looked at the trail of red down my bicep and the bright splotch of crimson that had landed on my pants, and then at the band-aid, also red, with white block lettering: “Flu Fighter.”

I do not want to be a fighter. I don’t want our healing, our protection, to be a fight. I don’t want us to be warriors in combat (against the virus, against each other), to congratulate each other for getting vaccinated as if we’ve…won a battle? I have won something. I won a privilege of continued safety and health that should not have had to be won. I don’t feel celebratory. I feel complicated. I feel angry, still. I feel sad. I am grieving for us, I am grieving for me and for those much less lucky, I am grieving for all we have lost to reach this supposed win.

Because I freelance and I choose my own schedule, I got home from my vaccine appointment and I quit work for the rest of the day. I made a vegetable soup, loaded with ginger and garlic and greens. I went to the backyard and crawled into the hammock. Reclined and held in the woven cocoon, I watched the trees bob in the breeze and listened to the trickles of birdsong, just trying to rest, to take time to embody it all.