This episode I am joined by Dr. Steven Wengel, a psychiatrist with the University of Nebraska Medical Center in Omaha. I wanted to talk to a professional about what they’re seeing with regards to the effects of the pandemic on mental health.

Dr Wengel and I discuss:

• The most detrimental effects from a mental health perspective of this pandemic so far?
• What good things have come out of this pandemic (there are some)
• What demographic is doing better than the rest?
• How to manage your expectations to lessen stress
• What people can do to keep themselves well, mentally and physically
• How important is sleep?

I enjoyed the interview. I hope you do too. One thing to come out of this - Dr. Wengel talked about doing a gratitude journal. I think I’m going to start a weekly column on that, just because we don’t know how long we’re going to be at this, and I get exhausted from all the negatitivity in the world and I’m guessing you do too.

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About the Transcript

Keep in mind that the following is a transcript. I use a service that automates the first draft. As much as “artificial intelligence” is included in the description of every bit of technology these days, it’s clear that computers understanding human speech is more artificial than intelligent. The transcript has been edited to take out human speech bites, you know, um, okay, uh, but it’s not been edited to be an “article”.

Transcription

Jon Johnston: Welcome to Jon’s PostLife Crisis. I am Jon Johnston founder of CornNation.com. Your Nebraska Cornhuskers site of mental health awareness. This episode, we’re talking with Dr. Steven Wengel. Dr. Wengel is a psychiatrist with the University of Nebraska Medical Center in Omaha, Nebraska. We will be talking about the mental health aspect of covid-19. Thank you for joining me, Dr. Wengel, can you get us give us a little bit a bit of background on UNMC, and what you do there?

Dr Steven Wengel: Yes. Well, thanks for the invitation. Incidentally, the chance to talk about this. I’m a geriatric psychiatrist by trade. There’s not very many of us around, but I was trained many years ago to take care of older adults with mental health problems, people over 65 that have depression or anxiety or schizophrenia, that sort of thing, as well as things like dementia, Alzheimer’s disease and other forms of dementia. So that’s my main clinical role. I’ve been doing that for about twenty nine years. But in addition to that, about two years ago, the university asked me to take on a new part time job. I work full time for the university, but I see patients about half time. The other half I do wellness related activities. So they gave me a new title. I’m the assistant vice chancellor for campus wellness for both UNMC and UNO. And so that’s a lot of words. But what does that really mean? My job, I think mainly is to try to help our students, medical students, nursing students, pharmacy students and so forth, as well as our faculty and staff, handle stress better. So I do a lot of talks on resilience and trying to lessen the effects of stress. And I was doing that again for the last couple of years, long before the pandemic. But of course, with the pandemic, guess what? We’re all under a lot of stress. I think it’s affecting everybody in our our country, but around the world, of course, in different ways. And so we’ve had to kind of redesign the work we do a little bit to try to try to help our students and faculty and staff as well as our patients try to cope with this. It’s just, you know, it’s a unique situation. It’s you know, it’s getting to be kind of a kind of trite almost to say it’s unprecedented, but it really is unprecedented. I don’t think any of us have been through something like this before.

Jon Johnston: So we’ve been at this pandemic for months now, by the way, the wellness thing. So you get to basically work with the youngest and the oldest.

Dr Steven Wengel: That’s that’s a good way to put it. Yeah, that’s a great point, right? I get to work with young folks like our students, our medical students, nursing students and all. And in my clinical world, yes, I get to work with people anywhere from sixty five up to one hundred. I actually have patients over one hundred years old. So both ends of the continuum there.

Jon Johnston: Well, I was going to start with, what have you seen have been the most detrimental effects from the mental health perspective of this pandemic so far? Because so far, because we don’t know how long this is going to go on.

Dr Steven Wengel: Right. Right. Yeah, that’s a great point. I think, six months now, at least of the time we’re talking here, it’s really taking its toll. And I think it’s largely having to do with isolation, like social isolation and loneliness, for one thing. Obviously, there are other big impacts for a lot of people. Unfortunately, a lot of people have lost their jobs or have had hours cut back because of the, you know, the hits to the economy, people that work in health care. Certainly my line of work in health care, it’s affected a lot of folks, especially the front line providers that work with covid positive patients and the stress that that brings. But not just them, of course, to teachers. You know, as we as we sit here talking today, the K-12 school system has just opened up in the last few weeks as well as the colleges. So everybody is struggling teachers, parents, students, everybody’s struggling, trying to figure out how to make this work and stay safe. It just takes its toll. I think this constant change, the rules change. Are masks good or are masks bad? Well, now we realize masks are a good thing normally. Obviously, I’m just sitting in my office with the door closed so I don’t have a mask on right now. But normally, I guarantee you as soon as I leave that office door and I go out into the hallway, I’ve got a mask on every minute of every day.

Dr Steven Wengel: I believe in them. But, you know, we didn’t know that a couple of months ago. So the rules change. The state of Nebraska is now opening up again because our our our rates are relatively low. And that’s good because now we can get back to some semblance of normality, but we still have to be really vigilant. So anyway, that constant change, kind of keeping track of the rules, what are the rules today compared to a week ago? It’s hard. We’re adaptable. It’s good in some hands, so stress is an interesting thing. We all need some. Think about weight training, for example. So think about, normally you’d be talking football probably and weight training, in the weight room and all that. You have to stress your muscles to make them bigger. And so stress isn’t all a bad thing. We all need a little bit of stress at least, or else we don’t improve. We don’t get better at what we do. Our muscles don’t grow stronger or whatever. So a little stress is a good thing for you, but too much stress, not such a good thing. You know, it causes a lot of anxiety and and sometimes depression and, you know, it takes its toll in many different ways.

Jon Johnston: So I mentioned that you’re working with the youngest and the oldest. Do you see differences in how age affects people in dealing with the stress and dealing with the anxiety that we’re going through, the uncertainty?

Dr Steven Wengel: Yeah. Again, I think that’s a really important question. I think so. Yeah, I would say so. So older adults, my my clinical population, the folks I see when I’m wearing my doctor hat. If you think about the average 75 or 85 year old, they’ve lived through a lot of stuff to make it to that age. They’ve lived through some tough times and they’ve overcome them. They’ve had losses. They’ve lost loved ones and friends. They have probably battled one or more health scares of their own and people around them. They may have lived through natural disasters and economic problems and so forth, and they’ve lived to tell the tale. And I think when you lived to tell the tale through those things, it does make you stronger and kind of helps you put things in perspective. Whereas, you know, somebody that’s younger, that hasn’t lived through something that stressful, this can seem really, really super overwhelming. So on one hand, I think older adults maybe have a perspective that the rest of us don’t always have. On the other hand, many older adults, not all but but some at least, are more vulnerable to some of the problems here because they are socially isolated, somebody that lives alone, for example, and may be afraid to go out of the house and go shopping and such, whereas a middle aged person might not have that problem or a younger adult might not worry so much about that.

Dr Steven Wengel: Older adults living in long term care settings like nursing homes and assisted living places. On one hand, they’ve got other people around them. But on the other hand, they may be confined to their room. I was I did Zoom visits this morning to a nursing home that I provide care to. I think almost half the patients I saw were talking about the stress of not being able to go outside, not being able to have visits with their family. I mean, they’re doing it through Zoom and their tablets and their smartphones and all that, which is great. But it’s not the same. It’s not the same as being in the same room. And some of them are talking about, gee, I’ve got grandchildren that they haven’t seen yet. They’ve never met because they can’t do it, you know, so it’s it’s a challenge.

Jon Johnston: When this pandemic first started, there was this kind of an attitude that, OK, we’re going to do this lockdown thing for maybe a couple of months and then everything will be fine. And it’s pretty clear now that it’s been a few months and it keeps going on and on and on and on. And it’s going to be going on for a while. We keep hearing that, oh, there’s treatments coming. Oh, there’s a vaccine coming. Those treatments and those vaccines will take a long time before they’re mass produced, and that’s after they’re been okayed to say that humans can have them. If we started this with the idea, this is about expectations, if we would have started this with the idea and everybody would have said to themselves, we’re going to be in this and it’s going to take a while, you think the stress would be different or the attitudes would be different, that people would be, well, less anxious, less anxious, less stressed. Do expectations have it a lot to do with it?

Dr Steven Wengel: Yeah, well, you know, I think I think they do. And, again, thinking about my clinical clinical hat, one of the forms of psychotherapy or talk therapy that we do a lot is called cognitive behavioral therapy. You know, you have people talk back to those negative thoughts that we all have, whether it’s about yourself, like, OK, I failed this thing at work or this thing didn’t go well. So I’m a loser and I’m always going to fail at stuff that would be an idea of a negative thought that you might get stuck in your head, that we can teach you to talk back to. So part of cognitive therapy and in fact, most forms of psychotherapy is setting realistic expectations because, yeah, if your goal is like this [hand raised high], OK, if I’m going to the only way I can possibly be happy is if I make this much money. I have this big of a house. I have this perfect of a relationship, whatever, all these unrealistic things. And your real life is down here [hand placed low], you’re always going to be unhappy because there’s a big gap. So you’re right, you can either try to elevate the reality or you can bring bring the target, you know, the goal down to reality a little closer. I think you bring up a really great point again. And I think setting expectations and making them realistic is really, really smart.

Dr Steven Wengel: And you’re right. This thing, again, I don’t know. I don’t have any insider information, even though I work at a world class medical center and we have amazing people that work in research and and clinical work with infectious disease. And these are like international experts in this. I don’t have any insider information about when when it’s going to be, quote, over and what does being over really mean. What’s it going to look like? What is the new normal going to look like and all that. But I do think it is safe to say, as you’re implying or saying, is that it’s going to go on a while. It has gone on a while. It’s going to keep going on a while. And I think you’re right. We just have to be realistic. If we go into this thinking, OK, just one more month and we’re clear, I think we’ve gotten past that. Hopefully most people have. But if not, I think we need to get past that mindset because it’ll just be dislodged by Thanksgiving or by or by Halloween. Boy, we’re back to normal. That’s that’s going to set us up for disappointment. I think we have to sort of go into this with their eyes wide open and figure out how to how to adapt.

Dr Steven Wengel: Not hoping for things that are unrealistic.

Jon Johnston: So right now, we’ve seen all these shutdowns, we’ve seen people isolated, job loss. I quit drinking in April and I started walking four miles a day, which for me to quit drinking was honestly shocking to everybody around me. I guess I just brought that up. But now there’s there’s going to be long term consequences from this. Do you have any idea of what you think those might be? What I tell people, you know, normally I would like you said, I’d be talking about college football or college volleyball. We speculate all the time, so speculate away.

Dr Steven Wengel: Oh, OK. First of all, like, congratulations on two big things that you’re doing for your health. The drinking and the walking. I mean, the exercise, man, that’s great. One thing I should say, maybe talk about speculating. I mentioned, for example, stress is not all bad. I remind people when I give stress talks and stress management talk, stress is a five letter word, five letter word, not a four letter word. So stress isn’t all bad. Some stress is good. Same way here. The pandemic, boy, I don’t want to sugarcoat things any way and say everything’s great and going to be rosy. It’s a bad thing and it’s caused a lot of problems and it’s going to keep causing some problems. But having said that, some good is coming out of it, just as you have done in your life. I think a lot of people are using this time to kind of reflect a little bit and say, you know, what’s really important to me, reconnecting with family. I think a lot of people are reconnecting with family members and friends maybe they haven’t talked to in a while. I think that’s a positive thing and I hope that continues. I hope that isn’t just one of those things we do for a while and then eventually when the dust does finally settle, we stop doing that.

Dr Steven Wengel: I hope that’s something that endures. What are the other long term costs? So there will be some positive long term consequences, I do believe. In my line of work. Again, in health care, we have switched to resume visits for taking care of our patients, especially in psychiatry. I don’t absolutely have to be in the same room with my patients at the same time. I don’t generally do a lot of physical examines, listen to their heart with a stethoscope and do things that other physicians might have to do. I do mostly talking and observing. I can do that with Zoom and that’s one hundred percent of the way I see patients now is through Zoom and the rules have changed during the pandemic to make it easier for us to do it. They’ve relaxed some of the rules that used to get in the way. I hope that endures too, because I think a lot of patients are finding this to be very convenient. They don’t have to leave their home. They don’t some patients, you know, what about a patient in that’s 300 away in west and central Nebraska that wants to come see me? Come on over. You know, it’s it’s it’s from my point of view, seeing you, whether you’re in Omaha or you’re three hundred miles away, it doesn’t matter to me because it’s all the same way.

Dr Steven Wengel: It used to be they’d have to drive in those was six hours or whatever, and they don’t have to do that anymore. But even if you live here in town, you don’t have to come to a waiting room and be around potentially sick people. We can see you from your own home. That’s something we were not able to do six months ago. The rules would not permit us to do patient care to a patient that was in their own home. So I think that will be a positive thing that endures. Having said that, what are what are some of the negatives? Well, we again, we don’t know, at least I don’t know what the long term economic consequences are going to be, you know? That’s something we’re going to have to figure out. That’s kind of way above my pay grade, but it’s clearly super important, I think health care. I mentioned some of the changes that I think are happening there and I think will probably endure. And I mentioned, again, societally and just kind of socially, I hope we I hope it helps us continue to be reconnected with people.

Dr Steven Wengel: I think as a society, we’ve kind of gotten disconnected from one another before the pandemic, sometime before the pandemic. We’re so busy parents with young kids, they’ve got so many extracurricular activities. Great. Sports are great. I’m not I’m not dissing sports in any way. But sometimes, families before the pandemic, we’re running hither and yon and all night, every night of the week going to different places. And families don’t have time to have dinner together. Well, guess what? Families have time for dinner together now. They don’t have a lot of other things to do. I’m seeing people out on the trail I live near. I’m fortunate enough to live near a hiker biker trail. And I’m seeing a whole lot more people out there than before the pandemic, including families with young kids. What a great thing. Getting outside, getting some exercise together. I hope that endures. There’s going to be clearly some negative consequences that are going to endure.From a mental health point of view, what about depression? What about anxiety? What are the lasting effects? We don’t know. We don’t know. But I think they’re going to be there. But they’re doing positive things, too.

Jon Johnston: You would think that there’d be this, I don’t know, like a break, you know what I mean? There’s always a bell curve. You’d think that those people who have resilience built in or understand resilience are going to become more resilient. But those people who are vulnerable are going to be way more vulnerable. So it’s going to be this, where there was this middle ground. It seems like there’s going to be much more difference between the highs and the lows.

Dr Steven Wengel: Yeah, I think you’re right. I think it does. You know, one thing I’ve been thinking about a lot in the last month or two is the way the pandemic has really exposed problems or put light on problems that were always there, socioeconomic problems. Again, we’re talking a lot about systemic racism these days and things like that. That’s not a new problem. But I think the pandemic is maybe highlighting some existing problems. Certainly if you have stresses from your socioeconomic status, for example, you’re going to be you may have fewer tools in your toolbox to cope with things, people that live alone. I mentioned older adults living alone, for example. No, again, not to say every older person that lives alone is lonely because that’s not necessarily. But a lot of them are. And those folks, you know, people like me, I’m fortunate enough to be married and have a family and all. And so I’m quite fortunate that way. Have sort of a built in social network, but not everybody does. I’m healthy enough. I can get my car and go for a drive if I get bored or something. But a lot of people can’t do that. They don’t have that transportation option or whatever. And so I think you’re right.It does highlight those those discrepancies I guess so. But the other thing is that you’re kind of talking about I think too is what about folks that start out with this that already have severe mental health problems, depression, for example, or schizophrenia or bipolar disorder. It can make those things worse. One thing we worried about early on I certainly did was like the availability of medication. You remember back to the early days of this, we couldn’t get enough hand sanitizer and things like that. People started worrying about, well, what about medication? What if the supply line for medication gets cut off? Thankfully, it hasn’t happened. I mean, for most most part, most commonly used medications are still widely available. But that was kind of a worry early on. If you have schizophrenia and you can get your medication, that sort of thing.

Jon Johnston: Is there a particular demographic that has suffered more or less during this?

Dr Steven Wengel: Those those those studies are being done right now and they’re I don’t know, off the top of my head this specific statistics, other than to say some of the recent work is demonstrating that there are some some differences that, again, when you think about vulnerable populations, people of lower socio economic demographics are at higher risk. I think there it is highlighting some racial differences, too. It’s still being fleshed out. It is going to kind of highlight some of those some of those demographic changes. Thinking about children again and the school system. I can’t remember how many, I think it’s something like 20 million kids in the country depend on school lunches or breakfasts, for their reliable, nutritious meal per day. And if schools are not open, they miss that, for example. So there’s a lot of kind of unintended consequences. So, there’s a lot and I don’t envy school superintendents and governors and others that have to make those decisions. But you open a school or not, and how do you make it work? Because, you know, there’s there’s risks and benefits both directions.

Jon Johnston: So what would you recommend to people to keep there... You said you mentioned at the start of this that you’re in charge of wellness for young people. I can tell you, when I was a 20, wellness meant I go party a lot. And now I can’t do that. So not only just the young people, but people might like me. I work in IT. I work remotely and I work at home almost all the time now. That’s quite a different discrepancy in recommendations on what would you do to keep me mentally well. Can you give us some pointers, please?

Dr Steven Wengel: I think that’s a great a great thing to to talk about. So interestingly, before the pandemic, I used to talk. A lot about what I call the three R’s of wellness, relationships, routines and relaxation, sometimes reflection. I think relaxation reflection kind of go together three or four hours. Interestingly, though, after the pandemic, guess when I still talk about those same three Rs and I think they’re really kind of the keys to this. So I think relationships, again, super important, we are social animals when we are around people that we like or love, we produce brain chemical called oxytocin that you may have heard about that some people call it the love hormone. And the more you’re around people, especially people you like, the more oxytocin you crank out. Physical touch brings that out to even more than just being in the same room. Well, guess what? Right now, we can’t do a lot of those things, so we have to settle for virtual visits. But that’s still better than nothing. One thing I would say to when it comes to communicating that it’s better to do things that are done in real time. So in other words, a video visit or a phone call in real time is better than texting or emailing, because even though we’re not in the same room, this real time communication seems to be healthier than asynchronous communication, which is kind of interesting.

Dr Steven Wengel: I mean it’s still not bad. I still send texts and emails, and I’m sure you do too. Nothing against IT. But I do think a live conversation is always best. So anyway, that’s the relationship, staying connected as best we can and following the rules, but staying connected. So that’s the first R. So routines. You mentioned some of the coping strategies that some people do, not just young people. Sometimes we are partying, sometimes drinking too much, sometimes using illicit drugs. Those are coping mechanisms, in fact, because they do make things make you feel better in the short run. So that is, in fact, a coping strategy. It’s maybe not the best coping strategy, of course, because we all know that, drugs and too much alcohol can can lead to very serious consequences. So those are not coping strategies I recommend, of course.

But what are some good coping strategies? One thing I really focusing a lot on with health care providers and our students is sleep. I think sometimes we undervalue how much of a role sleep or sleep deprivation plays. They’ve done studies with college students that are not anxious, and then they put them in an experimental protocol where they sleep, deprive them for a little while, and then they ask them to rate their mood and they start getting anxious. So not just sleepy, but they actually get anxious if they get sleep deprived. If you’re feeling kind of stressed out, one thing I tell people is try getting an extra half hour hour of sleep maybe.

Dr Steven Wengel: I think sometimes one of the coping strategies we use is, is immersing ourself in media. And again, I do the same. I’m not a Luddite. You know, I’m not saying don’t use IT, but maybe too much of a good thing is not a good thing. So too much web browsing instead of sleeping, too much social media, et cetera, too much news consumption. It’s not like, you watch the news. It’s just it can really stress anybody out. Right. I think of the media right now, it’s like a really powerful medication. If you need that powerful medication and we all do, we need to stay informed. Take your medication, don’t overdose on your medication because too much of a good thing is now a good thing. So anyway, I tell people you might want to throttle back on your your consumption of media, whatever that is, for maybe an extra cut back a half hour and go to get an extra half hour sleep. So start with that. So that’s one of the routines. Exercise you mentioned. I’m a big believer in that. I try to get, half hour to an hour of exercise most nights, if I can, I personally bicycle because, but that’s my thing.

Dr Steven Wengel: But whatever your thing is, it doesn’t matter as long as you get out move. Being out of doors, incidentally, is really good for the brain and the rest of the body. They did a study in Great Britain. They found that if you spent about two hours a week outside, whether you’re moving or even just sitting there on your porch having coffee two hours a week seems to be kind of the sweet spot. And your health and your well being will tend to improve. So there you go. Now, obviously, if you get out and walk at the same time, that’s, what, fifteen minutes a day or something like that. But if you do if you do both, you get exercise while you’re outside. Take advantage of this nice fall weather. You get two for one, you get a double word score as one of my mentors says, like it’s a Scrabble game, a double word score if you do both together. So sleep, exercise, healthy diet. Sometimes one of our coping strategies is maybe overindulging in the comfort food. Again, I’m not here to say don’t have ice cream or don’t have your favorite thing, but you might want to kind of watch that because sometimes we overindulge and I know how that goes. There’s some evidence now that if you kind of push more fruits and vegetables, really try to get five to seven servings a day, you will tend to be somewhat happier.

Dr Steven Wengel: It kind of changes the microbiome in the GI tract, which actually has some brain effects. Maybe we’re thinking. Who knew, who knew? So those are simple things, you know, so routine’s so that’s the second R. The last one is reflection or relaxation. I teach a lot of my students how to meditate. It’s actually not really hard to learn, but you’ve got to practice it. One real simple thing, though, if you don’t want to spend 10 or 20 minutes a day meditating, one real simple thing I tell people to do is to slow down your breathing. If you’re anxious, it actually really makes a difference if you take slow, deep breaths. And what I tell people to do is count to six, not out loud, just inside your head, count to six as you take a breath in, hold it for about a second, count to six on the way out. And that’s hard on the way out, counting to six because we don’t normally breathe that slowly. You do that about four breaths in a rows. So six seconds in, six seconds out, times four breaths. You will tend to feel calmer for a while. It’s simple. You can do it while you’re driving. You can do it in a movie theater if you go to movies, you can do it whenever. It’s pretty simple to do. And it kind of tends to distress your nervous system a little bit.

Jon Johnston: I was going to say that last thing about relaxation and breathing, people might want that so they can get through this election, let alone the pandemic, you know?

Dr Steven Wengel: No kidding. Interesting times for sure. Yeah. One last R, though that I kind of forgot. I mentioned reflexion. What the heck does reflexion mean. Well, that means, sometimes just thinking about what matters to you, what are your goals for life, because, I mean we still have to have goals for the long term, even though your goals for right now might be kind of temporarily postpone, gee, I want to go on a cruise in December. Well, you may not be able to.The short term goal like that, that might have to be postponed, but still a long term goal. I want to get a degree in such and such or I want to ultimately live in this other part of the country, whatever it is, you know, as long term goals are still really important. But so that’s part of reflection. But here’s a simple piece of reflection.

Dr Steven Wengel: Keeping a gratitude journal, a gratitude journal. There’s actually a whole science on gratitude. Normally when you think of gratitude or thankfulness, Thinking ahead. Thanksgiving’s a couple of months away. Thanksgiving can be every day. And it turns out there’s a science. There’s a number of scientists in the study this there’s one in particular in Sacramento, California. It’s done a lot of work on this. And he’s found that if you write down and it really makes you got to write it down, not just think about if you write down three things you’re grateful for once a week, twice a week, something like that, after you do that, while your brain starts changing in some good ways and it helps you start looking for positive things around you, because right now it’s really easy to see the negatives. There’s all kinds of negatives around us, but there’s also a lot of positives. But our brains filter out the positives sometimes when we’re under stress. If you start writing down the positives, it actually changes the way your brain perceives the world. Keeping a gratitude journal, I personally do that. Once a week I write down three things and I try to come up with three new things every week. And it kind of forces me to look at the world a little differently.

Jon Johnston: Do I have to actually write them with a pencil?

Jon Johnston: It matters. It actually does, yeah.

Dr Steven Wengel: So typing might be OK. I like computers do so again, not an anti IT guy, but doing something where you have to take your thoughts and turn them into a physical action. Typing or writing actually is is kind of the secret because it makes your brain process the information differently than if you just think it or say it. There’s something different about the act of writing things down. They found, for example, students that are in class, if you underline things in your notes or in a book, it doesn’t really help you retain information. But if you hand write some notes, like what the professor is saying or you hand write some things that you took out of a book, you remember it a lot better. So there’s something about writing that slows down your brain and makes it process information a little differently.

Jon Johnston: Oh, my God. My writing looks like a 90 year old meth addict dementia patient. I never write anything. I actually here I;ll show you this. This is a voice recorder and I have a microphone I wear when I walk my dog and I do journaling that way and then I transcribe it. Yeah. So that’s how I do it. And I keep track of my life. Then I go back and look at my God, you’re a horrible person. I have one more question, one more question and then I’ll let you go because it sounds like people are after you. You’re a busy guy, but, do you think that the mental health aspects of this pandemic have been largely ignored in favor of reporting on infections, masks and death? The negativity or the I suppose the more sensational parts of the pandemic?

Dr Steven Wengel: I would say they have not been highlighted, maybe it’s the way I would frame and maybe that’s my again, more my way of interpreting it, I think, especially when the pandemic was first hitting our shores and we’re still just trying to understand how is it transmitted and what are the symptoms like and all that and what, how do we keep people alive if they do get it and all that? I think necessarily we had to focus on the biology of the thing and the infectious disease element. I think mental health pieces are clearly super important and that’s what’s particularly important to me. So I don’t know if they’ve been I don’t think they’ve been deliberately overlooked or whatever, but they have not been highlighted for sure, because I think folks were just trying to figure the darn thing out and trying to keep people alive. But now that we’ve now that we’re getting a better handle again, we haven’t we clearly haven’t figured the whole thing out. And how do you how do you prevent it? How do you treat it? We know a lot more than we did six months ago. But I think now we really are starting to see more of the mental health aspects. But the thing about that, too. It’s not that different from other like natural disasters, like a flood. Think about the wildfires in the West Coast, you know, all that sort of thing, or tornadoes. You always worry about survival first. So if a tornado comes through town, let’s survive. Let’s get through that. We’ll worry about the other aftermath later. And so I think that’s kind of where we’re at with this now.

Dr Steven Wengel: We’re starting to become more aware of the mental health aspects as we get at least some kind of handle on the physical aspects of it. I’ve seen that play out before with other situations like this.

Jon Johnston: I’ve brought this up before. I said one more question. I think our problem when we look at medical problems is - we’ve seen episodes of Doctor House and in Doctor House, there’s some person comes to the hospital and they have a malady or whatever the technical term is. And in 45 minutes or 50 minutes, Dr. House solves the issue and finds some amazing illness no one’s ever heard of in their lives. It’s all wrapped up in a bow. They send the patients on and Dr. House himself is a wreck. But that’s part of the show. The packaging and that’s not the only show. When you look at doctor shows, they’re packaged into a segment and we go, oh, you show up, the doctor diagnoses you perfectly and you go on your way. And of course, there’s this implication of happily ever after. And that is that is none of this. Right. That goes back to what I said about expectations. I think it’s a real problem when we look at medical problems and health care.

Dr Steven Wengel: Yeah, right. Because rarely do we wrap things up with a bow so neatly or, you know, I think a situation comedies, you know, we’ve got a 30 minute situation. Comedy comes down to, what? Twenty two minutes of actual content. Inevitably, there’s a there’s some dramatic element or a conflict and but by golly, by twenty two minutes, they’ve solved by that last commercial break. They figured it out right. Or you’re right. A medical mystery like house. Yeah. We get it all wrapped up and we figured it out and you’re right, not realistic. That’s true for anything that I can think of or there’s very few there are a few illnesses that have been figured out and kind of solved, certain infectious diseases that we that pretty much don’t exist anymore. Certain surgical conditions where an operation fixes the thing you never have to worry about again, certainly. But most medical conditions, most psychiatric conditions have some degree of chronicity to them. Certainly this pandemic is the more we learn about it to right, the more we’re hearing that, yeah, most people, thankfully, have mild cases, get better quickly, go on with their lives. Some people not so much, they recover and then they still have fatigue, they still have headaches, they still have whatever. And that’s biology for you. Biology is messy and complicated.

Jon Johnston: All right, we’re going to end there. I hope that I can have you back at some point about what’s going on and maybe we understand outcomes and maybe we can do another wellness talk, because I think everybody could use that.

Dr Steven Wengel: I agree. I’d love to any time. Yeah, that’d be great.

Jon Johnston: All right. Thank you. Thanks to Dr. Wengel for joining me. Thanks to listening to Jon’s PostLife Crisis and Go Big Red.

Dr Steven Wengel: Go Big Red.