I remember the sound of pure joy and laughter when playing peek-a-boo with my daughter. She would look at me with her big blue eyes and giggle loudly. One of the reasons this game is interesting to children is the psychological concept of object permanence. In the abstract, object permanence is the realization that things exist, even when an object or person is out of sight. Over the years, there has been some debate as to when children reach this developmental milestone.
Sadly, children often have separation anxiety, which can be related to this concept of permanence. My daughter still struggles when I leave for work in the morning. The COVID-19 pandemic has exponentially increased her anxiety. When the pandemic started, physicians didn’t know how the pandemic would play out, how long it would last, or if we would need to stay out of the home for a discreet period of time to decrease the risk of infecting our loved ones. I think many children became aware of the changing climate we worked in as physicians.
As a parent, I have spent every non-working moment trying to support my children, reassure them, and make sure they feel safe. I have worked hard to teach them that I will come back every single day. I wanted them to feel that I was permanent to them. I made sure that our family was anchored.
It wasn’t until recently that I realized that all of these psychological milestones are being tested by the pandemic. Our country’s culture, the lifestyles we had, and the people we surround ourselves with have undergone a complete transformation in the last year. The children and adults that are having the hardest time adjusting are those fighting the changing reality. Instead of coping in a healthy way and trying to protect themselves with basic preventative measures, they are misplacing their anger by fighting the health care system and safety precautions.
This all became apparent to me with the sudden passing of my sister’s dog. This dog was, in fact, a part of our family. My children loved Reggie, a 7-year-old Shetland sheepdog. She suddenly developed respiratory distress and was diagnosed with pneumonia. Despite two different antibiotics, her breathing didn’t improve, and she developed heart failure. As a physician, none of this made sense to me. She was healthy, treated like a princess, fed well, exercised, and given the best care. I wondered why they didn’t admit her for IV antibiotics, breathing treatments, or even intubation. Clearly, my mind went immediately to COVID, despite its close to zero percent likelihood of infecting a dog.
When Reggie died, we had to tell my children, who are 7 and 5. My daughter’s face turned to ash, and she fell into my chest sobbing. Just when I thought she fell asleep, she would wake herself up and start crying again. This cry was different than any I have heard from my daughter. This cry wasn’t one born of anger, hurt feelings, or injury. Instead, I heard the distinctive cry of a broken heart. I have recognized the cry and was often when I felt my heart was shattered, and the life I once knew was dissolving.
At this moment, I realized that we need to do a better job of educating our kids. Object permanence in this world is conceptually a myth as we get older. We need to better prepare children for the reality that life isn’t stagnant. They would be better served to understand that we are all interconnected, interdependent, and that life can be fragile. If we taught the people that run around this country with the maladaptive expectation that life won’t change, that in fact, it can and is changing around them, then potentially they wouldn’t take things for granted.
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