Dr. Schmidt’s office manager called me. She said that Dr. Schmidt wished to refer a client. We spoke for about 15-minutes. She was “greatly concerned about an older gentleman.

The patient we will call Baxter for privacy purposes. Baxter was experiencing depression and anxiety. Additionally, Baxter was troubled by a case of psoriasis. I consented to take the referral. Due to COVID-19, Baxter was confined to his home. He had the company of two cats. I suggested their office staff person initiate a call to Baxter. Several hours later, he thanked me for taking his case. Because COVID was a concern, we agreed to conduct weekly sessions by telephone. Fatigue entered into the plan. Baxter could only tolerate 45-minutes. We agreed to an affordable fee and a regular time slot as a constant.

“I like some consistencies in my life.”

Several days later, we conducted our first telephone session. How are you, Baxter?

“Lousy. I’m in pain from my damn psoriasis. It’s spreading and it affects me the whole day. I can hardly sleep. I sit and watch TV all day.”

Baxter, do you have family living with you?

“No. My wife died three years ago. I have three grown children who I rarely see. COVID has kept us apart.”

Do you communicate with them?

“Yes, but not as often as I’d like. One, my daughter, lives an hour away. She’s married and has two children. Like I said, COVID kept us away. My son, he lives about 3-4 hours away. He’s with his partner. They call me once in a while. They have a small business that got shut down during covid. I think money is a problem for them. My other son is in the Navy. He’s on a ship. Not much communication from him. I heard they had a COVID outbreak on the ship. I’ve been worried sick about him; no word yet about him.”

Do you have any brothers or sisters, Baxter?

“I have three sisters. They all live out west. I haven’t seen any of them for two years. We used to have reunions but not for the last two years. I miss them all. Thank God I have my two tomcats. They like to fetch and sit on my lap. The last few months, however, I think they’re upset with me. You see, my psoriasis is getting worse. Clothes feel awful on me. I try wearing few clothes. I’ve not gone out during the cold months. I’ve ordered food online. But, I’m not hungry. I think I’ve lost weight.”

Baxter, you have a lot of discomfort from the psoriasis. Do you have a medical practitioner on this problem?

“I do. I’ve taken all different medications. Nothing seems to work. I seem to be angry a lot. I have to confess that my two cats are scared of me. They both hide when I get mad. I haven’t been able to go out and get vaccinated. Maybe if someone could do a house call, I’d get it. So you see, I’m scared of getting COVID on top of my psoriasis. I barely can read. I can hardly concentrate. I sleep awful. Maybe that’s why my PCP suggested I see a counselor. My psoriasis affects me.”

Do you have any neighbors who you’ve befriended?

Yes and no. When my wife was alive, she had lots of neighborhood friends. We had cookouts, holiday celebrations, and she even constituted block parties. After she passed, friends came by fairly regularly. When I look back, one of those weird things began to happen.”

Like what, Baxter? What weird things happened?

“Well, I’m not sure how to even explain it but I’ll try. You see, Monica, my wife, was friends with other women. Through those women, we met their husbands. After Monica died, some of the neighborhood women came by with food, drinks, and a kind word. Sometimes their husbands came with them. As time went on, the women dropped in to check on me. The husbands seemed to shy away. Two women continued to show compassion months later. Then one stopped coming, although she’d call to check up on me. The other woman, Betsy, came by for, as I think back, a final visit. She said something to me that caught me off guard.”

A brief silence follows from Baxter.

Baxter…Baxter? What are you feeling right now?

“I’m sorry. Now, you got me to recall the memory. I remember that she brought some food. She used to be warm and friendly. She considered herself my wife’s closest friend in the neighborhood. She couldn’t talk. Wow, I remember that. She usually held my hands. I remember her as a compassionate woman. She cried and apologized. She confided to me that her husband, Paul, was feeling jealous and getting weird. He accused her of getting too close to me. This would be her last visit. She might occasionally call me but not come by. I think her words struck a blow to my heart. To finally answer your question, since that time no one calls and no one comes by. It’s like I have a communicable disease and everyone’s afraid to catch it.”

I hear you, Baxter.

There’s a touch of irony in what you just said. Presently COVID-19 has, as you described, kept you quarantined. You haven’t gotten ill, thankfully, from COVID-19. Mourning the passing of your wife and its after-effects clearly isn’t a communicable disease. I feel sad for you. Your wife passed and in the aftermath, the lights went out, so to speak, when the neighbors stopped visiting.

While in all due respect, no one else died but this experience is like a loss; a grief experience. When a spouse passes, supportive family and friends outpouring of love and compassion can be uplifting. So in the present time you live with two cats. You have been physically separated from family and neighbors.

To what extent, Baxter, have you been affected?

“A lot man. I don’t complain but I’m lonely. I know I’ve got to get the vaccine to feel safe from COVID-19. Maybe then I can go out but my psoriasis is keeping me from going out. I’m embarrassed by how I look. I don’t need that grief, too. Get what I mean?”

Clearly, Baxter. Perhaps with your verbal consent, I can talk with your PCP. Maybe, too, there are ideas I have about getting community assistance for you. Can we talk again in a few days? It will give me time to consult with your PCP and also get some ideas from others to work with me. Ok?

“O.k.” Call me if you need to talk before the next session.

Let there be peace on earth and let it begin with me.