Berks County Medical Society Medical Record Summer 2020 - 18

Coronavirus Chronicles: Berks Responds

SITUATION & RESPONSE
Stress, Coping, Running and Covid-19
by William Santoro, MD, FASAM, DABAM
Chief, Section of Addiction Medicine
Reading Hospital - Tower Health

A

s I sit at my father's desk in my living
room taking a break from worrying about
Covid-19 I allow myself to think about
my morning run. The times we are living in are
stressful, to say the least, and that was before
Covid-19. Running manages my stress, and just
about everything else in my life. I run when I am
happy, sad, stressed, or grieving. I ran the day my
father died. I ran the morning of his funeral. I ran
the day each of my children was born. I ran the day
before, the day of, and the day after, I got married.
I ran on New Year's Eve 1999 and New Year's Day
2000, and timed the runs so I was at the top of my
favorite hill at both sunset and sunrise. I ran 2,000
miles in 1999 and 2,001 miles in 2000 (the real start of the new
millennium). I once ran to celebrate a new moon, a full moon,
a blue moon and a super-moon. I even ran to celebrate Mercury
in retrograde, and ran backwards for a quarter of a mile. Since I
started running marathons in 1993, I have run the equivalent of
running around the world-more than 25,000 miles.
I think most of us can easily define happiness, sadness and
grief. But exactly what is stress? One dictionary definition states
that stress is a response, as in being a verb. It defines stress as the
emotional response to an adverse, demanding or noxious situation
that is perceived as a threat. Another definition says stress is a noun
as in it is the actual object. This definition states stress is something
that causes a response. But I think of stress as a transaction
between the situation and the response, between the noun and
the verb. Thinking of stress this way, as neither the object nor the
response, neither the noun nor the verb, I allow myself the control
to cope with both the situation and my response to it.
That brings me to the next word, or concept, that I would like
to discuss... coping. How do we cope with stress? I think there are
two parts to coping. First, there is the solution-based coping. If
there is a situation that I need to respond to, I can minimize my
stress by working toward a solution to the situation. Second, there
is the emotion-based coping. If I am responding to a situation and
using mental and physical energy, I will also need to be certain that
when my response is over, I can feel good about the situation. If I
truly want to survive a situation and my response, I need to use the
two coping mechanisms, solution-based and emotion-based coping.
Today, we cannot avoid news about Covid-19. We go online
and people are arguing about it. Turn on the television and there is
24/7 coverage about it. This is neither solution-based nor emotionbased coping. We are solution-basing when we try to flatten the

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curve of the disease. We are solution-basing by
social distancing. But staying in our home with no
outside contacts can make anyone anxious, stressed,
or even crazy. Just seeing another human being from
a distance is comforting, and that is emotional-based
coping.
I am one of the many people considered to
be in an essential field from the beginning of this
crisis. I am a physician. My solution-based coping
mechanism means I go out and care for patients. My
solution-based coping mechanism is no braver than
the grocery worker whose solution-based coping
mechanism is to work in the local store making sure
there is ample food for all of us.
I go to the hospital each day and concentrate on making
progress toward a solution-based outcome. Just helping makes me
feel less stress. But when I come home after a day at the hospital,
or many times when I wake up and before going into the hospital, I
need to activate my emotion-based coping mechanism. Therefore,
I go for a run.
I am not unique in that many people in my generation have
been physically active their entire lives. Many of us have chosen
different activities. Some, like my younger brother, play basketball;
however, this usually involves close physical contact with others.
Others golf. However, depending on where one lives, the MarchApril weather is not usually cooperative. Golfing also requires the
golf course to be open. Some spin and others do yoga at the gym.
The gym is closed; the spin and yoga classes are canceled. Many
of these activities are restricted by being indoors and violate the
social distancing recommendation. But I chose running as my
activity for physical and mental well-being. Running has none of
these restrictions. Running does not require an organized race. All
around the world organized races have been put on hold, delayed or
canceled. The Boston marathon, rescheduled. The New York City
half marathon, canceled. The Tokyo marathon, canceled. The 2020
Olympics, postponed. The only thing required for running is a pair
of running shoes and the guts to use them.
Running has always cleared my mind and relieved me of a lot
of stress as an emotion-based coping mechanism. And whether I
am running on a road or on a trail I will inevitably pass another
runner. Today there seem to be more runners out here than usual.
It feels like the rest of the world has had some kind of epiphany and
taken up my sport. I haven't seen this many runners with me on
the road since I ran the New York City Marathon. It's okay; there
is plenty of room. I can always tell the new runners, they are either



Berks County Medical Society Medical Record Summer 2020

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