Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

I am worried. This is not an unusual state for me, as friends and colleagues will agree. Often, my worries can be assuaged by thoughtful preparation or action.  The worries of these days have left me in a state of paralysis.

Every day I speak to dozens of people, professionally or socially or just out in the business of daily life. Everyone has a story for me to hear, and none of it is good.

Many people I know have been fortunate enough. They are not underwater financially. They are not losing their homes. Their college-graduated children may be living at home, but with adjustments in these times, this seems a small price that families are happy to pay.

But everyone is troubled by how close the economic tsunami is to each person’s life. It isn’t six degrees of separation. It is two degrees. Most people have close friends and family members who have lost their jobs, whose incomes have been halved at least, if they are still working. They know people well whose lifestyle has changed in a seeming blink of the eye. The result is a toxic emotional stew of shame,

fear and anxiety. People know that they are closer and closer to that wall of water that could very likely wipe away an entire way of living.

Many have been forced to do things that were incomprehensible to them as recently as 18 months ago. No vacation. No summer place. Moving from an expensive city to a less expensive state nearby and commuting long distances to a job so that the children can attend public schools since there is no money for private school in an expensive urban environment. Selling expensive homes even though it may be for prices less than the mortgage and moving to rentals. These are the fortunate ones. Others lose their homes in foreclosures when they can no longer meet the mortgage payments and survive otherwise.

Image: CalculatedRisk.com

The reality is that six million jobs have already been lost since the beginning of the recession.  Two and half million more jobs are likely to be lost in the next half of 2009. This is the worst drop since 1948 (see right).

For many, a “temporary” job loss begins to feel less so, as the Washington Post noted today:

“A far larger share [of the unemployed] are not going to be able to go back to the same line of work. Such structural shifts in their careers are not that easy to do,” said Andrew Stettner, deputy director of the National Employment Law Project in New York. “They might not have the right skills, and firms might not be willing to take the chance on people who don’t have the exact background.”

Over the past 30 years, long-term unemployment has become more common — largely because more and more of the unemployed are workers who have been laid off, who generally take longer to find jobs than new entrants to the work force. In the 1980s, millions of women were still joining the labor market for the first time, and the labor force was on average younger.

With so many families facing these realities, non-working spouses are looking for work — though they still describe it in a “deer caught in the headlights” kind of way. I hear all the time: “I know I have to get a job to help out, but I need something part-time. I want a job where I can make a difference. I want to work in something culturally relevant.  I want to be able to spend summer time with my children. I want a job part-time in development at the local school, local hospital. I want to be a consultant.”

These were possible options before the economy collapsed. Now these part-time jobs, these rare consulting gigs,  will be grabbed — if they exist at all — by experienced professionals, former full-time employees, now on the market due to the contraction in the economy.

The specter of hope for an imminent economic recovery — say, within the next five years — is still hovering over us like toxic smog. This unrealistic evaluation of our economy is preventing Americans from buckling down and creating a new way of living and saving and spending less. We need to recognize and define the new normal.

This thing is not going away and we must all live in the world of reality, not the world of magical thinking.  Fewer Americans can keep their homes. Fewer Americans can educate their children at expensive colleges. Fewer college and high school graduates will have jobs. More Americans are taking jobs that offer up to 50 percent of what they were making two years ago, if they can get hired at all.

Meanwhile, the national debt to support the bailouts and buyouts and paying for wars in Iraq and Afghanistan is beyond comprehension. I could imagine the face of God as easily as I could understand the number that is our current national debt and the number that is the debt service payment that is due just like a mortgage payment.

I can live in the downsized world of today. But I sure don’t want to lose my country to the countries holding our bonds. If the way out of this economic nightmare is higher taxes for the companies that survive, and for those of us who have jobs, well, let’s face the face the music now before China sends over the repo man. Yes, I am worried.