Long COVID almost derailed cellist Joshua Roman. Instead, it set him on a new track

Joshua Roman was just a toddler in Oklahoma when he started playing cello. By 22, he'd nabbed the top cello seat in the Seattle Symphony, and his solo career took off, with prestigious appearances, great reviews, moved to New York. And then in January of 2021, he caught COVID — and he's never recovered.

Joshua Roman is one of millions living with Long COVID. Symptoms vary a lot from person to person. His have meant letting go of a vigorous career based on the pursuit of perfection at all times. But they have not meant the end of a life in music, and in fact, it's given him new purpose.

His solo album Immunity came out last year. He also has a show by the same name, combining that eclectic set list with personal narration, which he performs in intimate spaces, especially for folks touched by Long COVID. Joshua Roman recently spoke with GPB’s Sarah Zaslaw about his journey and his upcoming appearance the afternoon of Dec. 13 at a gallery in East Atlanta Village.

Interview Highlights

Edited for length and clarity.

Sarah Zaslaw: It’s almost five years to the month since you first got this disease. What tipped them off after that that you had Long COVID?

Joshua Roman: The main thing was that I just didn't get that much better. My COVID itself didn't have the flu-like symptoms — it was mostly the weird symptoms like loss of taste and smell, the incredibly intense fatigue, the brain fog, very strange neurological things. And when I got my sense of taste and smell back, other things just didn't quite come back. I still couldn't go up the stairs. I still couldn't walk very far. I couldn't read. I'm just incredibly lucky because my primary physician happened to know about Long COVID. ... He said this seems like something you should have checked out by this new class of Long COVID experts that was developing in the medical community. And so we went from there, and here we are almost five years later.

Sarah Zaslaw: You stopped playing for three months early on then, when it was just too hard to play. Three months might not sound that long to someone else, but for someone who does that every day their whole life, it's a big deal, right? So what made it seem worthwhile or possible to try to pick it up again?

Joshua Roman: I stopped after a couple of performances that I had. ... I pushed through and I crashed really hard. When I'm talking about a crash, I'm somebody who used to run a mile in under six minutes and then go off and play a concert the same day, and a crash looks like me not being able to open my eyes, not being able to speak, sometimes not even being able to get off the ground or lift my arm to indicate what I might need in that moment. It's incredibly intense and the after-effects can last a couple of days. So I was experiencing a major crash and I'd really just started to doubt whether it was worth it to try to play again because it was so hard to do anything — to wash the dishes, to walk. I couldn't grocery shop. And I thought, well, like, "What's the point anyway? Is music so important to me that I should brute force my way and further harm myself?" ... And eventually I pretty much had decided to leave music.

Then I picked up the cello because I'd promised a friend I would play for her party, and it was actually the cello that brought me back. It was holding it again, feeling the vibrations. The cello is the size of a human and you put it against your chest, you hold it between your knees, you're using both arms. It's— People have described it as like a hug. And when I felt those vibrations again, it was one of the few times in my life that I've been moved to tears just by the feeling of music moving through me with no one else around. And that immediately brought me back.

Whether you are a musician or not, if you focus so much on perfection, and even on developing a skill, being good at what you do, that's a great impulse. But in my case, I think I took it so far that I was trying to disappear myself from the process rather than letting myself be a human in the process. And in that moment, I was reminded that it's important for me to have a place, and that that place is not perfect and that it's very human, and actually that's part of why it's good. So now I'm back, and now I have a new tool as I continue my recovery from perfectionism, as it were.

Sarah Zaslaw: Your appearance in Atlanta is described as “a free concert experience for those living with chronic illness and/or Long COVID, family members, caretakers, and health care providers.” Is the general public discouraged from attending?

Joshua Roman: It's not so much discouraged as that these are specifically geared towards people who share some part of this experience. This program is so deeply personal to me, but that also means that I can go in stronger in one direction or another direction. Like, if I am playing for doctors, as I did a couple of days ago, I really lean hard on the elements of perfectionism and wanting to do well for people in the storytelling, because that's really something doctors feel. When I play for patients, I really lean on what it's like to have these symptoms and the strength that it might give us, despite everything that it takes away from us. So that is the core message of "Immunity" in the context of these performances for Long COVID patients and others with complex chronic illnesses. And we're also going to be livestreaming it, so, you know, everyone can tune in.

Sarah Zaslaw: Is there kind of a support-group vibe in the room? What sort of reaction do you get?

Joshua Roman: Yeah. You know, the conception was a concert performance, and it is. It's been on regular mainstage series. But the very first time I played it for Long COVID patients, it was in Oregon. I was hired by the Oregon Symphony to go play the Elgar Cello Concerto, kind of a normal thing for a cello soloist. And when you do something like that, you also do community outreach. You might do a master class or a school visit. And I said, "Well, I have this program that I want to do in a hospital for Long COVID patients." So they set it up. And when I walked into the room, we had around 80 to 100 Long COVID patients.

And in that moment, looking around, I didn't feel like I needed to play a note. Just being there — this is a new condition. This is something that is largely invisible to people. A lot of people who have it don't even know they have it. A lot of people struggle with this, with the idea of what it is, with managing it. So even just to be in a room with other people who get it, that was already in some ways more than I could ever do sharing my own story and playing music. And then of course, getting to do that and have people share their reactions and their experiences really takes it to another level. But yes, when you have a group of people who share something, especially if it's something that is unrecognized or unseen or maybe just doesn't quite get the attention that it needs from the rest of society and you acknowledge that, it's a very supportive, very warm, very encouraging vibe.

Sarah Zaslaw: In Atlanta, you're connecting with some part of Emory University and with the Black COVID Survivors Alliance.

Joshua Roman: In all of the cities that we're going to, we're trying to identify groups that already are on the ground connecting with these communities. It's not easy to find individuals with Long COVID in large, large quantities. And, you know, Long COVID, the particular symptoms of it, mean that a lot of us don't really go out and go to stuff. There are people that may not be looking for an event to go to; they may just be doing their best to get through each day at home. And we really want to reach — even if it's just letting those people know that it's happening or inviting them to tune into the livestream, if that's something that they can do. And especially if they can come and join us in person, that's something that we can't do on our own, so we engage with local partners.

We're also going to be having a discussion after the performance. Each of these includes a panel discussion. So after I share and we take a break, then we'll have experts in various parts of the COVID experience, from Long COVID doctors to community organizers to someone from a Long COVID collaborative, for example, and even people who are focused on policy and a discussion about the condition, what it is to have it, what's needed, and in my case, why music matters even in this circumstance. So with our local partners, it becomes even more of a rich experience and allows not only cross-pollination of ideas but literally for people to be meeting and learning more about the support and information and body of people who care that is out there in their own community.

Sarah Zaslaw: As you mentioned, research into Long COVID is only about as long as COVID itself, so you must have been following it pretty much since the beginning. What treatments have you tried and what helps you?

Joshua Roman: I tried to follow the research for a while, but as the medical scientific community has gotten more and more into Long COVID, which is fantastic, that also means that there's more and more literature to keep up with. And I just can't. But my basic understanding of it right now is that we still don't actually have the ability to identify the Long COVID itself and to treat directly or attack directly whatever that biological thing is. Rather, we can see and we can identify it because of the conditions it causes to arise and we can treat the symptoms of those conditions. So in my case, that means that I am actively treating the dysautonomia that I have. I have trembling and heart-rate spikes and I take beta blockers, in the morning, otherwise I would spill my water. 

Sarah Zaslaw: That's good for stage fright, too, right?

Joshua Roman: I don't know if they're still working by the time I get on stage, y'know, at like 7 in the evening. 

Ultimately, I would say the things that have been helping me have been those kinds of general purpose, take-care-of-yourself remedies: things like breathwork, getting enough sleep.

None of it is addressing the core issues with Long COVID — and that's something that I would stress I still struggle with very much. But by becoming my own quarterback and care team and making sure that I'm doing everything I can to maximize my well-being, which is very difficult to do — it's very hard, we don't have time to do that — but if I do that, then I get just a little bit more energy and I can do a few more things and feel a little bit more like I have some of my old abilities back. So, sleep, diet. Not exercise, unfortunately, I can't exercise. Beta blockers. I take creatine now. This is new, I still don't understand it, but it seems to give me like 5% more energy throughout the day, so that's nice. And a bunch of other random things like that.

Sarah Zaslaw: It seems you are now able to travel internationally and play longer repertoire again. Playing cello isn't as hard for you as it was, right?

Joshua Roman: Over the last five years, I would say I'm probably around 10% better. But I have learned so many coping and managing skills that I can appear to be a lot better. Even something like this interview, which is very interesting and easy and you're very easy to talk to, but it takes more than it used to. And so I have to rest before and after. I have to treat myself very differently.

And I feel very blessed or lucky ... that I can structure my days and my weeks around the moments when I need to have energy. So you may see me on stage playing a cello concerto, and someone might think, "Wow, he's like totally better" when actually, I've gotten a little better, but mostly I have learned how to manage my energy throughout the day, and to have the resources. Like, I literally travel with people who help me through everything that I do. Things like when I get off the stage, there's somebody waiting to take my cello. It's not always necessary right away, but even just knowing that that is there and that there are people who understand and can help. You know, I build in time to rest. There's always a couch in the dressing room now. It's little things like that that you won't see if you're not backstage, but there's a lot of support helping me be able to do what I do. And I feel that it allows me actually to deliver a more powerful experience, because I am more focused than ever around the moments where I am present with people making music.

Sarah Zaslaw: Joshua Roman offers his program "Immunity" at Atlanta's ABV Gallery Dec. 13 at 1 p.m. How can people find tickets or watch the livestream?

Joshua Roman: The easiest way is to go to joshuaroman.com. I have a schedule there; the links will take you to the Eventbrite where you can sign up to attend in person. Or you can follow the links to my Patreon page. Sign up for a free membership and the livestream will be streamed there.

Sarah Zaslaw: Joshua Roman, it's been so great to talk to you. Thank you very much.

Joshua Roman: Thank you so much.