by Helane Fronek
Physicians were struggling with epidemic levels of burnout – before a pandemic upended our lives and strained our coping mechanisms. Anxiety has risen as we fear our and our loved ones’ health, the future of our practices, our financial foothold, and what challenges the future holds. Then, there is the emotional toll of caring for patients in the Covid-19 era.
As physicians, we routinely encounter demands and challenges that can feel overwhelming. Balancing this stress are the benefits we derive from our work –relieving patients’ suffering, seeing patients improve, and our relationships with patients. These have evaporated as we shuttered practices, limited services, or converted to telehealth encounters. Covid-19 exacerbates our emotional strain as we worry about doing harm by delaying treatment or feel responsible for staff and their wellbeing. If we’re not on the front lines, we feel guilty we aren’t contributing more. Those on the front lines fear bringing the virus home or falling ill themselves. The horror of seeing so many - young and old – die within days, often without the comfort of family at their bedside, is causing significant psychological trauma. Doctors know something is wrong, but there is no time to mourn or acknowledge what has happened: another patient demands attention. This experience dehumanizes medical care and threatens our ability to provide compassionate care and go forward in our lives with a sense of purpose, meaning, and the potential for joy.
It is crucial that we take time daily to feel and acknowledge the emotions arising within and washing over us. Unless we have experienced war or another catastrophic event, we have not seen this level of medical need. Emotions of anger, fear, sadness, helplessness, despair, and anxiety are pervasive. What we refuse to feel comes out in other ways: one manifestation is the rise in domestic violence. And when we turn our backs on the parts of ourselves that are hurting, struggling to find footing amidst chaos and uncertainty, and feeling the loss of humanity in this experience, we perpetuate the trauma. One program director in a New York City hospital encourages residents to bow their heads and request a moment of silence each time a patient dies. This allows us to acknowledge the sacredness and importance of each life and to reconfirm our commitment to humanity, which is at the core of being a physician.
Whether we are sheltering at home, on the front lines, or somewhere in between, we need to prioritize our own wellbeing in this struggle. Exercise and mindfulness activities can relieve anxiety and stress, as can creating a schedule for each day. Spiritual connection through religious beliefs and traditions or connecting with a universal source of a higher power can comfort and strengthen us. And spending time daily welcoming and feeling our emotions should be considered an essential activity. Emotions are the most honest indication of what’s true for us. They come from the precious parts of ourselves that hold our core values, principles, and ethical standards. Feeling our emotions asserts the importance of these beliefs and our commitment to honoring the sacredness of life. It is these ideals that will sustain us and allow us to bring true caring to our patients as we live through this unprecedented time.