A couple of weeks ago there was a story in the New York Times entitled ”I couldn’t’ do anything” about a brilliant, compassionate and competent emergency room physician, Dr. Lorna Breen, who was treating patients with COVID-19 when she herself got infected. Her infection was severe, but eventually she recovered.
After recovering from the infection, she went back to treating patients with the coronavirus infection. The stress was overwhelming. She could not cope and finally she committed suicide. Another physician in France took his own life after discovering he was infected. Many healthcare workers took their own lives in many countries across the globe. Many physicians and other healthcare workers have succumbed to the disease. But the mental toll on others who did not get infected is unbearable.
Many people don’t imagine how the attachment to your patients affect your personal and professional life. They always teach you in medical schools to remain detached from your patients in order to maintain your objectivity and also prevent the frustration, the anger, the regret and the sense of helplessness that you will feel when one of your patients does not do well.
Many assume that the work of a physician or a healthcare worker is just like other jobs: You go to work, write some prescriptions, joke with the staff and go home. All of us wish this were true. You can’t avoid being attached to your patients and their journey from illness to recovery or lack thereof. Patients are not cars or machines being fixed. They are human beings. And you can’t just completely detach yourself from their anxiety, their pain, their fears, or their apprehension. They affect you. You build a bond with your patients; a bond of trust and mutual respect. This is the magical part of practicing medicine. It can also be the curse; because that bond that you establish with your patients is the same bond that devastates you when something bad happens to them.
I have not treated any patients with COVID-19. But I can imagine the heavy burden and the exhausting stress endured by those physicians and healthcare workers who take care of those patients. Some patients may succumb to their disease in front of your eyes and you can’t do anything. You feel helpless. All the medical knowledge, all the available medications and all that huge advancement in medicine can’t save them.
Most of those patients do not have their families with them. You may be the only human being that those patients cling to as they pass. The only connection to humanity. The only caring individual that may hold their hands and squeeze them to let them know that they are not alone and that you are there for them and you are not going to leave them. You cry with them. You encourage them and make them feel worthy of human emotions and human touch.
And in the middle of this emotional storm, you also have to worry about the possibility of being infected from the very patient that you are taking care of. You try to hide your tears, you hide your feelings. Many go to the bathrooms to cry and the majority cry on their way home or after they get home. This is not a job; it is a calling. When everyone is afraid of being infected, you go and help your patients knowing that you could be next. It is not dissimilar to firefighters who rush to the fire when everyone is running away from it.
When this cycle is repeated over and over, there is no time to grieve. No time to even cry. You have to wipe your tears, put an artificial smile on your face and go to the next patient trying to appear positive to give them hope and let them know that you will fight with them. After a while the burden becomes intolerable, the pain unrelieved and the sadness unconsoled.
The suicide rate among physicians is more than double the general population because of that stress that mounts on your soul layer by layer till the dust suffocates you. And rather than counseling patients you find yourself in need counseling.
Almost every physician I know has spent many nights awake unable to sleep because one of their patients was not doing very well. Actually, that happened to me a couple of weeks ago. I was concerned about one of my patients. I thought they might develop a complication. The night was long, heavy and tedious. Sleep was not to be found. You drift into a twilight full of nightmares. When that patient did well with no complications I was on the verge of tears. So, just the anxiety about one patient made my life miserable, so imagine those health workers who have to go back to attend to their patients, repeating the cycle of agony, fear, frustration and a great deal of deep, unrelenting sadness.
We say that those health workers are heroes. But do we really mean that? After the pandemic goes away, and it will, will we revert back to talking about waiting time in the emergency rooms and the uncaring doctors and nurses? Will we forget the hell that they went through without complaining? This was their calling and it was their oath to help, heal, support and soothe their patients.
Please when you see one of those heroes, tell them how much you and our country appreciate their heroic services and selfless devotion to their noble profession. And please thank them for being our unsung heroes.