Front-line doctors are struggling with trauma
We feel powerless, disposable, unheard
Last week, I woke up to the news from a physician friend that her colleague had killed himself. After hearing about a physician’s suicide, another doctor texted me saying she is having “suicidal thoughts at times.”
As an internal medicine doctor in San Jose, California, and a member of my hospital’s COVID-19 team, I too have felt helpless. And I’m increasingly worried about the scale of emotional trauma faced by our health care workers.
As I considered writing this column, I put out a call to action on social media, asking health care professionals all over the country to share what they are facing. Our traumas are overwhelmingly similar:
“I am an emergency medicine physician in a mini epicenter in Southwest Georgia,” said Dr. Nilam Vaughan in response to my call on Facebook. “We have had 11 deaths and our ICU is full. We have run out of (ventilators). I have intubated multiple COVID-19 positive patients and have positive exposures. And I haven’t seen my three kids in three weeks . ... I don’t sleep anymore because I’m constantly trying to make sense of all of this.”
We are “having panic attacks," said Janice Tham, an ICU nurse practitioner in San Diego. People are talking about “making sure living wills and advanced directives are updated.”
Their words bleed their pain.
Lacking protective equipment
Every day I talk to colleagues who are struggling with the painful deaths of patients and health care workers. They work while fearing infection from this highly contagious and fatal disease. They lack protective equipment.
As a result, they have trouble focusing. They have a hard time sleeping. When they do sleep, they wake up in the middle of the night with an impending sense of doom and helplessness as though their own deaths are imminent. I can’t let another friend die. Mental stresses such as exhaustion and burnout drive more than 400 doctors to kill themselves every year.
A survey of 1,257 health care workers who treated coronavirus patients in China revealed high rates of mental health trauma — more than half reported symptoms of depression, 44.6% reported anxiety, 34% insomnia and 71.5% distress.
It is unrealistic to think medical professionals can put aside stress as we witness this horrifying disease and its deaths on a daily basis. It’s easy for patients to see doctors on the front lines as impersonal figures — just workers wearing white coats, scrubs and masks (if they are lucky) whose duty is to take the burdens and stresses of intensive care trauma. But behind those masks are living, breathing human beings with the same coronavirus fears as everyone else.
The difference is they can’t show or acknowledge it. Those fears don’t disappear; instead, they fester.
I was familiar with trauma and feelings of paralysis and helplessness long before I became a doctor.
As a child in New Delhi, I witnessed a violent religious riot after the assassination of a prime minister.
Later in life, I survived a stroke, went through a painful divorce and suffered a miscarriage alone.
None of that has shaken me as much as America’s misguided response to coronavirus that is burdening ICUs across the country. None of those things have hurt me as deeply as the resulting trauma for health care workers who are trying to cope with fallout beyond their control.
Hear my scream
I recently lost my grandmother. This month, I also lost a family member to COVID-19 who was in his 40s. He left behind his wife and young kids. I had to schedule my grief after two days of work, because in an unprecedented crisis like this, where is the time to mourn?
There is nothing familiar about what we are enduring right now.
It is exhaustive to be strong. The collective soul of front-line health care workers is slowly and silently decaying with no rescue in sight. We need help carrying this massive weight because we are weary. We feel powerless, disposable, unheard and highly at risk.
In this column, I am screaming, and I am helping my colleagues to do so as well.