Another Resilience Strategy from the Front Lines.

I interviewed Sarah about a year ago to capture another front-line worker’s resilience story.  An Internal Medicine physician, she is at least a decade removed from her residency training.  Few professions prepare their candidates as rigorously as medicine.  First, there’s all those pre-med classes you have to take in college, followed by that stress-inducing test (the M-CAT).  For the privilege of attending four years of medical school training (peppered throughout with comprehensive exams and supervised, unpaid clinical duties) you will graduate with, on average, $200,000 in student loan debt.  To cap it all off, you must engage in four years of a rigorous physician-in-training program that usually borders on brutality.  What makes a person sign up for this arduous journey, that even after training, requires long hours away from family, friends, and hobbies, as well as a front row seat for little things like illness…dismemberment…death?  

The answer certainly varies from physician to physician, but Sarah provided a substantial hint at her answer.  “When it became clear that I would get to treat patients in this pandemic, I was a little excited,” she said.  “My life had meaning!  This is what I signed up for!”  Her response was cut from the same cloth as her colleague Mark, whom I interviewed for an articlethat SMC re-ran last week.  In his words, it was:  “a call to service.”   Unlike Mark who had a seriously ill wife, and school aged children who could become super-spreaders if infected, Sarah determined that her environment was significantly more low-risk than many of her colleagues.  As a millennial, she had young parents, a young healthy husband, and no children.   Motivated to make a difference, and without fear of infecting fragile relatives, Sarah offered more vulnerable colleagues the chance to give their COVID-ward shifts to her.  They gladly complied.  Compelled by service to patients and colleagues alike, imagine her surprise when a surrealistic experience began to repeat itself time and again.  

For her, the hardest thing about this disease, and working on the COVID unit was “Taking care of people who don’t believe in it!”  When I asked her to elaborate on what she meant by that, she told me the story of a man who had tested positive for COVID.  In fact, he became ill enough to be admitted into the intensive care unit in the COVID ward.  As she was placing him on a ventilator, he said, “I just have the flu.  You’re only calling this COVID so you can get paid extra.”  Remembering themotives that brought her into medicine in the first place…remembering the motives that brought her onto this life-threatening COVID unit…and remembering all the sacrifices she had made in her personal life… to treat this patient…I askedher, “How did that feel?”

“It hurts,” she said.  “It’s totally mind bending and upsetting to be told that this is a hoax, and you are consciously participating in it!”  In a similar vein, Mark described browsing Facebook and discovering a relative accusing physicians (like him) of deviously coding for COVID in order to make more money.  “We don’t get paid more money for treating COVID patients!” Sarah indignantly explained.  In fact, like all of her colleagues, the customary yearly raise, and some other financial benefits were cut due to a COVID-related drop in hospital revenues.  As a psychotherapist, I know that if you want to hurt somebody, take their most treasured value, and turn it against them.  For people like Sarah and Mark, the privilege of caring for sick patients, and their families, is as deep in them as their bones.  To insinuate that they would surrender their ethics for financial or ideological gain is to hit them in the deepest imaginable spot.    

She went on to describe an equally surrealistic scene at a different bedside, ventilating a previously convinced believer, who was now disillusioned.  Eyes wide with fear, the seriously ill patient exclaimed, “Trump lied to us!”  “This is real!”  “I’m very sick.”  “As a physician,”  Sarah explained, “I learned a long time ago to accept that in medicine, there will be good days, and bad days.  What has never happened in my career is for medicine to get politicized!”     

Most disturbing of all was the story of a terminally ill patient whose COVID test had not returned, but who manifested all of the most serious symptoms of COVID.  A call was placed to his out-of-town relatives to accompany him for what were likely to be his last hours on earth.  In route to the hospital, the patient died.  When the family arrived, it was Sarah’s job to break the bad news to them.  The words were scarcely out of her mouthwhen his son took the opportunity to scream into Sarah’s face, “You better not diagnose him with that disease!  That’s not what he died of!  This disease is a hoax!”  The test results came back positive for COVID.  Sarah allowed that families react to bad news in all kinds of sloppy ways.  It was the entrance of politics into the patient-doctor, and doctor-family relationship that caught her off guard.  In listening to Sarah, I couldn’t help but think that politics is to medicine as a bicycle is to a fish:  wrong tool; wrong vehicle.

So what is a lay person to make of Sarah’s experience?  From a resilience perspective, what can we learn from it?  It seems to me that Sarah’s story illustrates an observation that many of my colleagues and I are noticing.  Politics has gotten too big!  From my counselor’s chair, I notice it taking up way too much space in people’s days, and consequently, too much space in their heads, emotions, relationships, and lives.  What I have learned about resilience from my counseling clients was mirrored in Dr.Mark’s resilience strategy relative to our overweight, over-wrought politics.  “I just want to lead by example,” he said, “I don’t respond to that stuff!  I don’t even go on Facebook.  I avoid inflammatory media sources.”  Based upon Dr. Mark’s strategy, can you conduct an audit of your social-media, andother media practices to see if you are tithing too much of your consciousness to politics, and politically oriented conversations?

The other thing I noticed in Sarah’s story was, that regardless of political accusations and insinuations, Sarah deliver competent and compassionate care.  Rather than getting hooked by the peculiar addiction that is inflaming our nation like a psychoactive substance, perhaps it is time to use our spirituality as an anti-inflammatory medicine so that we can treat brothers and sisters of any political leaning with compassion and dignity.  Could you resolve to be a healing presence even for those who disagree with you…even if they insult you?  

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