“After this is over, we are going to have a lot
of doctors with PTSD.” My friend made this statement toward the end of
one of our video conferences. The group of roughly 20
men that I meet with to discuss faith and life, has been discussing the
coronavirus and how we are managing our lives on this new frontier. About
half of the participants are physicians, many of them on the front lines of
this war against an illusive enemy. We
heard the stories from China and Italy, then New York and California. The
virus has advanced its front line to Chicago.
Some of these physicians are amongst the best people I know, and after a few
very frank conversations, a couple things became very clear. First, they are very scared. And second, this virus will change their lives much more than it will change for
most.
Legitimate and Necessary Fear
They are literally heading to the front lines, sometimes on a daily basis and very frustrated with people who don’t take this virus seriously. They are scared for themselves, and scared of bringing this virus back to their families. If they infected their spouse or parents, they know the reality that could ensue and the tremendous amount of guilt they would have. Many don’t have the choice of working from home. Just like times of war, despite all the technology, we have to have “boots on the ground” to do the necessary work to win this thing, or at least minimize the casualties. Having a healthy amount of fear can be very effective in maximizing our alertness, energy, and attention to detail. All of these are necessary in the trenches. No matter how much faith one has in God, in government, or in the healthcare system, if the coronavirus touches your life, you may lose faith in one of them.
They are literally heading to the front lines, sometimes on a daily basis and very frustrated with people who don’t take this virus seriously. They are scared for themselves, and scared of bringing this virus back to their families. If they infected their spouse or parents, they know the reality that could ensue and the tremendous amount of guilt they would have. Many don’t have the choice of working from home. Just like times of war, despite all the technology, we have to have “boots on the ground” to do the necessary work to win this thing, or at least minimize the casualties. Having a healthy amount of fear can be very effective in maximizing our alertness, energy, and attention to detail. All of these are necessary in the trenches. No matter how much faith one has in God, in government, or in the healthcare system, if the coronavirus touches your life, you may lose faith in one of them.
The Immediate Effects
Exposure to trauma can bring about negative thoughts about
oneself or the world, which could include blaming others or rejection of
previously held values. This is common in post traumatic stress disorder. For all those on the front lines, including all
other healthcare professionals and hospital workers, they and their families
are reflecting on their mortality on a daily basis. This actually isn’t
that much of a surprise, given that many doctors have come out and shared their
stories on the internet from around the world. So, why is being a healthcare
worker in a pandemic so unique?
The Vietnam War And Its Unique Trauma
As my friend said, I do fear that many healthcare professionals will struggle with at least some symptoms of PTSD, if not a formal diagnosis. As I thought about his statement, I remembered a book I read in graduate school. Achilles In Vietnam, by Jonathan Shay was assigned reading when studying PTSD. In the book, the author discusses why Vietnam was so particularly difficult for veterans. Along with the usual trauma of war, Vietnam had some unique characteristics. In his book, he talks about how many Vietnam veterans had the unique experience of feeling betrayed by their government due to insufficient support of military backup and/or supplies. Also, it was a unique war because they often were unsure who the enemy was, and they were fighting in unfamiliar terrain. And when our soldiers returned, they were ridiculed and spit on.
The Parallel Experience of the COVID-19 Healthcare Worker
So far, every one of these scenarios has been parallelled in this war against COVID-19. We heard our president call it a “hoax” and tell people it would “magically disappear.” We have had equipment shortages around the world. Hospitals are fighting an invisible enemy, one that science hasn’t fully grasped. They are having to make difficult decisions, like cancel elective surgeries, and decide who gets the ventilator, only to be critized by patients and their families. They are watching patients die alone, without families, because they are trying to protect the survivors from contracting the virus, only to be chastized by those same people for not calling them to the bedside soon enough. Whether you are losing lives because of poorly built M-16s or insufficient N-95s, the effect on the front lines can be the same; lost lives and feelings of abandonment.
As my friend said, I do fear that many healthcare professionals will struggle with at least some symptoms of PTSD, if not a formal diagnosis. As I thought about his statement, I remembered a book I read in graduate school. Achilles In Vietnam, by Jonathan Shay was assigned reading when studying PTSD. In the book, the author discusses why Vietnam was so particularly difficult for veterans. Along with the usual trauma of war, Vietnam had some unique characteristics. In his book, he talks about how many Vietnam veterans had the unique experience of feeling betrayed by their government due to insufficient support of military backup and/or supplies. Also, it was a unique war because they often were unsure who the enemy was, and they were fighting in unfamiliar terrain. And when our soldiers returned, they were ridiculed and spit on.
The Parallel Experience of the COVID-19 Healthcare Worker
So far, every one of these scenarios has been parallelled in this war against COVID-19. We heard our president call it a “hoax” and tell people it would “magically disappear.” We have had equipment shortages around the world. Hospitals are fighting an invisible enemy, one that science hasn’t fully grasped. They are having to make difficult decisions, like cancel elective surgeries, and decide who gets the ventilator, only to be critized by patients and their families. They are watching patients die alone, without families, because they are trying to protect the survivors from contracting the virus, only to be chastized by those same people for not calling them to the bedside soon enough. Whether you are losing lives because of poorly built M-16s or insufficient N-95s, the effect on the front lines can be the same; lost lives and feelings of abandonment.
The Shift Ends, But the Effects Do Not
Then they drive home only to see and hear stories of people continuing to gather in large groups, ignoring shelter-in-place orders, putting them and their families at further risk. Just like so many stories of war veterans, they go home and isolate themselves from their families, partially out of fear of infecting them, and partially because they need the time to physically and emotionally recover...because tomorrow they will have to do it again. It would be wise for us to remember that the number of times we send them to the front lines will depend on our ability to stay home as much as possible. If you are a spouse or a family member of a healthcare worker, please educate yourself on the symptoms of PTSD, and encourage our heroes to seek help as needed.
Then they drive home only to see and hear stories of people continuing to gather in large groups, ignoring shelter-in-place orders, putting them and their families at further risk. Just like so many stories of war veterans, they go home and isolate themselves from their families, partially out of fear of infecting them, and partially because they need the time to physically and emotionally recover...because tomorrow they will have to do it again. It would be wise for us to remember that the number of times we send them to the front lines will depend on our ability to stay home as much as possible. If you are a spouse or a family member of a healthcare worker, please educate yourself on the symptoms of PTSD, and encourage our heroes to seek help as needed.
Shaken Faith and Doing Our Part
Seeing good people die can shake your
faith. We see this with many soldiers after they go to war. They
see friends and innocent people dying, and it challenges their sense of a
merciful and compassionate God. Sometimes it results in a loss of
faith. However, the loss of God at a
time of pain and healing, can lead to heightened feelings of loneliness and
hopelessness. This time will test your faith, your patience, and your compassion. This has been a lonely time for many. Indeed, many of my
clients are expressing strong feelings of sadness, anxiety and boredom as they work from home, or take online classes. We
are in a new kind of war. I salute
veterans who have fought for our country in past wars, and I salute those who
are on the front lines fighting this war against COVID-19. Just as our
citizens have supported our troops in the factories and natural resources
industries, we need to support our healthcare workers and all who support
them. Stay in your home. Be vigilant
about how you are interacting with people. Tell your friends and family to stay
home. Thank them, and other "essential" workers. Of course, wash your hands
often. And when this is all over, and we no longer need to be socially distant, let's have a parade for them.
