Many people do not realize the stress that health care workers live under every day and, in many ways, it’s our own fault. It is not in the nature of people who work in health care to call attention to the stress we experience. While many of us living closest to the risks of healthcare are beginning to speak about the worry and exhaustion we are experiencing, we are not expressing our greatest fears.
We get up every day and head into our jobs where life and death are always in the balance. Even in the professions who see the least sickness and death, there is always a risk that one or other will come to pass. We do everything we can to prevent the worst from happening but sometimes illness is just too strong.
Someone you thought was recovering will spike a fever suddenly. The tumour that had disappeared returns, after years of quietly lulling its host into a hopeful, recovered life. The boy who was so happy to have finished high school last week is found dead of an overdose two weeks later.
These situations recur, again and again, because that is the nature of illness. Even when the natural history shouldn’t surprise us, it does.
The wisest thing I learned as a Resident in Psychiatry was this one truth from my inpatient supervisor after a young man died by suicide:
“If there are no suicides in your practice, you are not really looking after anyone who is truly unwell.”
Everyone in healthcare must remember this, remember and honour the disease, still unpredictable for all we have learned and however much our knowledge has increased. Disease still has the power to take life and injure and our most important work is to provide care and comfort.
Most doctors of my generation and of those generations younger than mine have never faced a disease quite like COVID-19. Most of us are working harder through the pandemic than we have ever worked. We are capable of learning a lot of information fast and thoroughly. We know how to use that information efficiently and creatively to save lives and heal. Still, the intricacies of this new illness are baffling.
We work even harder and still the answers do not come. If politicians and those organizing the public response provide advice or guidance that does not follow science, we become even more distressed. We must express our concerns. If we do not so this, we feel ourselves to be negligent.
This is discouraging and, every day, I can see that my friends and colleagues are so exhausted and overwhelmed that they feel they must let people know. They must let patients and families and governments know that, unless there is action taken to reduce the spread of this disease, doctors and health care workers will succumb – to the illness, to the exhaustion, to the depression.
We are balancing on an illness tightrope, and we are working without a net.
(Note: This is Edvard Munch’s The Scream. Someone I know has said that this captures the terror he is feeling.)