“Thanks to all of the healthcare heroes on the frontlines who continue to risk their lives daily during this coronavirus pandemic!”
— Hospital administration
Give me a break.
No, seriously, I could use a vacation. Being essential amidst the chaos of the COVID-19 pandemic has been exhausting, rewarding, and disheartening all at the same time.
I am a New York-based resident ob/gyn physician. Ob/gyn is already a specialty known to have a high burnout rate, and even more so among women. Unfortunately, the needs of healthcare workers have been overlooked during the health crisis. The rates of physician burnout during COVID-19 have increased in prevalence compared to non-COVID-19 times.
While the situation in New York City and other parts of the country has improved significantly, the stress has not fully subsided. Could it be the lingering concerns over PPE shortfalls, the act of treating patients who are likely to die, the unhealthy levels of pressure at work, the 80-hour work weeks, the enduring anxiety that we may still somehow bring the disease home to our loved ones, or all the above?
I began my residency training with hopes of impacting the communities I serve by helping to bring new lives into the world and sharpening my surgical skills. If you had told me I would one day be part of an internal medicine team on a step-down unit (for patients that were recently transferred out of the ICU) managing a brain-dead patient on a ventilator being kept “alive” only by drips infusing her cold body until her family pulled the plug, I would not believe you. This was day one for me on the COVID-19 floors.
There, I met Ms. N: a kindhearted, elderly patient who loved talking about her daughter, nursing career, and all the foods she would love to eat again. As I struggled to make out the muffled words that came out from underneath her oxygen mask, the monitors would beep incessantly as her body’s oxygen levels dropped from 100% to 70%. She was suffering from COVID-19 pneumonia and needed assistance breathing. She was very sick and even more alone. After endless conference calls and communications through the patient relations hotline, I became the bridge between the patient and the patient’s rightfully concerned loved ones. I went home after an hour-long family conference call one day informing them that we were beginning to see improvements, only to come back the following day to learn that she had passed overnight. Each day was a fight, and I witnessed far too many people lose the battle and succumb to the infection.
Due to the overwhelming influx of COVID-19 patients and scarcity of physicians early on in the pandemic in New York, my hospital recommended that physicians who tested positive for COVID-19 were to present to work wearing an N-95 mask if they only had mild symptoms and no fever. As physicians, we have been mandated to consistently and silently go above and beyond our regularly scheduled duties to meet the needs of a poorly managed pandemic. Giveaways, banners displayed in our honor, and free government-funded lunch do not remedy the fact that we are being overworked and do not feel well supported. We are expected to thrive in situations for which we were never trained, with resources to leave one wanting.
We need to change many of our expectations for physicians working on the front lines, not only during the pandemic, but for the long-term. Physician burnout can be reduced by encouraging support from family, friends, and colleagues; mobile health tools for mental health support; better work hours; a more resourceful work environment; structured training on large-scale disaster management and response; access to PPE; and decreased workload. The suicide of Lorna Breen, MD, was a shock to many, but her death and the death of other physicians during this pandemic should not be in vain.
We need to move past the idealized image of a physician existing only to help other people. I am not unbreakable. I am not your hero. I am human. I am your friend, your neighbor, and the stranger you pass on the street every day. When was the last time you asked your doctor or colleague, “Are you okay?” We can only move forward if we move together.
Blessing Aroh, MD, MSc, is a resident physician in ob/gyn at SUNY Downstate Medical Center.