Doctors and nurses are not OK right now. The term “compassion fatigue” is frequently used to describe our emotions, but what we're feeling is worse.
Compassion fatigue was what we experienced in the good old days before the pandemic, when going to work didn't involve potentially infecting ourselves and our families with COVID-19. Now our reality is that people are refusing to get vaccinated and turning a blind eye to the harmful consequences of their choices for us on the front lines. It's beyond upsetting.
Many people in my hometown of Richmond don't realize that our city is on code black, meaning nearly every hospital is full and turning away ambulances. As unvaccinated people fill up our ICU beds, deplete hospital resources, and put health care workers at risk, it becomes more and more distressing for doctors and nurses. It's gotten so bad that a few weeks ago I got into my car after the end of my shift and burst into tears. I haven't done that in at least five years. (I actually wrote about it: EMN. 2016;38:1; https://bit.ly/3kpAYuK.)
That prior episode was due to a shift that was unusually brutal. Now brutal shifts are commonplace, happening nearly every time we go in. Knowing that our physical, mental, and emotional trauma is entirely preventable at this point triggers fierce and resentful emotions that make compassion fatigue look like child's play.
We Have PTSD
The only way a lot of us know how to keep going is to compartmentalize ferocious feelings, burying them deep down to fester. We so desperately need normalcy to recharge that we don't talk about work when we are with family and friends. We make an intentional effort to keep our thoughts away from work. We throw ourselves into nonmedical diversions.
I've signed up for more volunteering hours with my sons' football program, a creative writing class, and a marathon in the past few weeks, all in an attempt to stay moving and distracted.
Doing and discussing other things allows me to temporarily forget about the devastating reality staring me in the face every time I set foot in the ED. For better or for worse, distractions allow me to repress the anger, sadness, fear, and whatever other emotions I still haven't processed. Besides, nobody wants to hear physicians complain.
Despite being just as human as everyone else, we are held to a higher standard, even outside of work. We bottle our feelings to get through each day without appearing unprofessional. We bottle them to continue showing care and concern every day for our fellow humans. We bottle feelings just to survive, but that doesn't mean we're OK. We're all going to have PTSD.
Get the Vaccine
I know I have an unhealthy amount of pent-up anger. I feel angry that we all lost so much before the vaccine in the name of controlling COVID-19—trips, sport seasons, graduations, weddings, and even jobs or businesses for some. Now that we have a vaccine to achieve the kind of control for which we all sacrificed in 2020, it's hard to convince people to get it. I feel angry that people who wouldn't know a randomized double-blind placebo-controlled study if it bit them on the nose are able to use the media to sway health care choices formerly decided between doctor and patient.
I feel angry that hospitals have no room to care for myocardial infarctions, surgical emergencies, and diabetic complications because our beds are taken by those who are too misinformed to get the vaccine. As young unvaccinated COVID patients are dying, it angers me when people pretend COVID doesn't exist.
I feel angry that it's taken for granted that we'll be there to take care of people, exposing ourselves to COVID and potentially foregoing our own health. I feel angry when people with fevers and COVID symptoms take off their masks and cough while nurses and doctors are in the room with them, as if our health were of no importance. I feel angry that I gave up my 20s, spent nights in the library while my friends were partying, was less of a mom than I wanted to be, and missed family holidays ultimately to feel devalued not only by the business of medicine but also by the very people for whom we care.
I feel angry that the front line is becoming more and more exhausted while much of the general public is still ignoring our pleas for them just to get the darn vaccine. If the general public cared about the front line as much they claimed early in the pandemic, they would spare us the hero lip service and go get their shot.
I guarantee others are feeling the same anger. Many public service workers—nurses, police, teachers, physicians—feel some variant of these emotions right now. Unfortunately, our feelings about COVID not only cause pain but also make us feel judged and shamed. “Professionalism” is a stick many use to beat us into silence. When we don't talk about what angers us, either for our own sanity or for maintaining professionalism, the public is all too happy to think their refusal to get vaccinated doesn't have consequences.
The lamentable reality is that the volume of people refusing to get vaccinated feels like callous disregard to those of us struggling on the front lines. We went into this career because we love people, and now many of us find ourselves facing something far more sinister than compassion fatigue: outright anger toward people. I wouldn't be angry about sacrificing my physical and mental health to care for COVID patients if there weren't so many people refusing to care for us in return by complying with a basic public health measure for our protection. To be good caretakers, we need to feel that we are cared for too. I hope more people will show us they care and get the vaccine.
Dr. Simonsis a full-time night emergency physician in Richmond, VA, and a mother of two. Follow her on Twitter@ERGoddessMD, and read her past columns athttp://bit.ly/EMN-ERGoddess.