The Emotional Toll of Being a Health Care Provider During a Global Pandemic

 From the 10/16/2020 newsletter

Kern Grand Rounds Preview

The Emotional Toll of Being a Health Care Provider During a Global Pandemic

Paul A. Bergl, MD - Pulmonary, Critical Care, and Sleep Medicine

Dr. Bergl will be part of a Grand Rounds panel discussion sponsored by the Kern Institute during MCW’s Professionalism Week. The presentation will be held virtually on Thursday, October 22nd from 9:00 - 10:00am CT. To register, click here.

When I was asked to contribute a written reflection on the emotional toll that COVID-19 has had on healthcare workers, my first reaction was - and still is - genuine fear. Fear that any public emoting would come off as disingenuous or hyperbolized for rhetorical effect. Fear that I would come off as whiny, as weak, as lacking resilience. Fear that I had little to offer and nothing particularly novel to say about a pandemic that has been covered from every last angle. Most importantly, fear that, as a gainfully employed and financially comfortable white man, I might leave others wondering, “He thinks he has a reason to feel burned out?”

In this loosely chronological reflection, I do not assume that I have captured the sentiments of many of my colleagues; instead, I only offer my own. And I hope that I have made evident my sincere sympathy for those suffering greatly from the fallout of COVID-19 and my perpetual gratitude for those working even harder than I.

The "early" days

February. I remember my first reaction to COVID-19 was blithe naivete. Skeptical of media hysteria, I encouraged friends and families to keep on with their daily lives. “You are far more likely to die from a bolt of lightning than a novel virus spreading overseas.”

After coming to my senses as SARS-CoV-2 spread among our neighbors, I next experienced exhilaration. Here was my moment to fulfill the great dreams I had as a twenty-something applying to medical school... To save lives! To be part of living history! To serve on the frontlines of a crisis! Rapidly elevated to hero status, I dutifully reported to my clinical roles and spent most waking hours helping my colleagues prepare for Armageddon. We developed protocols; we debated how we would allocate scarce resources. We strategized about how to save our medical students’ education. Despite long hours in the ICU and countless email exchanges and Zoom meetings outside of my clinical work, I was indefatigable.

The pandemic continues

Of course, incredible sorrow interspersed these periods of elation. I witnessed patients succumbing to COVID-19 in an airtight room, devoid of any symbol that they indeed were a person. No family. No photos of loved ones. No spiritual guides. No favorite sweatshirt. Who wouldn’t cry after holding the phone to a dying octogenarian’s ear while her family pleaded with an unyielding fate?

Soon, guilt settled in. Guilt that I had regular opportunities to see real actual live people while millions of lonely people huddle indoors, comforted at best by faces on LCD screens and at worst, discomforted by total solitude. I reported dutifully to a job in which solidarity was high... A shared sense of purpose in a fight against a new enemy. Why should I have any sense of grief when so many collected unemployment? Or experienced the exasperation of witnessing racial injustices on two fronts? Or suffered through the grief of losing a loved one to a crisis partly of our own making?

Then came a rising and ultimately unmitigated anger. My fellow citizens began flouting social distancing. My leaders began politicizing every part of the fight. Millions assumed that because most cases were mild that the entire thing had been blown out of proportion. These attitudes depreciated not only the work my colleagues and I were doing in the ICU every day, but also the efforts of our greater scientific, medical, and public health communities. Yes, I am still pretty pissed off.

My own experience as a COVID-19 patient

In August, I suffered the profound malaise of two weeks of a so-called “mild case” of COVID-19 that sapped not only my energy and sense of smell but my optimism that we were turning the corner on a crisis. To add insult to injury, I believe I contracted the virus while performing a bedside procedure that conflicted with my own values... but a procedure that I was ethically obligated to provide nonetheless, at least within the framework of how we provide healthcare in America.

Where we are now

Now, as cases surge to their highest levels, I can see the lassitude that heralds burnout on my own face and those around me. I try to remind myself every day that I am privileged. And I am. I try to ignore the outside noise when I am at the bedside. “Remember Paul, your obligations are to this patient, this human being, and you need to be the best damn doctor you can be right now.” Sadly, there are few outlets to recharge from exhaustion these days. And after all, depersonalization is probably adaptive, right?

Paul A. Bergl, MD, is an Assistant Professor of Medicine in Pulmonary, Critical Care, and Sleep Medicine at the Medical College of Wisconsin. He will be part of a Grand Rounds panel discussion sponsored by the Kern Institute on Thursday, October 22, 2020 from 9:00 – 10:00am CT. To register, click here.