The Sick & the Tired

Pandemic Fatigue & the Hard Work of Compassion

Bren Ingle is a member of the National Disaster Medical System, a federally funded emergency response medical team that Lev Facher of STAT News describes as "a National Guard for healthcare." Facher shadowed Ingle's team when they were deployed to Louisiana amid a Covid-19 surge caused by the delta variant. The hospitals were short-staffed because of a combination of employees burned out or quarantined after contracting Covid-19. Ingle and her crew were assigned to the direst patients in the ICU—those that were intubated and had lost consciousness. Their job was to make sure the patients were as comfortable as possible. Ingle, who leans on her Christian faith to cope with her job, told Facher, "It's very emotional watching people die every day. You start seeing the same look on their face where their eyes are bugging out and they're grabbing at you: Don't let me die. Don't let me die. And all you can do is intubate them and hope for the best."1

One survey found that nearly two-thirds of healthcare professionals reported a deterioration in their mental health and almost one-third said they have considered leaving the profession.2 Even if they do not want to leave their jobs, more than half are feeling burned out and anxious. Among frontline healthcare workers, many of those experiencing anger over their jobs have either lost patients to Covid-19 or have contracted Covid-19 themselves.3

While much of disaster ethics deliberates on how best to allocate limited medical supplies, the other side of the discussion is the mental and physical toll on everyone affected by the disaster. In normal circumstances compassion fatigue is an occupational hazard for those in "helping" professions, such as doctors, nurses, counselors, and caregivers. They can become completely depleted mentally and emotionally and are unable to do their jobs. The pandemic has not only exacerbated compassion fatigue in these professions, but teachers, students, parents, and managers, to name a few, are also emotionally depleted. That means most of the people we encounter are struggling in one way or another.

A Gentle Answer

The late Dr. Edmund Pellegrino wrote of the importance of cultivating a virtuous character in general, and in the medical profession in particular. He says that the purpose of medicine is the patient's good, and the virtuous doctors should be "so habitually disposed to act in the patient's good, to place the good in ordinary instances above his own, that he can reliably be expected to do so."4 This is good advice for all of us. Because we are all interacting with struggling people, we too need to seek the other's good.

While some healthcare workers express frustration toward the unvaccinated, there are others expressing ways of choosing to respond with compassion. Dr. Jay Baruch, an emergency physician, bioethicist, and writer, said in a recent commentary that, when an unvaccinated patient shows up in his ER, he never asks "why" for the same reasons he never asks "why" someone decided to drive drunk, or, speaking of himself, "why" he eats junk food even though he has high blood pressure. "We humans are beautifully flawed creatures with inexplicable needs and impulses that run counter to our best interests," he explains. Baruch believes not getting a vaccine is a poor health choice, but when the patient comes to his ER, he says the blame turns to sorrow. Even when it is difficult to find sympathy for a patient, "this challenge cuts to the heart of what it means to be a physician in a moral profession."5

Rather than judging his patients, Dr. Baruch identifies with them. He sees them as human beings navigating a difficult situation. "Many of the unvaccinated people I've talked with are hard-working, loving individuals struggling to catch a break in a life that hasn't been fair," he says. Baruch admits to his own sense of frustration but says it's important to meet the patients where they are. In his experience with addicts, by being non-judgmental and open, he can build trust with his patients, which in turn, allows them to be more open about their struggles. Baruch says we should "tone down the rhetoric and create opportunities whose purpose isn't to convince people with contrary opinions that they're behaving irresponsibly, but to invite them into our lives and appreciate why each of us might feel morally injured. I believe there remain islands of shared values and purposes for building further discussions."

The Atlantic interviewed Dr. Rhea Boyd, a pediatrician and public health advocate who speaks to churches, schools, and community groups about the vaccines.6 She talks with people about their fears and concerns in a way that welcomes questions as legitimate and important, rather than telling people to "just trust the science":

The language we use around unvaccinated people comes with a judgment—a condescension that "you're unvaccinated and it's your choice at this point." That attitude is papering Twitter. It's repeated by our top public-health officials. They're railing on the unvaccinated as if they're holding the rest of us back from normalcy. But unvaccinated people aren't a random group of defectors who are trying to be deviant. They're not all anti-vaxxers. They're our kids! Any child under 12 is in that group.

She says many of the people she talks to have good questions and legitimate concerns.

If I was only going off what I saw online, I'd probably agree that everyone who wasn't vaccinated is being selfish and difficult. But talking to people like those church groups has changed how I feel completely.

Finding Humility, Finding Hope

The SARS-CoV-2 virus spreads asymmetrically, in that one person can spread it to multiple people or to no one at all. Additionally, like other viral diseases such as mononucleosis, each person's experience is unique. One person could get a very mild case of Covid-19, while another person could have a lingering cough that lasts for months. Or they may end up with debilitating fatigue and muscle pain, now referred to as "long-Covid." Others may be hospitalized from lung damage and low oxygen levels. And some may die. This kind of uncertainty has forced many of us to confront our finitude.

Some people respond with denial. Some belittle or diminish others' experiences. Others become angry. Often people try to control what they can because they feel so out of control about everything else. I saw this firsthand when I was going in to get bloodwork done at the cancer center during the fall 2020 surge. Everyone was required to wear a mask to enter the building, and spouses and caregivers had to stay in the lobby. One elderly man, whose wife was a patient, became indignant with the nurses because he couldn't go with her. He placed his mask on top of his head saying that now he was "wearing" it. Anyone could sympathize with his frustration even if his response was inappropriate. Similarly, most of us can sympathize with the frustrations caused by a pandemic, even if we do not agree on how to respond to it.

Physician and cancer survivor Amy Givler, in her book Hope in the Face of Cancer said for her one of the hardest things about having cancer was knowing she wasn't in control of her life. "I knew, as everyone does, that a car could hit and kill me anytime while I was just crossing the street. Life is temporary. But never had that concept seemed so real." In encountering other people, she says, "Cancer is also a blaring reminder that 'human existence is but a breath.' Sometimes people try to avoid reminders that life is brief."7

Givler is a doctor, yet it wasn't until she had cancer at age thirty-four that she really dealt with the brevity of life. Similarly, all of us have been forced to consider death and uncertainty. That isn't necessarily a bad thing. Suffering and hardship can help us have compassion for others.

Among those same frontline workers who wanted to quit, three-fourths of them also said they are hopeful, because this pandemic, like pandemics of the past, will eventually end. In the meantime, we can take a cue from the many virtuous healthcare workers who choose to prioritize their patients' good and choose to do the hard, and sometimes costly, work of showing compassion and grace to those around us.

Notes
1. Lev Facher, "'It's Soul-Draining': Health Workers Deployed to Covid Hot Zones Are Overwhelmed by Deaths Among the Unvaccinated," STAT News (Aug. 18, 2021): statnews.com/2021/08/18/health-workers-overwhelmed-covid-deaths-among-unvaccinated.
2. "The Toll of the Coronavirus Pandemic on Health Care Workers," KFF/The Washington Post Frontline Health Care Workers Survey (April 6, 2021): kff.org/report-section/kff-the-washington-post-frontline-health-care-workers-survey-toll-of-the-pandemic.
3. Ibid.
4. "The Virtuous Physician and the Ethics of Medicine," Chapter 8 in Physician & Philosopher: The Philosophical Foundation of Medicine: Essays by Dr. Edmund Pellegrino, Bulger and McGovern, eds (Carden Jennings Publishing, 2001).
5. Jay Baruch, "It's easy to judge the unvaccinated. As a doctor, I see a better alternative," STAT News (Aug. 27, 2021): statnews.com/2021/08/27/its-easy-to-judge-the-unvaccinated-seek-a-better-alternative.
6. Ed Yong, "America Is Getting Unvaccinated People All Wrong," The Atlantic (July 22, 2021): theatlantic.com/health/archive/2021/07/unvaccinated-different-anti-vax/619523.
7. Amy Givler, M.D., Hope in the Face of Cancer (Harvest House Publishers, 2003), p. 17. See also Annette L. Stanton and Tammie Denyse, "'Reentry' after cancer treatment offers lessons for emerging from the pandemic" STAT News (Sept. 3, 2021): statnews.com/2021/09/03/reentry-after-cancer-treatment-lessons-post-pandemic-life.

has an M.S. in chemistry from the University of Texas at Dallas, and an M.A. in bioethics from Trinity International University. She resides in Dallas and currently works as a freelance science writer and educator.

This article originally appeared in Salvo, Issue #59, Winter 2021 Copyright © 2022 Salvo | www.salvomag.com https://salvomag.com/article/salvo59/the-sick-the-tired

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