Emergency medicine locum tenens physician Ripal H. Patel, MD, MPH, reflects on how COVID-19 impacted the medical community and how we can find the path to healing from the pandemic.
The last two years continue to linger in my subconscious. I keep thinking back to all we endured as healthcare professionals and try to reconcile those haunting sentiments against a brighter reality now. COVID is waning, there are prospects of weaker variants, vaccine boosters are readily available, and I personally haven’t seen a COVID case in months. The pandemic has been a long, painful journey, but I want to look forward with hope and talk about the path to healing after the COVID-19 pandemic.
Hospitals weren’t — and still aren’t — prepared
Because hospitals didn’t make the appropriate preparations, physicians were forced to reuse masks that were never meant to be reused. We wore trash bags as gowns (because we ran out), and hospitals were over capacity. Even so, hospitals were cutting hours, benefits, and shifts for healthcare workers in the ERs due to low patient volumes, all while they were receiving federal subsidies to stay “afloat.”
And now, with rising patient volumes, ERs are short-staffed all over the country. To top it off, nurses are capitalizing on the massive nursing shortage and leaving their staff jobs to pursue travelers pay. Physicians are beginning to realize how thin the hospital’s loyalty was to them. Even more disturbing, the residency match for emergency this year resulted in hundreds of unfilled spots. Theories abound, perhaps medical students — standing back and witnessing it all — saying no, thanks.
COVID’s heavy emotional and physical toll
COVID has done more than stress the healthcare system. It put us at risk. Physician couples had to separate to avoid exposure to their partner or family. Respiratory therapists — probably at the highest risk — were hospitalized for severe COVID infections just for doing their job. And a nation tore apart, with one contingent questioning even the most basic science on masks and germ theory. But beyond that, it exposed an inner monster: people, fed by social media and false news, all of a sudden claimed to know more than their healthcare providers. Patients were now questioning the advice of their own physicians and clambering at any article or news bit that would support that belief.
I remember when the pandemic hit a surge. I was on an empty flight to New Mexico for a locums assignment to cover the ER. It was one of the first times in my life I was truly scared to go to work. If you have not witnessed the horror of a COVID death, I have. The patient’s eyes widen as they’re gasping for air and suffering as they struggle to breathe against an insidious infection overcoming their lungs.
I worried I would get COVID again. My first bout of COVID almost had me hospitalized. What would I do if the hospital was full (it was), and we couldn’t transfer people out (we couldn’t)? Those were nightmarish times.
I think many people left healthcare, throwing their hands up in the air and saying it just wasn’t worth it. A new era was dawning. We had a minority of patients who were — and still are — questioning the veracity of vaccines, the reality of COVID, and experimenting with unproven treatments that the medical community was warning against. And when those patients were sick and came into the hospital for treatment, we’d have to endure them not listening. I think that deadened us inside and numbed a large amount of empathy that drove us into this profession.
From all of that, did we as healthcare providers step back and heal? I’ll be frank. I certainly did not. I don’t think I had time to. I faltered on explanations, claiming that this was my job. And yet each shift, I felt myself get more and more emotionally numb. My family said speak to a therapist, but how on earth would someone on the other side of a computer screen, sitting in the safety of their living room, understand? I am at times to the point now where day-to-day emotions — things that others might gain much elation or horror from — do not affect me much. And that translates to patient care, resulting in less empathy for my patients, and less patience for people who treat you poorly.
Have we learned from our mistakes?
I question now what remains. As the dust settles, how has the landscape changed? Have hospitals learned more efficient ways to guide patient flow after the first few waves? Are patients savvier? Will hospitals be prepared with proper personal protective equipment? And will patients fully trust their physicians again?
Most of my colleagues shake their heads and say no, that the many measures that need to be implemented will likely not come to pass. And so, when the next pandemic hits, I’m dubious that the medical system will stand on its weak base. The 1918 flu pandemic should have taught us so much, and almost every mistake they made then we make now.
I don’t mean to sound pessimistic, but I do strive to be realistic. With what happened over the last few years, and the healthcare workers who remained, I think we are mentally and physically stronger, far less trusting, and more ready for what our institutions may or may not have in store for us. During this period of lull, which I pray lasts for an eternity, I think physicians should continue to share our stories of what we endured with our colleagues and how we made it through. That time of healing is now, and truly in my opinion the only ones who will ever really get it are the ones we were in the trenches with.
Healing is best done with others
I try to focus on what came positively from the pandemic. I feel more fluent and balanced with managing COVID. I have immense levels of respect for all my colleagues and partners who stood through it with me. I witnessed true heroes, like the nurses with families coming in day after day to care for the sickest of the sick. And even patients were realizing that perhaps their “emergency” was not a true emergency, and that their bed in the ER may be better served with someone sicker.
I’ve talked to my staff about all the horrors; it often comes up even today in our day-to-day. “Remember during COVID when … ” Each time we confess and commiserate, I feel the healing becomes deeper. All those emotions and experiences congeal into a force that makes us stronger. I don’t know many who went to therapy or took time off. We propped each other up. We all get it. We experienced it. Through the resilience of my physician colleagues, my nurses, and my technicians, we all stood our front and became better and more calculating healthcare workers from it. We’re on the path to healing from the COVID-19 pandemic. And whatever is on the horizon, I am confident we will be ready again.