The last few weeks have been very difficult for all of us. Like many of you, the Covid-19 pandemic has placed new stress on me individually. It takes me longer per patient to get my rounds done. It takes me longer to get a meal and eat that meal. It is much harder for me to get into a rhythm of high productivity. Whenever I try to stay connected with my colleagues, I get distracted by social media and emails.
Although there is some semblance of control, the unknown invisible nature is a little scary, but especially difficult to assess the immediate benefits of my actions. I wash my hands hundreds of times per day. I shower multiple times as I return home from work, get in exercise, and sometimes because it was my prior routine. I wipe down door knobs, steering wheels, my cell phone, and other things I touch multiple times with antiseptic wipes, not because I am paranoid, but because I have so much contact with the healthcare environment and also my home with 5 awesome stay-at-home people following the effort to flatten the curve and keep Dad’s friends alive and well.
I recently sent a colleague of mine the two year monthly tracking of my Well-Being Index. Normally I have been fluctuating between Average to Excellent. I noticed two big dips or valleys as well as a 3 month period hovering in an average level in the tracking. Each of those spots corresponds to a period of grief from the loss of a colleague due to suicide. There are many other potentially contributing factors. Assessments and tracking are not intended to diagnose. They are intended to guide and raise awareness.
Is it a coincidence that just the other day a vascular surgeon and member of the Society for Vascular Surgery with whom SurgeonMasters is collaborating on peer-support and moral injury, shared with me the Harvard Business Review article by Scott Berinato That Discomfort You’re Feeling is Grief. The article relays a conversation the author had with David Kessler. I found the conversation particularly interesting and related to the Covid-19 pandemic in two particular areas: 1) Anticipatory grief and 2) Collective grief.
Grief is associated with a loss. “Grieving is not a stage-like, sequential predictable process across time. … Grief can involve complex, fluctuating, emotional reactions.” Cautioning Health-Care Professionals – Bereaved Persons Are Misguided Through the Stages of Grief.1
Grief causes fluctuations of emotions and thoughts such as denial, anger, bargaining, depression, acceptance, and many others. Although Kessler is a proponent of the stages of grief, I want to acknowledge his valuable experience and insights. While we can acknowledge our emotions and thoughts, and those of others, we are most empowered by acceptance. With the current crisis, many of us are experiencing a loss of normalcy, connection, and economic stability. Perhaps the elephant in the room for many of us is the anticipation to bear witness to the death of so many patients that would otherwise be preventable. In my soul, I have a very uncomfortable feeling in anticipation of the loss of any healthcare professional.
Anticipatory grief is usually applied to the impending death of someone nearing death from extreme illness. It can also be the grief that occurs before another great loss. “Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. With a virus [the Coronavirus, …We’re feeling that loss of safety.” Certainly fear and anxiety are associated emotions with grief. Anxiety is a normal emotion and physiological response in anticipation of possible necessary actions and reactions. If uncontrolled, this can turn into panic. With acceptance, we notice what we can control, and we take action there.
I have added some to David Kessler’s recommended actions:
- Find balance in the things you’re thinking. When you notice your mind going to the negative or worst-case, blend in the positive and better case scenarios.
- Come back to the present. Planning for tough contingencies is great. Anticipating them is less healthy. Breathe. Mindfully come back from the future to keep functioning in the moment.
- Let go of what you can’t control. We can’t control the actions of others, how others are reacting, or truly predict what will happen. We can maintain a positive attitude, follow our own best practices of social distancing, handwashing, and use of the PPEs available. We can limit our exposure to negative news and social media, and how we respond to others.
- Stock up on compassion. Everyone is responding to the crisis and fear of loss differently. Some are in denial. Some are angry. Some are depressed or anxious. Let’s show understanding.
“This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.” You feel it in the air. There is a huge amount of collective anticipatory grief from many of us in healthcare.
Collective Acceptance & Meaning
While this is a widespread experience, we have such a great opportunity to collectively succeed. Individually and collectively, we will be experiencing this grief differently. We will heal, recover, and adapt to lives lost and the changes which will be permanent. Since this is unpredictable, complex, and emotional, what if we are there to support each other? What if we find purpose or new purposes together as we work through all of this?
You can find support in our SurgeonMasters community. We are hosting a weekly Surgeon Wellness During COVID-19 Community Focus Group Webinar, Online Yoga, and other special events to bring us together.
You might even find purpose through coaching or becoming a SurgeonMasters Peer Coach. Attend an information session to learn more, or visit the Physician Coach Training site to find online training dates and to register.
Let me know how you will find purpose through all of this or how you can use support from our community.
Berinato, Scott. “That Discomfort You’re Feeling Is Grief.” Harvard Business Review, 26 Mar. 2020, hbr.org/2020/03/that-discomfort-youre-feeling-is-grief.