“The COVID-19 pandemic has been raging in the United States for over two years. Health care workers across the country have been chronically pushed to their limits as we navigate difficult situations on a daily basis. The advent of the COVID-19 vaccine, although a powerful tool in our crusade against the pandemic, has created a new branch of emotions for health care workers towards unvaccinated patients or those with vaccine hesitancy. The empathy we are often expected to have without fail can be difficult to maintain in the face of these new challenges. Nonetheless, COVID-19 persists. We owe it to ourselves and our patients to find ways to deal with these complex emotions.”

Masood R. Mohammed is an emergency medicine resident.

He shares his story and discusses his KevinMD article, “How to cope with pandemic fatigue.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at kevinmd.com/rate. Subscribe at kevinmd.com/follow. Today on the show, we have Masood Mohammed. He is an emergency medicine resident, and he wrote the KevinMD article “How to cope with pandemic fatigue.” Masood, welcome to the show.

Masood R. Mohammed: Kevin, thank you so much for having me. I’m really a big fan. Happy to be here.

Kevin Pho: Well, thank you so much for contributing. I’m interested in hearing your story and journey to where you are today.

Masood R. Mohammed: Yeah, absolutely. So I was originally born and raised down in South Florida, so I’m a little bit of a ways from home. I always had a bit of an interest in medicine. My dad was an ER nurse, so I think that’s where a lot of it started. I kind of drifted away from that a little bit in college. I thought I was a little bit more interested in research, science, those kinds of things. But at the end of the day, I couldn’t quite scratch the itch, so I came back to medicine. I went to medical school down in South Florida, and now I’m up here doing emergency medicine in lovely New England, western Massachusetts.

Kevin Pho: So you’ve done most of your emergency medicine training during the pandemic. What would you say is the single biggest thing that you’ve learned from training during a pandemic?

Masood R. Mohammed: Yeah, I think the biggest thing is probably just learning to be adaptable. I mean, there was a sliver where there was no pandemic and I was training, so I have some fond memories of that. But so many things changed in such a rapid sequence of time during the start of the pandemic, in terms of donning and doffing PPE all the time and how we would intubate patients. I remember for a short period of time, we were using plexiglass over the patients to try to intubate them, to not aerosolize the room so much. It was just things like that, and learning how to adapt to these constantly changing things, just getting new research on COVID and how we need to change our practices to adapt to the virus.

Kevin Pho: So do you see any long-term changes to emergency medicine because of the pandemic?

Masood R. Mohammed: I think I do. I think one of the big things is probably going to be the PPE, right? Although COVID was kind of raging in the United States, we saw a down-trending of a lot of the other respiratory viruses. Influenza and RSV really weren’t there as much when the pandemic was at its peak, and probably a big part of that was the masks and the hand washing. So I think, more than anything, that’s probably going to be one of the big things that sticks around. No one’s going to be coughing mask-free in the ED anymore.

Kevin Pho: Sure. And you talk about something called pandemic fatigue in your KevinMD article titled “How to cope with pandemic fatigue.” So before getting into that, what exactly is pandemic fatigue from your perspective?

Masood R. Mohammed: Yeah, so I think pandemic fatigue is really just getting tired of the complex emotions and situations and interactions because of the pandemic. That applies to everyone, but probably to none more than medical professionals, who are dealing with these patients every day: the ones that are really sick, the ones that are not sick, the ones that are vaccinated, and the ones that are unvaccinated. It’s just kind of getting fatigued in terms of how much we care, how much we take care of ourselves, and all of the other emotions that kind of come with that.

Kevin Pho: So take us into your emergency department and tell me how those emotions all play a role in your daily life. Can you give me an example or a story?

Masood R. Mohammed: Yeah, so I guess, to give context for everyone, I’m at a level one trauma center. It’s pretty busy, high acuity, 120,000 visits a year, so quite a busy area. And we have seen the full gamut of COVID-19 patients, as I’m sure everyone else has.

I remember fondly, I guess not fondly, but one of the cases was a patient who came in as a trauma because he suffered a gunshot wound. While there were probably 10-15 people in the room doing our evaluation, worried about this guy’s gunshot wound, he just casually mentioned that he had COVID. And I had been up in this guy’s face, kind of talking to him, right next to his ear. It’s just moments like that that are so frustrating, because you’re trying to do your job. You’re trying to take care of someone, and here they are, knowing that they have this virus that’s causing this pandemic, and it just casually slips out after about 30 minutes of being right next to them.

So it’s a lot of situations like that every day: people withholding information, people arguing with the information that you’re trying to provide them. Those kinds of things really contribute to the pandemic fatigue, unfortunately.

Kevin Pho: Now tell me some of the ways, as you talk about in your article, that medical professionals can cope with that.

Masood R. Mohammed: Yeah, so I think there are a lot of different ways. I think my whole inspiration for this kind of just came from self-reflection, from being so burned out about dealing with this every day, dealing with the unvaccinated patients and taking PPE on and off 20 times a day. I felt really burned out, and I kind of reflected on myself and the things that I could do to improve and not feel that way, and kind of dig myself out of the hole. As I was doing that, I compiled this article and came up with a lot of these things.

I think one of the biggest things really is right there: the self-reflection, just being honest with yourself. I know health care workers have this mentality of, “Next patient. Just got to keep trudging on. It’s just a part of the job.” But I think we really need to stop and take pause and take account of what we’re feeling, why we’re feeling it, what went good in our day, and what went bad in our day, and just give ourselves the insight into those emotions, because they’re not easy emotions to deal with.

And then, once we’ve done that, it’s really just talking about it with people, whether that’s co-workers, family, or friends, and just getting their perspectives, or just being able to vent and get some of those things out. People may be hesitant to do that at first, but after you do it, I can guarantee that you’ll feel a lot better, and you’ll realize that you’re not alone in the things that you’re feeling and the things that you’re experiencing.

Kevin Pho: Now, as you were dealing with pandemic fatigue, is this something that you had to struggle with by yourself? Did you have your colleagues to commiserate with, or someone to tell you, “Hey, take a step back and self-reflect”? Did you have any professional help? So tell me, how did you get through this? Tell me about that journey.

Masood R. Mohammed: Yeah, I think a couple of things. Fortunately, I’m in a residency program and at a hospital right now where they really did focus on our wellness and on giving us time away from all these things. So I think there were a lot of resources there, through my program and through my hospital, to help us.

I think one thing that was difficult for me, that I kind of had to manage on my own and that I mentioned in my article, is disconnecting. Like I said, this pandemic, this virus, was such a new thing, and information was coming out and things were changing so quickly. So I remember every day waking up before work, going on CNN, and watching that little side panel about the seven-day average in the number of new cases, and just trying to be so up to date on all of this information every single day. And you’re never going to know everything, right? No one’s ever going to know everything about COVID-19. So it’s really just a matter of you forcing yourself, and me forcing myself, to disconnect and relax and calm things down before getting back into the swing of things so quickly.

Kevin Pho: So how are things between you and, say, the other emergency physicians that you work with, whether it’s your fellow residents or the attendings? What are some other ways you saw of dealing with this potential burnout and fatigue?

Masood R. Mohammed: Yeah, I think one of the great things about working in my emergency department is that we have a really good rapport with one another. It’s never too serious on shift unless it absolutely needs to be. We all have this sense of belief that we’re in this together and we’re going to get through this together. So everyone really brings their own positive attitude and is always joking and positive on shift, and we’d get food or something like that after shift and just kind of unwind about a difficult patient or about this crazy thing that happened.

I think, more than anything, really, that was probably one of the biggest things: just being able to take these people that I work with, that I’m really in the trenches with, and just go out and have a drink or have some food and be in a relaxed environment, and see that they’re dealing with the same things that I’m dealing with, whether we’re talking about it or not.

Kevin Pho: We’re talking to Masood Mohammed. He’s an emergency medicine resident. He wrote the KevinMD article “How to cope with pandemic fatigue.” Masood, you’ve almost finished your emergency medicine training. What’s the landscape of emergency medicine today?

Masood R. Mohammed: That’s an excellent question, and you’re probably going to ask nine different people and get 10 different answers. I think it’s rapidly evolving. I know that there are concerns about the emergency medicine shortage and how we’re going to continue to deal with this pandemic and all of these different things. But I think emergency medicine as a whole, because of the pandemic, in a weird way kind of shifted more to what emergency medicine should be. A lot of people were not leaving their homes, not going out and interacting, so when they were coming to the hospital, when they were coming to the ER, it was more appropriately for emergencies, rather than just a little bruise on their arm. So emergency medicine, as with all other fields of medicine, is rapidly changing, and we’re kind of just having to roll with the punches as they come.

Kevin Pho: Now, we have medical students who listen to this podcast. For those students who are considering a career in emergency medicine, what kind of advice would you have for them?

Masood R. Mohammed: Just dive in, honestly. Emergency medicine is fast-paced. It’s unpredictable. It’s something that’s hard to describe and hard to understand unless you experience it. So whether you can do shadowing shifts or whether you’re working as a scribe, just get out there and get that experience to see what it’s like. I think emergency medicine is really one of those divisive fields where, as soon as you start to do it for a little bit, you’ll figure out whether or not this is for you, because it really takes a special type of personality and a different kind of mental fortitude. But getting that exposure and just getting out there in the department is one of the best things, I think, that can help.

Kevin Pho: And then, as you reflect over the last few years, as you trained during the pandemic, is there anything that you would have done differently?

Masood R. Mohammed: That’s a good question. I don’t think there’s anything that I would have done differently. It would have been nice to know about the pandemic before it started to happen. But I think the pandemic, in a nutshell, was kind of just what emergency medicine is: having to deal with a ton of information very rapidly and make the best with what you’ve got. That’s something that we frequently have to do in the emergency department, and now with COVID-19, it’s something that we also have to do. So I try to be as adaptable as I can. There’s always room for improvement, so maybe that would be the one thing, just being a little bit more adaptable, on my toes. But I think I’m pretty happy with the trajectory of how things have gone, as best as I can.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Masood R. Mohammed: Yeah, I think the one big take-home message that I want to give is, I know a lot of people say this, “It’s OK to not be OK.” But I think, even more than that, you need to do something to kind of curbside that, to turn that around. Medicine is not easy. You’re going to be dealing with tough social interactions, tough patients, and really sad cases, so there are going to be a lot of negative emotions there. Those things are going to happen, and it’s OK that those happen and that you’re feeling a little bit down. But everyone needs to find their outlet and their resources to deal with that, whether it’s talking to friends and family, whether it’s finding new hobbies, or whether it’s a vacation or taking one day out every week to just do something different. I think that’s the biggest thing that can help us all do better at this job, help us all last longer in this job, and just lead happier and more satisfying lives overall.

Kevin Pho: Thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Masood R. Mohammed: Thank you so much, Kevin. I appreciate it.